Neonatal Vaccine-Strain Varicella-Zoster Virus Infection 22 Days After Maternal Postpartum Vaccination
Midtown Community Health Center, Children's Clinic, Suite A, Ogden, UT 84405 , USA.The Pediatric Infectious Disease Journal (Impact Factor: 2.72). 05/2012; 31(9):977-9. DOI: 10.1097/INF.0b013e31825d2a1b
A 25-day-old infant developed varicella 22 days after her mother received varicella vaccine postpartum. Infection with vaccine-strain varicella-zoster virus was confirmed by genetic analysis. The mother had no postvaccination rash nor did other contacts have rash or recent vaccination. The potential means of transmission to the infant are explored.
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ABSTRACT: SUMMARY Varicella-zoster virus (VZV) was once thought to be a fairly innocuous pathogen. That view is no longer tenable. The morbidity and mortality due to the primary and secondary diseases that VZV causes, varicella and herpes zoster (HZ), are significant. Fortunately, modern advances, including an available vaccine to prevent varicella, a therapeutic vaccine to diminish the incidence and ameliorate sequelae of HZ, effective antiviral drugs, a better understanding of VZV pathogenesis, and advances in diagnostic virology have made it possible to control VZV in the United States. Occult forms of VZV-induced disease have been recognized, including zoster sine herpete and enteric zoster, which have expanded the field. Future progress should include development of more effective vaccines to prevent HZ and a more complete understanding of the consequences of VZV latency in the enteric nervous system.
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ABSTRACT: Objectives: To propose guidelines for clinical practice regarding pertussis, influenza, varicella and rubella vaccination in the early post-partum. Materials and methods: Bibliographic searches were performed with PubMed and Cochrane databases, and within national guidelines and their references. Results: Women that have not got vaccinated in the past 10 years should receive a dose of diphtheria-tetanus-acellular pertussis-poliomyelitis vaccine in the early post-partum, and the family and friends should be included in the cocooning strategy (professional consensus). During seasonal influenza epidemic, influenza vaccine should be offered to women, who were not vaccinated during pregnancy, and delivered a vulnerable neonate (professional consensus). For all other women, the vaccination can be discussed on a case-by-case basis (professional consensus). In order to prevent congenital or neonatal varicella in a subsequent pregnancy, scientific data are weak to suggest a systematic screening and vaccination against varicella in women with no history or uncertain status about varicella, excepted in women coming from sub-Saharan Africa, East and Central Europe, more likely to have a negative serology for varicella (professional consensus). In order to prevent severe varicella in adulthood, the vaccination should be discussed with potentially seronegative women as recommended by the French High Council for Public Health (professional consensus). Rubella vaccine is recommended in the early post-partum with women with negative serology during pregnancy with a dose of measles-mumps-rubella vaccine (professional consensus). A new pregnancy should be avoided in the month following rubella and varicella vaccination, but contraception is not obligatory (professional consensus). Breastfeeding, recent rhesus immunoglobulin injection and blood transfusion do not prevent to perform vaccination in the early post-partum (professional consensus).
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