Can I Get Chickenpox Again as Adult
Med J Armed services India. 2015 Jul; 71(Suppl 1): S214–S216.
Reinfection of Varicella zoster in a vaccinated adult
Mona Dubey
aResident, Department of Customs Medicine, Armed Forces Medical College, Pune 411040, India
Gurpreet Singh
aResident, Department of Customs Medicine, Military machine Medical College, Pune 411040, Republic of india
V.One thousand. Bhatti
bCol Health, HQ Northern Command, C/o 56 APO, India
A. Mahen
cDPMO, HQ Western Air Command, New Delhi, Republic of india
Renuka Kunte
dManager Health (Air Force), Regular army HQ, New Delhi, Republic of india
S.K. Katara
eastResident (Obst & Gynae), Base Infirmary, Delhi Cantt, Republic of india
Received 2013 Jul 27; Accepted 2014 Mar 17.
Keywords: Chickenpox, Varicella zoster, Varicella vaccine, Reinfection
Introduction
Chickenpox is an astute, highly infectious illness caused by Varicella-zoster virus. Approximately 90% of cases occur in children and lesser in adults. As per literature 55 percentage of Varicella-associated deaths occur amid adults.i One attack gives durable amnesty and second attacks are rare.1 People who already had chickenpox and get information technology again – is known every bit "reinfection".2 If this happens, a milder form of the disease usually occurs, with fewer symptoms. Diagnosis is usually made on clinical grounds, based on rash characteristics and on epidemiologic features, such every bit 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 available in Bharat.
Even so, reports of Varicella outbreaks in highly immunized groups in Nippon and USA have made effectiveness of Varicella vaccine questionable. Nosotros present a case of Varicella in a young adult patient who gave history of chickenpox in babyhood and was previously immunized with Varicella vaccine, withal manifested a full blown affliction.
Case report
A 19-year-onetime male patient, presented with skin rash of two days duration. He gave history of having fever on day one of appearance of peel rash. He denied history of any drug intake, respiratory or gastrointestinal symptoms prior to the onset of skin rash. He gave history of contact with a known case of chickenpox during his get out, 17 days before the onset of present symptoms. He gave history that he had chickenpox at five years of age and also that he was vaccinated with 2 doses of Varicella vaccine at the age of 15 years. Same was further confirmed by his mother who is health care personnel past profession. On general concrete examination on the 24-hour interval of presentation he had mild fever. Dermatological examination showed numerous symmetrical pleomorphic peel lesions in various stages of development similar macules, papules, vesicles, pustules (Fig. 1) distributed over the scalp face, cervix, breast and abdomen (Fig. 2). Systemic exam did not 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 whatsoever complexity. Polymerase chain reaction amplification and subsequent DNA sequencing of the sample from the fresh fluid filled lesions confirmed the virus genome to be VZV of wild type.
Close view of characteristic lesions.
Distribution of rash on trunk.
Word
This was a clinically and laboratory confirmed case of Varicella in a patient with prior history of similar episode and vaccination. Fever and rash actualization on the aforementioned day is characteristic characteristic of Varicella infection. It 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 not possible to cheque his VZV antibody titers in this instance. Although reinfection of chickenpox is difficult to bear witness, a study from Nippon in the year 2002 reported that xiii% of children presenting with chickenpox had experienced a well-documented previous episode, thus suggesting that clinical recurrence may be more mutual than previously thought.3 however in that location are no population-based data on the frequency of reported second infections with Varicella in Indian population.
Breakthrough Varicella is an infection with wild-type VZV occurring in individuals afterwards 42 days of Varicella vaccination characterized by shorter illness and fewer than 50 skin lesions which are predominantly maculopapular rather than vesicular. However, 25%–30% of persons vaccinated with 1 dose with quantum Varicella accept clinical features typical of Varicella in unvaccinated people.ii Since the clinical features of breakthrough Varicella are ofttimes balmy, it tin can exist hard to make a diagnosis on clinical presentation alone. There is express information nearly quantum Varicella in persons who have received two doses of vaccine compared to persons who have received a single dose of Varicella vaccine.4 This case presented with a full diddled clinical film despite previous vaccination. Studies take demonstrated vaccine effectiveness in the range of 85%–90% for prevention of clinical illness and 100% for astringent disease.4 A chickenpox outbreak was reported from a school at Oregon, USA in 2000 in which 97% of students without a prior history of chickenpox were vaccinated. Students vaccinated more v years earlier the outbreak were at hazard 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,half dozen We do not know whether there is a mutant strain of VZV in India; thus this case could further help us to study epidemiological transition of VZV infection. There are no reported cases of reinfection in India along with breakthrough Varicella in to the best of our knowledge. Widespread apply of vaccine is likely to change the epidemiological pattern of this disease, shifting it from early on childhood to adolescents or young adults.i
There is a need to carry out studies to establish the upshot of Varicella vaccination and reinfection on the disease design in Indian population.
Conflicts of interest
All authors take none to declare.
References
ane. Park K. Epidemiology of infectious disease. In: Park K., editor. Parks Textbook of Preventive and Social Medicine. 21th ed. Bhanot; 2007. pp. 124–125. [Google Scholar]
2. Dalya G., Mona M., Seward Jane F. Varicella and canker 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. Second varicella infections: are they more than mutual than previously thought? Pediatrics. 2002;109:1068–1073. [PubMed] [Google Scholar]
iv. Tugwell B.D., Lee L.E., Hilary Gillette R.N., Lorber Eastward.Thou., Hedberg K., 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.L. Varicella-zoster virus gE escape mutant VZV-MSP exhibits an accelerated cell-to-cell spread phenotype in both infected prison cell cultures and SCID mice. Virology. 2000;275(2):306–317. [PubMed] [Google Scholar]
half dozen. Tipples Thousand.A., Stephens G.Chiliad., Sherlock C. New variant of varicella-zoster virus. Emerg Infect Dis. 2002;8(12):1504–1505. [PMC complimentary article] [PubMed] [Google Scholar]
Articles from Medical Journal, Armed services Republic of india are provided here courtesy of Elsevier
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529600/
0 Response to "Can I Get Chickenpox Again as Adult"
Post a Comment