Charged with reporting on biological mechanisms, the committee reviewed evidence presented in case reports/clinical write-ups, laboratory tests, and animal models. An observational post-licensure (Phase IV) study was conducted at Kaiser Permanente Northern California (KPNC), a US managed care organization, to assess the safety of zoster vaccine in people 60 years of age or older, vaccinated in routine medical care. We searched MEDLINE (January 1966 to December 2010), EMBASE (January 1980 to January 2011), LILACS (January 1982 to December 2010), the Cochrane Neuromuscular Disease (NMD) Group Specialized Register (10 January 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (10 January 2010 in the Cochrane Library, Issue 4, 2010) and the Chinese Biomedical Retrieval System (January 1978 to December 2010). This phase 4, open-label, multicenter study was undertaken to assess the immunogenicity and safety of a single dose of ZOSTAVAX (refrigerator-stable formulation) given within 6 mo of its expiry date in individuals ≥50 y of age. The vaccine might not be protective in persons who subsequently become immunocompromised. There have been reports of subacute sclerosing panencephalitis (SSPE) in children with no history of infection with wild-type measles but who did receive measles vaccine. Zostavax, a live attenuated vaccine, has been approved in the United States for use in older individuals to reduce the risk and severity of herpes zoster (HZ), also known as shingles.
Your health care professional can tell you what situations you may need to avoid. I know first-hand how disruptive the illness can be for the family. In most cases of adult varicella the source of infection was unknown. For both B and T cells in a typical immune response to an antigen exposure, the latency between the first (primary) exposure and development of the primary response is characterized by a lag phase, logarithmic phase, and plateau phase. When adults contract varicella, not only the patients themselves suffer from high fever and sore throat, but also they act as the source of infection, if they are medical care workers. Furthermore, in public, the contraction of varicella results a socioeconomic loss from suspension of business caused by the illness. Prophylaxis with varicella vaccine, therefore, should be considered, when there are people who have never contracted varicella, whether or not they are medical staff.
Uebe B, Sauerbrei A, Burdach S, Horneff G. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. Eur J Pediatr, 2002 Aug; 161(8):442–4. A 27-month-old girl developed an impressive herpes zoster infection 16 months after varicella vaccination that was localized in three adjacent cervical dermatomes. Sept. Binder NR, Holland GN, Hosea S, Silverberg ML. Contributing to the activation of B and T cells and the initiation of the adaptive immune response are cells classically associated with the innate immune system (e.g., macrophages and dendritic cells).
J AAPOS, 2005 Dec; 9(6):597–8. A case of pediatric herpes zoster ophthalmicus in a child that had been vaccinated against varicella and otherwise had no known exposure to varicella-zoster virus and the initial presentation of HZO was a painful and diffuse subconjunctival hemorrhage that appeared before any of its classic signs were observed. Kohl S. Rapp J, La Russa P, Gershon AA, Steinberg SP. Natural varicella-zoster virus reactivation shortly after varicella immunization in a child. Pediatr. Infect.
Gary S. 1999 Dec;18(12):1112–3. This in turn results in prolonged exposure of the cells of the innate immune system to antigen (Tritto et al., 2009). Levin MJ, Dahl KM, Weinberg A, Giller R, Patel A, Krause PR. Development of resistance to acyclovir during chronic infection with the Oka vaccine strain of varicella-zoster virus, in an immunosuppressed child. J Infect Dis. 2003 Oct 1;188(7):954–9.
A 1-year-old boy was vaccinated with the Oka strain of varicella just prior to the discovery of a tumor that required intensive antitumor therapy. Three months later he developed herpes zoster, which developed into chronic verrucous lesions that were refractory to treatment with acyclovir and which subsequently disseminated. DNA from a biopsy specimen of a chronic herpes-zoster lesion indicated that the Oka vaccine strain of the virus caused this severe complication. That is proof that the vaccine manufactures do not study the vaccine well enough before releasing it on an unsuspecting public. Plasmids containing this altered gene were unable to produce functional thymidine kinase in an in vitro translation system. T cells have various functions in the immune response. This is the first report of Oka-strain varicella virus causing severe disease after reactivation and of resistance to acyclovir during an infection caused by this virus.
Ota K, Kim V, Lavi S, Ford-Jones EL, Tipples G, Scolnik D, Tellier R. Vaccine-strain varicella zoster virus causing recurrent herpes zoster in an immunocompetent 2-year-old. Pediatr Infect Dis J. 2008 Sep;27(9):847–8. Varivax III is a live attenuated vaccine against varicella zoster virus (VZV). The authors report “a case of recurrent vaccine-strain herpes zoster in an immunocompetent 2-year-old child.” This report aims to alert physicians that recurrent vaccine-strain herpes zoster can be a rare complication of VZV vaccination in apparently immunocompetent hosts. Iyer S, Mittal MK, Hodinka RL.Herpes Zoster and Meningitis Resulting From Reactivation of Varicella Vaccine Virus in an Immunocompetent Child.
Ann Emerg Med. In addition, activated CD8+ T cells secrete cytokines, molecules critical to intercellular communication, that recruit and activate macrophages and neutrophils (Harty et al., 2000). Herpes zoster complicated by meningitis has been mainly reported in immunocompromised patients after reactivation of wild-type varicella-zoster virus. We present one of the first cases of aseptic meningitis after herpes zoster caused by reactivation of vaccine-type varicella-zoster virus in an immunocompetent child. We also highlight the increasing role of both wild-type and vaccine strains of varicella-zoster virus as a cause of viral meningoencephalitis and the use of appropriate laboratory tools to rapidly and accurately identify the virus in order to provide prompt patient care and management. Sincerely, Gary S. Goldman, Ph.D.
Gary Goldman Nov. 1, 2009 at 12:15am Varicella (chickenpox) and herpes zoster (shingles) both develop from the same varicella-zoster virus (VZV). As varicella vaccination became more widespread, incidence of shingles among adults has nearly doubled. This is due to an immunologically-mediated link between varicella and herpes zoster. In summary, T cells contribute to the establishment and maintenance of immune responses, the clearance of pathogens, and the maintenance of self-tolerance. This boosted the adults’ cell-mediated immunity to help suppress or postpone the reactivation of herpes zoster.