If I Have Ra and Had Chicken Pox Can I Get Again
Med J Armed Forces India. 2022 Jul; 71(Suppl 1): S214–S216.
Reinfection of Varicella zoster in a vaccinated adult
Mona Dubey
aResident, Department of Customs Medicine, War machine Medical Higher, Pune 411040, India
Gurpreet Singh
aResident, Department of Customs Medicine, Armed Forces Medical Higher, Pune 411040, India
V.K. Bhatti
bCol Health, HQ Northern Command, C/o 56 APO, India
A. Mahen
cDPMO, HQ Western Air Command, New Delhi, Bharat
Renuka Kunte
dDirector Health (Air Forcefulness), Army HQ, New Delhi, India
S.Thou. Katara
eResident (Obst & Gynae), Base of operations Infirmary, Delhi Cantt, India
Received 2013 Jul 27; Accustomed 2022 Mar 17.
Keywords: Chickenpox, Varicella zoster, Varicella vaccine, Reinfection
Introduction
Chickenpox is an acute, highly infectious disease caused by Varicella-zoster virus. Approximately ninety% of cases occur in children and lesser in adults. As per literature 55 percent of Varicella-associated deaths occur among adults.ane Ane attack gives durable immunity and second attacks are rare.1 People who already had chickenpox and go it again – is known as "reinfection".2 If this happens, a milder form of the affliction usually occurs, with fewer symptoms. Diagnosis is usually made on clinical grounds, based on rash characteristics and on epidemiologic features, such as contact with other Varicella cases.2 Laboratory tests are available to confirm diagnosis of Varicella, assess immune condition, and genotype of VZV strains. Varicella vaccine (OKA strain) is bachelor in India.
Still, reports of Varicella outbreaks in highly immunized groups in Japan and USA accept made effectiveness of Varicella vaccine questionable. We present a case of Varicella in a immature adult patient who gave history of chickenpox in babyhood and was previously immunized with Varicella vaccine, even so manifested a total blown affliction.
Case written report
A 19-twelvemonth-erstwhile male person patient, presented with skin rash of ii days elapsing. He gave history of having fever on day one of appearance of skin rash. He denied history of whatever drug intake, respiratory or gastrointestinal symptoms prior to the onset of peel rash. He gave history of contact with a known case of chickenpox during his leave, 17 days before the onset of nowadays symptoms. He gave history that he had chickenpox at 5 years of age and also that he was vaccinated with two doses of Varicella vaccine at the age of 15 years. Same was further confirmed past his mother who is wellness care personnel by profession. On general physical examination on the solar day of presentation he had mild fever. Dermatological examination showed numerous symmetrical pleomorphic peel lesions in diverse stages of development like macules, papules, vesicles, pustules (Fig. one) distributed over the scalp face, neck, breast and belly (Fig. 2). Systemic examination did non reveal any aberration. He was diagnosed clinically as a case of Varicella and managed with calamine lotion, antipyretics & antiviral (Tab acyclovir). He recovered in 7 days without whatever complexity. Polymerase chain reaction amplification and subsequent Dna sequencing of the sample from the fresh fluid filled lesions confirmed the virus genome to exist VZV of wild type.
Shut view of characteristic lesions.
Distribution of rash on trunk.
Discussion
This was a clinically and laboratory confirmed instance of Varicella in a patient with prior history of similar episode and vaccination. Fever and rash appearing on the same day is characteristic feature of Varicella infection. Information technology is well known that natural immunity following chickenpox is largely protective against reinfection. Severe symptoms were possibly prevented in this case because of residual antibodies due to prior infection.two Unfortunately, it was non possible to check his VZV antibody titers in this case. Although reinfection of chickenpox is difficult to prove, a study from Japan in the twelvemonth 2002 reported that 13% of children presenting with chickenpox had experienced a well-documented previous episode, thus suggesting that clinical recurrence may be more common than previously idea.3 however there are no population-based data on the frequency of reported 2d infections with Varicella in Indian population.
Breakthrough Varicella is an infection with wild-type VZV occurring in individuals later on 42 days of Varicella vaccination characterized by shorter illness and fewer than 50 pare lesions which are predominantly maculopapular rather than vesicular. However, 25%–30% of persons vaccinated with 1 dose with breakthrough Varicella have clinical features typical of Varicella in unvaccinated people.two Since the clinical features of breakthrough Varicella are often mild, it tin exist difficult to make a diagnosis on clinical presentation alone. There is express information about quantum Varicella in persons who accept received two doses of vaccine compared to persons who have received a unmarried dose of Varicella vaccine.4 This case presented with a full blown clinical picture despite previous vaccination. Studies have demonstrated vaccine effectiveness in the range of 85%–90% for prevention of clinical disease and 100% for astringent disease.iv A chickenpox outbreak was reported from a school at Oregon, U.s. in 2000 in which 97% of students without a prior history of chickenpox were vaccinated. Students vaccinated more five years before the outbreak were at adventure for breakthrough disease. Vaccine effectiveness was found to be 72% (95% confidence interval: 3%–87%).3
New variants of VZV have also been reported recently, including VZV-MSP, isolated in St. Paul–Minneapolis, MN, and VZV-BC, isolated in British Columbia.5,6 Nosotros do not know whether there is a mutant strain of VZV in India; thus this case could further help usa to study epidemiological transition of VZV infection. There are no reported cases of reinfection in India along with quantum Varicella in to the best of our knowledge. Widespread use of vaccine is likely to alter the epidemiological pattern of this disease, shifting information technology from early childhood to adolescents or young adults.one
There is a demand to carry out studies to establish the effect of Varicella vaccination and reinfection on the affliction pattern in Indian population.
Conflicts of interest
All authors have none to declare.
References
one. Park K. Epidemiology of infectious disease. In: Park M., editor. Parks Textbook of Preventive and Social Medicine. 21th ed. Bhanot; 2007. pp. 124–125. [Google Scholar]
2. Dalya K., Mona M., Seward Jane F. Varicella and herpes zoster. In: Wallace Robert B., editor. Maxcy Rosenau Final, Public Health and Preventive Medicine. 15th ed. The McGraw-Hill Companies; 2008. pp. 127–132. [Google Scholar]
3. Hall South., Maupin T., Seward J. 2nd varicella infections: are they more than common than previously thought? Pediatrics. 2002;109:1068–1073. [PubMed] [Google Scholar]
4. Tugwell B.D., Lee L.E., Hilary Gillette R.North., Lorber East.Yard., Hedberg Grand., Cieslak P.R. Chickenpox outbreak in a highly vaccinated school population. Pediatrics. 2004;113:455–459. [PubMed] [Google Scholar]
5. Santos R.A., Hatfield C.C., Cole Northward.Fifty. Varicella-zoster virus gE escape mutant VZV-MSP exhibits an accelerated prison cell-to-cell spread phenotype in both infected cell cultures and SCID mice. Virology. 2000;275(2):306–317. [PubMed] [Google Scholar]
6. Tipples G.A., Stephens G.M., Sherlock C. New variant of varicella-zoster virus. Emerg Infect Dis. 2002;8(12):1504–1505. [PMC complimentary commodity] [PubMed] [Google Scholar]
Articles from Medical Journal, Armed Forces Republic of india are provided here courtesy of Elsevier
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529600/
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