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Wang H, Huang S, Wang Z, Zhen H, Li Z, Fan W, Lu M, Han X, Du L, Zhao M, Yan Y, Zhang X, Zhen Q, Shui T. Association between meteorological factors and varicella incidence: a multicity study in Yunnan Province, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:117817-117828. [PMID: 37874521 DOI: 10.1007/s11356-023-30457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
This multicenter study aimed to investigate the relationship between varicella incidence and meteorological factors including mean temperature, relative humidity, sunshine duration, diurnal temperature difference, wind speed, and rainfall, as previous studies have produced varying results. Our study also sought to identify potential sources of heterogeneity. Data on reported daily varicella numbers and meteorological factors were collected for 14 cities in Yunnan Province from 2017 to 2021. A distribution-lagged nonlinear model was constructed to explore the relationship between meteorological conditions and varicella incidence in each included city. We then used multiple meta-regression to explore sources of heterogeneity using demographic economics indicators, air pollutants, and geographic location as potential modifiers. The cumulative hazard effect plot showed an inverted S-shape for the relationship between temperature and varicella, with the smallest RR (relative risk) (0.533, 95% CI: 0.401-0.708) at temperatures up to 27.2 °C. The maximum RR (1.171, 95% CI: 1.001-1.371) was obtained when the relative humidity was equal to 98.5%. The RR (1.164, 95% CI: 1.002-1.352) was greatest at a diurnal temperature range of 2 °C (1.164, 95% CI: 1.002-1.352) and least (0.913, 95% CI: 0.834-0.999) at a diurnal temperature range of 16.1 °C. The maximum RR (1.214, 95% CI: 1.089-1.354) was obtained at 0 h of sunshine, and the minimum RR (0.808, 95% CI: 0.675-0.968) was obtained at 12.4 h of sunshine. The RR (0.792, 95% CI: 0.633-0.992) was minimum at a wind velocity of 4.8 m/s. Residual heterogeneity ranged from 1 to 42.7%, with PM10 (particles with an aerodynamic diameter less than 10 μm), GDP (gross domestic product), and population density explaining some of this heterogeneity. The temperature has a dual effect on varicella incidence. Varicella cases are negatively correlated with diurnal temperature range, sunshine duration, and wind speed, and positively correlated with relative humidity. GDP and PM10 may have a significant role in altering the association between temperature and varicella, while PM10 and population density may alter the association between wind velocity and varicella.
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Affiliation(s)
- Hao Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, China
| | - Shanjun Huang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhaohan Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Hua Zhen
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhuo Li
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Wenqi Fan
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Menghan Lu
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xin Han
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Lanping Du
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Meifang Zhao
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yuke Yan
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinyao Zhang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
- Department of Social Medicine and Health Care Management, School of Public Health, Jilin University, Changchun, China
| | - Qing Zhen
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China.
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, China.
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
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Abstract
Varicella poses an occupational risk and a nosocomial risk for susceptible healthcare personnel and patients, respectively. Patients with varicella are thought to be infectious from 1 to 2 days before rash onset until all lesions are crusted, typically 4–7 days after onset of rash. We searched Medline, Embase, Cochrane Library and CINAHL databases to assess evidence of varicella-zoster virus (VZV) transmission before varicella rash onset. Few articles (7) contributed epidemiologic evidence; no formal studies were found. Published articles reported infectiousness at variable intervals before rash onset, between <1 day to 4 days prior to rash, with 1–2 patients for each interval. Laboratory assessment of transmission before rash was also limited (10 articles). No culture-positive results were reported. VZV DNA was identified by PCR before rash onset in only one study however, PCR does not indicate infectivity of the virus. Based on available medical literature, VZV transmission before rash onset seems unlikely, although the possibility of pre-rash, respiratory transmission cannot be entirely ruled out.
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Aygun D, Aygun F, Kılınc AA, Cam H, Cokugras H, Camcıoglu Y. Lung abscess from Staphylococcus aureus after varicella infection in a 3-month-old infant. J Infect Public Health 2016; 10:129-132. [PMID: 27349422 DOI: 10.1016/j.jiph.2016.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/08/2016] [Accepted: 05/11/2016] [Indexed: 11/30/2022] Open
Abstract
Varicella is a common, highly contagious viral infection of childhood. Varicella is a usually benign and self-limited disease, but it can be complicated by severe bacterial infections, especially in immunocompromised hosts. In this study, we describe a previously healthy 3-months-old infant who was admitted with high fever, cough, and respiratory distress, who had a history of varicella infection three weeks before, with exposure from her adolescent, unvaccinated sister. A lung abscess caused by Staphylococcus aureus complicating the varicella infection was discovered. The patient was aggressively treated with drainage of the abscess and intravenous antibiotics and had a good recovery.
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Affiliation(s)
- Deniz Aygun
- Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
| | - Fatih Aygun
- Department of Pediatric Intensive Care Unit, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ayse A Kılınc
- Department of Pediatric Pulmonology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Halit Cam
- Department of Pediatric Intensive Care Unit, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Haluk Cokugras
- Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Yıldız Camcıoglu
- Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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The effects of ambient temperature on outpatient visits for varicella and herpes zoster in Shanghai, China: A time-series study. J Am Acad Dermatol 2015; 73:660-5. [DOI: 10.1016/j.jaad.2015.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 07/03/2015] [Accepted: 07/11/2015] [Indexed: 11/27/2022]
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Tang JW, Wilson P, Shetty N, Noakes CJ. Aerosol-Transmitted Infections-a New Consideration for Public Health and Infection Control Teams. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2015; 7:176-201. [PMID: 32226323 PMCID: PMC7100085 DOI: 10.1007/s40506-015-0057-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Since the emergence of the 2003 severe acute respiratory syndrome (SARS), the 2003 reemergence of avian A/H5N1, the emergence of the 2009 pandemic influenza A/H1N1, the 2012 emergence of Middle East respiratory syndrome (MERS), the 2013 emergence of avian A/H7N9 and the 2014 Ebola virus outbreaks, the potential for the aerosol transmission of infectious agents is now routinely considered in the investigation of any outbreak. Although many organisms have traditionally been considered to be transmitted by only one route (e.g. direct/indirect contact and/or faecal-orally), it is now apparent that the aerosol transmission route is also possible and opportunistic, depending on any potentially aerosol-generating procedures, the severity of illness and the degree and duration of pathogen-shedding in the infected patient, as well as the environment in which these activities are conducted.This article reviews the evidence and characteristics of some of the accepted (tuberculosis, measles, chickenpox, whooping cough) and some of the more opportunistic (influenza, Clostridium difficile, norovirus) aerosol-transmitted infectious agents and outlines methods of detecting and quantifying transmission.
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Affiliation(s)
- Julian W. Tang
- Clinical Microbiology, Leicester Royal Infirmary, University Hospitals Leicester, Leicester NHS Trust, Leicester, LE1 5WW UK
| | - Peter Wilson
- Clinical Microbiology, University College London Hospitals NHS Trust, London, UK
| | - Nandini Shetty
- Clinical Microbiology, University College London Hospitals NHS Trust, London, UK
| | - Catherine J. Noakes
- Institute for Public Health and Environmental Engineering, School of Civil Engineering, University of Leeds, Leeds, UK
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Varicella-zoster virus and virus DNA in the blood and oropharynx of people with latent or active varicella-zoster virus infections. J Clin Virol 2014; 61:487-95. [PMID: 25453570 DOI: 10.1016/j.jcv.2014.09.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/04/2014] [Accepted: 09/14/2014] [Indexed: 12/28/2022]
Abstract
Varicella-zoster virus (VZV) can be detected in the blood from approximately 5 days before to 4 days after varicella. VZV DNA, primarily in T-lymphocytes, is detected as early as 8-10 days prior to rash and can persist for a week. The duration and magnitude of VZV DNAemia correlates with immune status and the efficacy of antiviral therapy. VZV DNA is also readily detected in the oropharynx just prior to rash and for 1-2 weeks thereafter. Detection of VZV DNA in blood and saliva has been useful for diagnosis and prognosis in atypical cases of varicella. Herpes zoster (HZ) is also characterized by VZV DNAemia at onset and for many weeks thereafter, and VZV DNA is present in the oropharynx shortly after HZ onset. Detection of VZV DNA in blood and saliva facilitates the diagnosis of zoster sine herpete and other atypical manifestations of VZV reactivation, such as neurologic syndromes when cerebrospinal fluid is not available, Bell's palsy, and atypical pain syndromes. VZV DNA is sometimes present in the blood and saliva of asymptomatic individuals. In total these observations extend understanding of the pathophysiology and epidemiology of VZV, and increasingly contribute to the clinical management of VZV infections.
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CHAN JYC, LIN HL, TIAN LW. Meteorological factors and El Nino Southern Oscillation are associated with paediatric varicella infections in Hong Kong, 2004-2010. Epidemiol Infect 2014; 142:1384-92. [PMID: 24074377 PMCID: PMC9168225 DOI: 10.1017/s0950268813002306] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 08/07/2013] [Accepted: 08/28/2013] [Indexed: 11/06/2022] Open
Abstract
Varicella accounts for substantial morbidities and remains a public health issue worldwide, especially in children. Little is known about the effect of meteorological variables on varicella infection risk for children. This study described the epidemiology of paediatric varicella notifications in Hong Kong from 2004 to 2010, and explored the association between paediatric varicella notifications in children aged <18 years and various meteorological factors using a time-stratified case-crossover model, with adjustment of potential confounding factors. The analysis found that daily mean temperature, atmospheric pressure and Southern Oscillation Index (SOI) were positively associated with paediatric varicella notifications. We found that an interquartile range (IQR) increase in temperature (8·38°C) at lag 1 day, a 9·50 hPa increase in atmospheric pressure for the current day, and a 21·91 unit increase in SOI for the current day may lead to an increase in daily cases of 5·19% [95% confidence interval (CI) 1·90-8·58], 5·77% (95% CI 3·01-8·61), and 4·32% (95% CI 2·98-5·68), respectively. An IQR increase in daily relative humidity (by 11·96%) was associated with a decrease in daily paediatric varicella (-2·79%, 95% CI -3·84 to -1·73). These findings suggest that meteorological factors might be important predictors of paediatric varicella infection in Hong Kong.
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Affiliation(s)
- J. Y. C. CHAN
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H. L. LIN
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - L. W. TIAN
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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Chan JY, Tian L, Kwan Y, Chan W, Leung C. Hospitalizations for varicella in children and adolescents in a referral hospital in Hong Kong, 2004 to 2008: a time series study. BMC Public Health 2011; 11:366. [PMID: 21605371 PMCID: PMC3119164 DOI: 10.1186/1471-2458-11-366] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 05/23/2011] [Indexed: 11/24/2022] Open
Abstract
Background Varicella accounts for significant morbidities and remains a public health issue worldwide. Climatic factors have been shown to associate with the incidence and transmission of various infectious diseases. We describe the epidemiology of varicella in paediatric patients hospitalized at a tertiary referral hospital in Hong Kong from 2004 to 2008, and to explore the possible association between the occurrence of varicella infection and various climatic factors. Methods The hospital discharge database of Princess Margaret Hospital was retrospectively analyzed for admissions associated with varicella from 2004 to 2008. Meteorological data were obtained from the monthly meteorological reports from the Hong Kong Observatory website. Time series analysis was performed with Poisson regression using a Generalized Estimating Equation (GEE) approach. Results During the study period, 598 children were hospitalized for varicella. The mean age on admission was 57.6 months, and the mean duration of hospitalization was 3.7 days. The overall complication rate was 47%. The mean monthly relative humidity, especially in cool seasons, was inversely correlated with the monthly varicella cases of the same month. Conclusions Varicella can lead to serious complications and prolonged hospitalization, even in previously healthy children. Lower relative humidity in cool seasons is associated with higher number of paediatric varicella hospital admissions. These findings are useful for a better understanding of the pattern of paediatric varicella hospitalization in Hong Kong.
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Affiliation(s)
- Johnny Yc Chan
- Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, China
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Rice PS. Ultra-violet radiation is responsible for the differences in global epidemiology of chickenpox and the evolution of varicella-zoster virus as man migrated out of Africa. Virol J 2011; 8:189. [PMID: 21513563 PMCID: PMC3094303 DOI: 10.1186/1743-422x-8-189] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Accepted: 04/23/2011] [Indexed: 11/10/2022] Open
Abstract
Background Of the eight human herpes viruses, varicella-zoster virus, which causes chickenpox and zoster, has a unique epidemiology. Primary infection is much less common in children in the tropics compared with temperate areas. This results in increased adult susceptibility causing outbreaks, for example in health-care workers migrating from tropical to temperate countries. The recent demonstration that there are different genotypes of varicella-zoster virus and their geographic segregation into tropical and temperate areas suggests a distinct, yet previously unconsidered climatic factor may be responsible for both the clinical and molecular epidemiological features of this virus infection. Presentation of the hypothesis Unlike other human herpes viruses, varicella-zoster virus does not require intimate contact for infection to occur indicating that transmission may be interrupted by a geographically restricted climatic factor. The factor with the largest difference between tropical and temperate zones is ultra-violet radiation. This could reduce the infectiousness of chickenpox cases by inactivating virus in vesicles, before or after rupture. This would explain decreased transmissibility in the tropics and why the peak chickenpox incidence in temperate zones occurs during winter and spring, when ultra-violet radiation is at its lowest. The evolution of geographically restricted genotypes is also explained by ultra-violet radiation driving natural selection of different virus genotypes with varying degrees of resistance to inactivation, tropical genotypes being the most resistant. Consequently, temperate viruses should be more sensitive to its effects. This is supported by the observation that temperate genotypes are found in the tropics only in specific circumstances, namely where ultra-violet radiation has either been excluded or significantly reduced in intensity. Testing the Hypothesis The hypothesis is testable by exposing different virus genotypes to ultra-violet radiation and quantifying virus survival by plaque forming units or quantitative mRNA RT-PCR. Implications of the hypothesis The ancestral varicella-zoster virus, most probably a tropical genotype, co-migrated with man as he left Africa approximately 200,000 years ago. For this virus to have lost the selective advantage of resistance to ultra-violet radiation, the hypothesis would predict that the temperate, ultra-violet sensitive virus should have acquired another selective advantage as an evolutionary trade-off. One obvious advantage could be an increased reactivation rate as zoster to set up more rounds of chickenpox transmission. If this were so, the mechanism responsible for resistance to ultra-violet radiation might also be involved in reactivation and latency. This could then provide the first insight into a genetic correlate of the survival strategy of this virus.
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Affiliation(s)
- Philip S Rice
- Department of Medical Microbiology, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK.
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Davidovici BB, Balicer RD, Klement E, Green MS, Mendelson E, Smetana Z, Cohen DI. Comparison of the dynamics and correlates of transmission of Herpes Simplex Virus-1 (HSV-1) and Varicella-Zoster Virus (VZV) in a sample of the Israeli population. Eur J Epidemiol 2007; 22:641-6. [PMID: 17668279 DOI: 10.1007/s10654-007-9169-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 07/09/2007] [Indexed: 11/26/2022]
Abstract
Herpes simplex virus types-1 (HSV-1) and Varicella-zoster virus (VZV) are herpes viruses that share many characteristics. However, HSV-1 spreads by close contact while VZV spreads mainly by the airborne route. In this study we compared the dynamics and correlates of transmission of these viruses in the same population. In 2000-2001, 1555 sera from an age-stratified general population sample were tested using commercial ELISA kits to measure type-specific HSV-1 and varicella IgG antibodies. The VZV seroprevalence increased rapidly with age reaching 50% seropositivity by the age of 3 years, while HSV-1 reached 50% seropositivity at the age of 14 years. The highest VZV force of infection was in the 3.5-5.5-year age group followed by the 5.5-10.5 years age group, while for HSV-1 the age specific force of infection was substantially lower and stable over the various age groups. Multivariate analysis revealed that HSV-1 seroprevalence was significantly, independently associated with age, country of birth, country of origin, ethnicity, socio-economic status and VZV sero-status. Only age, country of origin and HSV-1 sero-status were found to be associated with VZV seropositivity. In developed countries such as Israel the transmission of VZV is much quicker and less dependent on socioeconomic status as compared with HSV-1.
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Affiliation(s)
- Batya B Davidovici
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel
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Affiliation(s)
- Craig N Burkhart
- The Department of Immunology and Microbiology, Medical College of Ohio at Toledo, Toledo, OH 43623, USA.
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Tang JW, Li Y, Eames I, Chan PKS, Ridgway GL. Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises. J Hosp Infect 2006; 64:100-14. [PMID: 16916564 PMCID: PMC7114857 DOI: 10.1016/j.jhin.2006.05.022] [Citation(s) in RCA: 353] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Accepted: 05/19/2006] [Indexed: 12/29/2022]
Abstract
The epidemics of severe acute respiratory syndrome (SARS) in 2003 highlighted both short- and long-range transmission routes, i.e. between infected patients and healthcare workers, and between distant locations. With other infections such as tuberculosis, measles and chickenpox, the concept of aerosol transmission is so well accepted that isolation of such patients is the norm. With current concerns about a possible approaching influenza pandemic, the control of transmission via infectious air has become more important. Therefore, the aim of this review is to describe the factors involved in: (1) the generation of an infectious aerosol, (2) the transmission of infectious droplets or droplet nuclei from this aerosol, and (3) the potential for inhalation of such droplets or droplet nuclei by a susceptible host. On this basis, recommendations are made to improve the control of aerosol-transmitted infections in hospitals as well as in the design and construction of future isolation facilities.
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Affiliation(s)
- J W Tang
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
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Ku CH, Liu YT, Christiani DC. Case report: occupationally related recurrent varicella (chickenpox) in a hospital nurse. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:1373-5. [PMID: 16203249 PMCID: PMC1281282 DOI: 10.1289/ehp.7766] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Commonly accepted outcomes of varicella-zoster virus (VZV) infections include chickenpox (primary) and shingles (recurrence or latency), as well lifetime immunity against chickenpox. We report the case of a registered nurse who worked in a neurologic surgery ward in a general hospital in Taipei, Taiwan. While working there for approximately 1 year, she developed recurrent chickenpox after caring for a paraparesis patient, who had herpes zoster during hospitalization in August 2002. The varicella incubation period was 10 days, which matched the range (10-21 days). Recently negative specific serum IgM and positive specific serum IgG indicated a past VZV infection. The nurse did not get herpes zoster from the second episode of varicella on 9 August 2002 to 4 April 2005 and is now convalescing. We conclude that occupational VZV hazards exist in the health care environment and suggest testing for VZV antibody and a VZV vaccination program for susceptible health care workers. Key words: chickenpox, indirect fluroscent antibody, occupational exposure, polymerase chain reaction, shingles, Taiwan, varicella-zoster virus.
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Affiliation(s)
- Chih-Hung Ku
- School of Public Health, National Defense Medical Center, National Defense University, Taipei, Taiwan
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Suzuki K, Yoshikawa T, Ihira M, Ohashi M, Suga S, Asano Y. Spread of varicella-zoster virus DNA to the environment from varicella patients who were treated with oral acyclovir. Pediatr Int 2003; 45:458-60. [PMID: 12911484 DOI: 10.1046/j.1442-200x.2003.01746.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The purpose of the present study was to determine the degree of spread of varicella-zoster virus to the environment (VZV) from varicella patients who received oral acyclovir treatment. METHODS Over a period of 8 months, seven healthy children (two girls and five boys, 23-64 months of age) with varicella who visited Fujita Health University School of Medicine were treated with routine doses of oral acyclovir (ACV) for 5 days, commencing within 24 h after onset of the disease. Swab samples from the throats of patients and their family members as well as from air purifier filters in their houses were collected for 7 days as frequently as possible after starting treatment for the disease. The VZV DNA in the samples was identified by a sensitive polymerase chain reaction amplification assay. RESULTS The VZV DNA was detected in 33-100% of throat swab samples from varicella patients by day 7 of the disease, in 17-32% of throat swab samples from family members by day 4 and in 29% of filters from air purifiers by day 3. CONCLUSIONS The results suggest a broad spread of VZV, probably by the airborne route, from the patients with varicella even after the administration of oral ACV.
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Affiliation(s)
- Kyoko Suzuki
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Suzuki K, Yoshikawa T, Tomitaka A, Suzuki K, Matsunaga K, Asano Y. Detection of varicella-zoster virus DNA in throat swabs of patients with herpes zoster and on air purifier filters. J Med Virol 2002; 66:567-70. [PMID: 11857538 DOI: 10.1002/jmv.2182] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Zoster patients are considered to be less contagious than those with varicella because their infectious lesions are localized. However, it is not known when the spread of varicella-zoster virus (VZV) from zoster patients begins, how long it continues, and how far the virus spreads from the zoster patients. Twelve cases of hospitalized zoster patients were studied. The polymerase chain reaction (PCR) was used to detect VZV DNA in samples taken from the surface of their eruptions, throats, and the air purifier filters in their rooms. In all patients, VZV DNA was detected in the samples from eruptions. VZV DNA was detected in 8 of 12 patients from the throats. VZV DNA was detected for 9 of 12 patients from the filter samples. This study shows the possibility of a wide distribution of VZV DNA to the environment from infected patients. VZV may be excreted from cutaneous eruptions or from the throats of patients.
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Affiliation(s)
- Kayoko Suzuki
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
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Barker J, Stevens D, Bloomfield SF. Spread and prevention of some common viral infections in community facilities and domestic homes. J Appl Microbiol 2001; 91:7-21. [PMID: 11442709 PMCID: PMC7166786 DOI: 10.1046/j.1365-2672.2001.01364.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J Barker
- Pharmaceutical Sciences Institute, School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK.
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Yoshikawa T, Ihira M, Suzuki K, Suga S, Tomitaka A, Ueda H, Asano Y. Rapid contamination of the environments with varicella-zoster virus DNA from a patient with herpes zoster. J Med Virol 2000. [DOI: 10.1002/1096-9071(200101)63:1<64::aid-jmv1009>3.0.co;2-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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