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Li Y, Li J, Zhu Z, Zeng W, Zhu Q, Rong Z, Hu J, Li X, He G, Zhao J, Yin L, Quan Y, Zhang Q, Li M, Zhang L, Zhou Y, Liu T, Ma W, Zeng S, Chen Q, Sun L, Xiao J. Exposure-response relationship between temperature, relative humidity, and varicella: a multicity study in South China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:7594-7604. [PMID: 36044136 DOI: 10.1007/s11356-022-22711-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Varicella is a rising public health issue. Several studies have tried to quantify the relationships between meteorological factors and varicella incidence but with inconsistent results. We aim to investigate the impact of temperature and relative humidity on varicella, and to further explore the effect modification of these relationships. In this study, the data of varicella and meteorological factors from 2011 to 2019 in 21 cities of Guangdong Province, China were collected. Distributed lag nonlinear models (DLNM) were constructed to explore the relationship between meteorological factors (temperature and relative humidity) and varicella in each city, controlling in school terms, holidays, seasonality, long-term trends, and day of week. Multivariate meta-analysis was applied to pool the city-specific estimations. And the meta-regression was used to explore the effect modification for the spatial heterogeneity of city-specific meteorological factors and social factors (such as disposable income per capita, vaccination coverage, and so on) on varicella. The results indicated that the relationship between temperature and varicella in 21 cities appeared nonlinear with an inverted S-shaped. The relative risk peaked at 20.8 ℃ (RR = 1.42, 95% CI: 1.22, 1.65). The relative humidity-varicella relationship was approximately L-shaped, with a peaking risk at 69.5% relative humidity (RR = 1.25, 95% CI: 1.04, 1.50). The spatial heterogeneity of temperature-varicella relationships may be caused by income or varicella vaccination coverage. And varicella vaccination coverage may contribute to the spatial heterogeneity of the relative humidity-varicella relationship. The findings can help us deepen the understanding of the meteorological factors-varicella association and provide evidence for developing prevention strategy for varicella epidemic.
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Affiliation(s)
- Yihan Li
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jialing Li
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Zhihua Zhu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Qi Zhu
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jianguo Zhao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Lihua Yin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Yi Quan
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Qian Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Manman Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Li Zhang
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Yan Zhou
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Siqing Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Qing Chen
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Limei Sun
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jianpeng Xiao
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China.
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Marshall HS, Clarke M, Heath C, Quinn H, Richmond PC, Crawford N, Elliott E, Toi C, Kynaston A, Booy R, Macartney K. Severe and Complicated Varicella and Associated Genotypes 10 Years After Introduction of a One-Dose Varicella Vaccine Program. J Infect Dis 2019; 219:391-399. [PMID: 30184182 DOI: 10.1093/infdis/jiy518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/26/2018] [Indexed: 11/14/2022] Open
Abstract
Background This national, sentinel prospective study aimed to identify children with severe hospitalized varicella, despite availability of universal 1-dose vaccination since 2005, and determine associations between virus genotypes and disease severity. Methods Children with varicella or zoster from 5 Paediatric Active Enhanced Disease Surveillance hospitals were enrolled. Lesions were swabbed for genotyping. Associations with disease severity were analyzed using multiple regression. Results From 2007 to 2015, 327 children with confirmed varicella (n = 238) or zoster (n = 89) were enrolled. Two hundred three (62%) were immunocompetent children; including 5 of 8 children who required intensive care unit management. Eighteen percent (36 of 203) of immunocompetent children had been previously vaccinated. Vaccinated children aged >18 months were less likely to have severe disease (9%; 5 of 56) than unvaccinated children (21%; 21 of 100; P = .05). Three of 126 children who had virus genotyping (2 immunocompromised) had varicella (n = 2) or zoster (n = 2) due to the Oka/vaccine strain. European origin clades predominated and were independently associated with more severe disease (odds ratio = 3.2; 95% confidence interval, 1.1- 9.5; P = .04). Conclusions Severe hospitalized varicella still occurs with a 1-dose varicella program, although predominantly in unvaccinated children. Most 1-dose vaccine recipients were protected against severe disease. Viral genotyping in complex hospitalized cases is important to assist in monitoring disease due to Oka-vaccine strain.
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Affiliation(s)
- Helen S Marshall
- Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Australia
| | - Michelle Clarke
- Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Australia
| | | | - Helen Quinn
- National Centre for Immunization Research and Surveillance, Westmead, Sydney, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Peter C Richmond
- Wesfarmer's Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia.,Division of Paediatrics, University of Western Australia, Perth, Australia.,Princess Margaret Hospital, Perth, Australia
| | - Nigel Crawford
- Murdoch Children's Research Institute, Parkville, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Elizabeth Elliott
- Discipline of Paediatrics and Child Health, University of Sydney, Australia.,Children's Hospital Westmead, Sydney, Australia.,Australian Paediatric Surveillance Unit, Westmead, Australia
| | - Cheryl Toi
- Department of Medical Entomology, Centre for Infectious Disease Microbiological Laboratory Services, Pathology West-ICPMR, Westmead Hospital, Sydney, Australia
| | - Anne Kynaston
- Lady Cilento Children's Hospital, Brisbane, Australia
| | - Robert Booy
- National Centre for Immunization Research and Surveillance, Westmead, Sydney, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia.,Children's Hospital at Westmead, Sydney, Australia
| | - Kristine Macartney
- National Centre for Immunization Research and Surveillance, Westmead, Sydney, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia.,Children's Hospital at Westmead, Sydney, Australia
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Epidemiology and factors influencing varicella infections in tropical countries including Sri Lanka. Virusdisease 2018; 29:277-284. [PMID: 30159361 DOI: 10.1007/s13337-018-0459-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/29/2018] [Indexed: 02/07/2023] Open
Abstract
Varicella zoster virus (VZV) infections occur worldwide but the epidemiology differs between different geographical regions. Epidemiology of varicella is partly understood in tropical and subtropical regions. Various hypotheses showing differences in exposure rates in different age groups have been proposed. Exposure to VZV during late childhood or adolescent stage causes high morbidity, especially in high school children, university students and young work force in tropical nations. Exposure to VZV infection or sero-prevalence rates through anti-VZV immunoglobulin G appears to be lower in Sri Lanka, similar to other tropical countries prior to the millennium. In contrast, a more recent study in a group of antenatal women showed a relatively higher exposure rate to VZV when compared to the exposure rates prior to 2004 in Sri Lanka. Climatic factors, socioeconomic conditions, mobility and cultural practices appear to play a role in the differences in the exposure rates to VZV infection in the tropics. In most tropical Asian countries including Sri Lanka, routine vaccination against varicella is not carried out. Individuals with negative history for varicella take the vaccine when there is a necessity. Medical and nursing students take the vaccine prior to their clinical training to avoid adulthood varicella.
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Daulagala SWPL, Noordeen F, Fara MMF, Rathnayake C, Gunawardana K. Exposure rate of VZV among women attending antenatal care clinic in Sri Lanka - a cross sectional study. BMC Infect Dis 2017; 17:625. [PMID: 28915849 PMCID: PMC5602960 DOI: 10.1186/s12879-017-2725-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/11/2017] [Indexed: 02/01/2023] Open
Abstract
Background Varicella or chickenpox was not a notifiable disease until 2005 in Sri Lanka and only a few studies have been conducted on the epidemiology of VZV infection in the country. The antiVZV IgG sero-prevalence among antenatal women is extremely limited and thus a selected group of antenatal clinic attendees were chosen to determine the exposure rate to VZV infection. Methods Women attending the antenatal clinic at Teaching Hospital, Peradeniya, Sri Lanka were selected for the study and 3 mL of venous blood was collected from 181 participants and the demographic data was obtained through a pretested questionnaire. Sera of the women were then tested for the presence of antiVZV IgG using ELISA (HUMAN Diagnostics, Germany). Data was analysed using the SPSS statistical software for Windows, Version 12.0. Results Of the 181 antenatal women who took part in the study, 141 were positive for antiVZV IgG giving a sero-prevalence of 77.9% for the past exposure to VZV. Of the 141 antiVZV IgG positive women, 43.3% (n = 61) were from urban, 41.8% (n = 59) were from rural and 14.9% (n = 21) were from estate populations (an ethnic population living in small settlements in the tea estates whose ancestors were brought from India during the British colonial period to work in the tea plantations in Sri Lanka). Out of the 88 antenatal women with a positive history for varicella, 85 (96.6%) were positive for anti-VZV IgG. The highest number of antiVZV IgG positivity was seen in the 31–35 age group, which was 85.0% of the total number of antenatal women included in that category. An increase in the antiVZV IgG sero-prevalence with increasing age was also noted in the study sample. Conclusion Exposure rate of VZV infection as confirmed by antiVZV IgG in the present study sample of antenatal women was 77.9%. Age specific, population based future sero-prevalence studies should be conducted in Sri Lanka to understand the anti-VZV IgG status in the country.
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Affiliation(s)
| | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
| | | | - Chathura Rathnayake
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Kapila Gunawardana
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Characterization and phylogenetic analysis of Varicella-zoster virus strains isolated from Korean patients. J Microbiol 2017; 55:665-672. [PMID: 28752294 DOI: 10.1007/s12275-017-7171-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/15/2017] [Accepted: 06/22/2017] [Indexed: 12/24/2022]
Abstract
Varicella-zoster virus (VZV) is a causative agent of chickenpox in primary infection and shingles after its reactivation from latency. Complete or almost-complete genomic DNA sequences for various VZV strains have been reported. Recently, clinical VZV strains were isolated from Korean patients whose genome was sequenced using high-throughput sequencing technology. In this study, we analyzed single nucleotide polymorphism (SNP) of VZV strains to genetically characterize Korean clinical isolates. Phylogenetic analyses revealed that three Korean strains, YC01, YC02, and YC03, were linked to clade 2. Comprehensive SNP analysis identified 86 sites specific for the 5 VZV clades. VZV strains isolated from Korea did not form a phylogenetic cluster. Rather, YC02 and YC03 clustered strongly with Chinese strain 84-7 within clade 2, more specifically cluster 2a. Signature sequences for the cluster 2a were identified and found to play an important role in the separation of cluster 2a strains from other clade 2 strains, as shown in substitution studies. Further genetic analysis with additional strains isolated from Japan, China, and other Asian countries would provide a novel insight into the significance of two distinct subclades within clade 2.
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Sun Z, Guo Y, Li M, Yao Z. Genotype analysis of varicella-zoster virus isolates from suburban Shanghai Municipal Province, China. J Med Microbiol 2015; 65:123-128. [PMID: 26654224 DOI: 10.1099/jmm.0.000208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To determine the predominant genotype of the varicella-zoster virus (VZV) in suburban Shanghai Municipal Province, specimens were collected from the lesions of 95 outpatients clinically diagnosed with varicella or herpes zoster. Of these, 69 patients (72.6%) were positive for VZV DNA. The 69 isolates were all genotyped as the genotype J1/clade 2. Based on sequencing of the 447 bp sequence in ORF22, 66 isolates were identified as genotype J/clade 2 strains and three were identified as type M2/clade 4 strains. To confirm the classification of these three strains, we determined the presence of 27 single-nucleotide polymorphisms (SNPs) and found that isolates 1270/1450 shared seven SNPs that differed from those of clade 2, in which three SNPs were unique to clade 3 and another three were unique to clade 4. Isolate 1456 had two markers of clade 4 that differed from clade 2. The phylogenetic tree showed that our isolates clustered primarily with clade 2 and that the three M2/J1 strains clustered between clades 2 and 4. It is likely that isolates 1270/1450/1446 may represent a new subclade of either clade 2 or 4, or some recombinant events. In addition, our isolates were WT strains. We also observed significant inter-strain variations.
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Affiliation(s)
- Z Sun
- Department of Dermatology, Fengxian Institute of Dermatosis Prevention, Shanghai, PR China
| | - Y Guo
- Department of Dermatology, Fengxian Institute of Dermatosis Prevention, Shanghai, PR China
| | - M Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Z Yao
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
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Abstract
Torque teno viruses (TTVs) are recently discovered DNA viruses, with heterogeneous genomes, highly prevalent in populations worldwide. The species that infect humans are Torque teno virus (TTV), Torque teno midi virus (TTMDV) and Torque teno mini virus (TTMV). High-resolution melting analysis (HRMA) is a sensitive and effective method for genotyping and mutation scanning. Up to now, HRMA has not been utilized for detection of TTVs. The aim of this study was to asses if HRMA is suitable for detecting TTVs variants. DNA was extracted from the blood and saliva of 13 healthy subjects for method optimization. Additionally, saliva samples from 100 healthy individuals were collected for estimating the TTVs' prevalence. Viral DNA was amplified by heminested polymerase chain reaction (PCR). Second round amplicons were used for the HRMA. The samples were analyzed using two fluorescent dyes, SYBR (®) Green I and EvaGreen®. The prevalence values for TTV, TTMDV and TTMV were 71.0, 31.0 and 54.0%, respectively. The three major melting curve patterns corresponding to TTV, TTMDV and TTMV on HRMA can be easily distinguished regardless of kit used. Our results showed that HRMA is a rapid and efficient method of detecting human TTVs.
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Quinlivan M, Breuer J. Clinical and molecular aspects of the live attenuated Oka varicella vaccine. Rev Med Virol 2014; 24:254-73. [PMID: 24687808 DOI: 10.1002/rmv.1789] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 02/25/2014] [Accepted: 02/26/2014] [Indexed: 12/24/2022]
Abstract
VZV is a ubiquitous member of the Herpesviridae family that causes varicella (chicken pox) and herpes zoster (shingles). Both manifestations can cause great morbidity and mortality and are therefore of significant economic burden. The introduction of varicella vaccination as part of childhood immunization programs has resulted in a remarkable decline in varicella incidence, and associated hospitalizations and deaths, particularly in the USA. The vaccine preparation, vOka, is a live attenuated virus produced by serial passage of a wild-type clinical isolate termed pOka in human and guinea pig cell lines. Although vOka is clinically attenuated, it can cause mild varicella, establish latency, and reactivate to cause herpes zoster. Sequence analysis has shown that vOka differs from pOka by at least 42 loci; however, not all genomes possess the novel vOka change at all positions, creating a heterogeneous population of genetically distinct haplotypes. This, together with the extreme cell-associated nature of VZV replication in cell culture and the lack of an animal model, in which the complete VZV life cycle can be replicated, has limited studies into the molecular basis for vOka attenuation. Comparative studies of vOka with pOka replication in T cells, dorsal root ganglia, and skin indicate that attenuation likely involves multiple mutations within ORF 62 and several other genes. This article presents an overview of the clinical aspects of the vaccine and current progress on understanding the molecular mechanisms that account for the clinical phenotype of reduced virulence.
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Affiliation(s)
- Mark Quinlivan
- Division of Infection and Immunity, University College London, London, UK
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Toi CS, Lay MLJ, Lucas R, Chew CB, Taylor J, Ponsonby AL, Dwyer DE. Varicella zoster virus quantitation in blood from symptomatic and asymptomatic individuals. J Med Virol 2013; 85:1491-7. [DOI: 10.1002/jmv.23605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2013] [Indexed: 12/31/2022]
Affiliation(s)
- Cheryl S. Toi
- Clinical Virology, Centre for Infectious Diseases and Microbiology-Public Health and Laboratory Services, Institute of Clinical Pathology and Medical Research; Westmead Hospital and University of Sydney; Westmead NSW Australia
| | - Meav-Lang J. Lay
- Clinical Virology, Centre for Infectious Diseases and Microbiology-Public Health and Laboratory Services, Institute of Clinical Pathology and Medical Research; Westmead Hospital and University of Sydney; Westmead NSW Australia
| | - Robyn Lucas
- National Centre for Epidemiology and Population Health; College of Medicine, Biology and Environment, The Australian National University; Canberra ACT Australia
| | - Choo Beng Chew
- Clinical Virology, Centre for Infectious Diseases and Microbiology-Public Health and Laboratory Services, Institute of Clinical Pathology and Medical Research; Westmead Hospital and University of Sydney; Westmead NSW Australia
| | - Janette Taylor
- Clinical Virology, Centre for Infectious Diseases and Microbiology-Public Health and Laboratory Services, Institute of Clinical Pathology and Medical Research; Westmead Hospital and University of Sydney; Westmead NSW Australia
| | - Anne-Louise Ponsonby
- Murdoch Childrens Research Institute; The Royal Children's Hospital; Parkville Victoria Australia
| | - Dominic E. Dwyer
- Clinical Virology, Centre for Infectious Diseases and Microbiology-Public Health and Laboratory Services, Institute of Clinical Pathology and Medical Research; Westmead Hospital and University of Sydney; Westmead NSW Australia
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Changes in patterns of hospitalized children with varicella and of associated varicella genotypes after introduction of varicella vaccine in Australia. Pediatr Infect Dis J 2013; 32:530-7. [PMID: 23249914 DOI: 10.1097/inf.0b013e31827e92b7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Varicella in children, although usually mild, can cause hospitalization and rarely death. This study examined patterns of hospitalized children with varicella, and associated varicella genotypes, in 4 tertiary children's hospitals throughout Australia before and after varicella vaccine was introduced. METHODS We obtained coded data on discharge diagnoses from each hospital before (1999 to 2001) and after (2007 to 2010) varicella vaccine introduction in 2005, adding active surveillance to capture clinical features, complications and immunization history in the latter period. Varicella vesicles were swabbed, and genotyping of varicella strains was performed by real-time polymerase chain reaction amplification. RESULTS Overall, a 68% reduction in coded hospitalizations (varicella, 73.2% [P < 0.001]; zoster, 40% [P = 0.002]) occurred post-vaccine introduction. Of children with detailed clinical data (97 varicella and 18 zoster cases), 46 (40%) were immunocompromised. Only 6 of 32 (19%) age-eligible immunocompetent children were immunized. Complications, most commonly secondary skin infections (n = 25) and neurologic conditions (n = 14), occurred in 44% of children. There were no deaths; but 3 immunocompetent unimmunized children had severe multiple complications requiring intensive care. All strains genotyped were "wild-type" varicella, with Clade 1 (European origin) predominating. CONCLUSIONS After the introduction of varicella vaccine, coverage of greater than 80% at 2 years of age was achieved, with varicella hospitalizations reduced by almost 70%. Of hospitalized children age-eligible for varicella vaccine, 80% were unimmunized, including all cases requiring intensive care.
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Roycroft E, Rose L, Scallan MF, Crowley B. Molecular characterization of varicella-zoster virus clinical isolates from 2006 to 2008 in a tertiary care hospital, Dublin, Ireland, using different genotyping methods. J Med Virol 2013; 84:1672-9. [PMID: 22930517 DOI: 10.1002/jmv.23344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Varicella-zoster virus (VZV), a herpesvirus, is a ubiquitous organism that causes considerable morbidity worldwide and can cause severe complications on reactivation. Phylogenetic analysis was performed on 19 clinical VZV isolates (16 zoster and 3 varicella) found in Ireland, between December 2006 and November 2008, in order to determine whether previously reported viral heterogeneity was still present and whether viral recombination was evident. Open reading-frames (ORFs) from genes 1, 21, 50, and 54, were sequenced. Clades 1, 2, 3, and 5 were identified. Four putative recombinant isolates were detected (three clade 3/1 and one clade 5/3/1). Further sequencing and examination of ORF 22 and 21/50, did not elucidate the putative recombinant genotypes further. These two previously published genotyping schemes were examined in light of the new consensus genotyping scheme proposed in 2010. Remarkable VZV heterogeneity remains prevalent in Ireland. This is the first evidence of putative VZV recombination found in Ireland.
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Affiliation(s)
- Emma Roycroft
- Central Pathology Laboratory, Clinical Microbiology Department, St James' Hospital, Dublin, Ireland
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Varicella Outbreak in an Indian Couple Living in Germany Caused by VZV Clade VI Acquired during a Trip to The Netherlands. Case Rep Med 2012; 2012:838241. [PMID: 22481957 PMCID: PMC3312227 DOI: 10.1155/2012/838241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 12/20/2011] [Accepted: 01/07/2012] [Indexed: 02/06/2023] Open
Abstract
Varicella-zoster virus (VZV), the cause of varicella and zoster, is divided into five major clades and four provisional clades, the latter of which have been rarely reported worldwide to date. We present a varicella outbreak by the provisional clade VI within an Indian couple in Germany returning from a trip to Amsterdam. To the best of our knowledge, this is the first case of varicella by the VZV clade VI described in Germany, but the disease was acquired in The Netherlands.
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Sauerbrei A, Stefanski J, Gruhn B, Wutzler P. Immune response of varicella vaccinees to different varicella-zoster virus genotypes. Vaccine 2011; 29:3873-7. [DOI: 10.1016/j.vaccine.2011.03.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 03/15/2011] [Accepted: 03/17/2011] [Indexed: 02/01/2023]
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Sauerbrei A, Stefanski J, Philipps A, Krumbholz A, Zell R, Wutzler P. Monitoring prevalence of varicella-zoster virus clades in Germany. Med Microbiol Immunol 2010; 200:99-107. [PMID: 21072536 DOI: 10.1007/s00430-010-0178-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Indexed: 11/29/2022]
Abstract
The global surveillance of varicella-zoster virus (VZV) clades is an important tool for investigation into viral evolution, host-virus interactions, role of immigration and travel for importation of viral strains as well as possible recombination events between wild- and vaccine-type VZV strains. In this prospective study, comprehensive data on the current distribution of VZV clades in Germany were collected. VZV strains from 213 patients with varicella and 109 with zoster were genotyped using the scattered single-nucleotide polymorphism method on the basis of sequencing open reading frames 1, 21, 22, 37, 50, 54 and 60. In varicella, clade 3 was detected in 45.5%, clade 1 in 30.0%, clade 5 in 21.1% and clade 2 in 0.9% of the cases. The analysis of zoster strains revealed clade 3 in 50.5%, clade 1 in 46.8%, clade 2 and clade 4 in 0.9% of the cases each. Five strains from varicella and one strain from zoster could not be attributed to any of the major and provisional VZV clades. Statistical analysis verified significantly lower frequency of clade 1 and significantly higher frequency of clade 5 in patients with varicella compared to zoster. In addition, varicella patients with clade 5 strains were significantly younger than the patients with clade 3. In conclusion, almost one half of VZV infections in Germany were caused currently by VZV clade 3. In primary VZV infection, nearly 20% of clade 1 has been replaced by clade 5 that might spread more effectively in the population than the European VZV clades.
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Affiliation(s)
- A Sauerbrei
- Institute of Virology and Antiviral Therapy, Jena University Hospital, Hans-Knoell- Strasse 2, 07745, Jena, Germany.
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