Varicella-Zoster Infections

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	Section 1 Section 2 Section 3 Section 4 Section 5 Appendices

The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Varicella-Zoster Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
Care of Exposed People

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CLINICAL MANIFESTATIONS: Primary infection results in varicella(chickenpox), manifesting as a generalized, pruritic, vesicularrash typically consisting of 250 to 500 lesions in varying stagesof development and resolution (crusting), mild fever, and othersystemic symptoms. Complications include bacterial superinfectionof skin lesions, pneumonia, central nervous system involvement(acute cerebellar ataxia, encephalitis), thrombocytopenia, andother rare complications such as glomerulonephritis, arthritis,and hepatitis. Varicella tends to be more severe in adolescentsand adults than in young children. Reye syndrome can followcases of chickenpox, although the incidence of Reye syndromehas decreased dramatically with decreased use of salicylatesduring varicella or influenza-like illnesses. In immunocompromisedchildren, progressive severe varicella characterized by continuingeruption of lesions and high fever persisting into the secondweek of illness as well as encephalitis, hepatitis, and pneumoniacan develop. Hemorrhagic varicella is more common among immunocompromisedpatients than immunocompetent hosts. Pneumonia is relativelyless common among immunocompetent children but is the most commoncomplication in adults. In children with human immunodeficiencyvirus (HIV) infection, recurrent varicella or disseminated herpeszoster can develop. Severe and even fatal varicella has beenreported in otherwise healthy children receiving intermittentcourses of high-dose corticosteroids (>2 mg/kg of prednisoneor equivalent) for treatment of asthma and other illnesses.The risk especially is high when corticosteroids are given duringthe incubation period for chickenpox.

The virus establishes latency in the dorsal root ganglia duringprimary infection. Reactivation results in herpes zoster ("shingles").Grouped vesicular lesions appear in the distribution of 1 to3 sensory dermatomes, sometimes accompanied by pain localizedto the area. Postherpetic neuralgia, which may last for weeksto months, is defined . . . [Go to Full Text]

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This topic has been referenced by these articles:

Dodd, D. A., Burger, J., Edwards, K. M., Dummer, J. S. (2001). Varicella in a Pediatric Heart Transplant Population on Nonsteroid Maintenance Immunosuppression. Pediatrics 108: e80-80 [Abstract] [Full Version]
Scheinfeld, N., Cohen, S. R. (2000). Varicella Causes Skin Pits and Keloids{---}More Reasons for the Varicella Vaccine. Pediatrics 106: 160-160 [Full Version]
Haddad, M. B., Hill, M. B., Pavia, A. T., Green, C. E., Jumaan, A. O., De, A. K., Rolfs, R. T. (2005). Vaccine Effectiveness During a Varicella Outbreak Among Schoolchildren: Utah, 2002-2003. Pediatrics 115: 1488-1493 [Abstract] [Full Version]
Quinn, D. (2001). Use of Psychoactive Medication During Pregnancy and Possible Effects on the Fetus and Newborn. Pediatrics 107: 1498-1498 [Full Version]
Ziebold, C., von Kries, R., Lang, R., Weigl, J., Schmitt, H. J. (2001). Severe Complications of Varicella in Previously Healthy Children in Germany: A 1-Year Survey. Pediatrics 108: e79-79 [Abstract] [Full Version]
Hall, S., Maupin, T., Seward, J., Jumaan, A. O., Peterson, C., Goldman, G., Mascola, L., Wharton, M. (2002). Second Varicella Infections: Are They More Common Than Previously Thought?. Pediatrics 109: 1068-1073 [Abstract] [Full Version]
Perez, E. E., Bokszczanin, A., McDonald-McGinn, D., Zackai, E. H., Sullivan, K. E. (2003). Safety of Live Viral Vaccines in Patients With Chromosome 22q11.2 Deletion Syndrome (DiGeorge Syndrome/Velocardiofacial Syndrome). Pediatrics 112: e325-325 [Abstract] [Full Version]
Bonilla, F. A. (2004). SAFETY OF LIVE VIRAL VACCINES IN PATIENTS WITH CHROMOSOME 22Q11.2 DELETION SYNDROME (DiGEORGE SYNDROME/VELOCARDIOFACIAL SYNDROME). Pediatrics 114: 550-550 [Full Version]
Hill, G., Chauvenet, A. R., Lovato, J., McLean, T. W. (2005). Recent Steroid Therapy Increases Severity of Varicella Infections in Children With Acute Lymphoblastic Leukemia. Pediatrics 116: e525-e529 [Abstract] [Full Version]
Lesko, S. M., O'Brien, K. L., Schwartz, B., Vezina, R., Mitchell, A. A. (2001). Invasive Group A Streptococcal Infection and Nonsteroidal Antiinflammatory Drug Use Among Children With Primary Varicella. Pediatrics 107: 1108-1115 [Abstract] [Full Version]
Laupland, K. B., Davies, H. D., Low, D. E., Schwartz, B., Green, K., the Ontario Group A Streptococcal Study Group, , McGeer, A. (2000). Invasive Group A Streptococcal Disease in Children and Association With Varicella-Zoster Virus Infection. Pediatrics 105: 60e-60 [Abstract] [Full Version]
Ibia, E. O., Imoisili, M., Pikis, A. (2003). Group A {beta}-Hemolytic Streptococcal Osteomyelitis in Children. Pediatrics 112: e22-26 [Abstract] [Full Version]
Ulloa-Gutierrez, R., Dobson, S., Forbes, J. (2005). Group A Streptococcal Subdural Empyema as a Complication of Varicella. Pediatrics 115: e112-e114 [Abstract] [Full Version]
Kramer, J. M., LaRussa, P., Tsai, W. C., Carney, P., Leber, S. M., Gahagan, S., Steinberg, S., Blackwood, R. A. (2001). Disseminated Vaccine Strain Varicella as the Acquired Immunodeficiency Syndrome-Defining Illness in a Previously Undiagnosed Child. Pediatrics 108 : e39-e39 [Abstract] [Full Version]
Cieslak, P. R., Hedberg, K., Lee, L. E. (2004). Chickenpox Outbreak in a Highly Vaccinated School Population: In Reply. Pediatrics 114: 1131-1131 [Full Version]
Heath, K., Watson, B. (2004). Chickenpox Outbreak in a Highly Vaccinated School Population. Pediatrics 114: 1130-1131 [Full Version]
Jumaan, A. O., Harpaz, R. (2004). Chickenpox Outbreak in a Highly Vaccinated School Population. Pediatrics 114: 1130-1130 [Full Version]
Tugwell, B. D., Lee, L. E., Gillette, H., Lorber, E. M., Hedberg, K., Cieslak, P. R. (2004). Chickenpox Outbreak in a Highly Vaccinated School Population. Pediatrics 113: 455-459 [Abstract] [Full Version]
Brunell, P. A., Argaw, T. (2000). Chickenpox Attributable to a Vaccine Virus Contracted From a Vaccinee With Zoster. Pediatrics 106: 28e-28 [Abstract] [Full Version]
Caruso, J. M., Tung, G. A., Brown, W. D. (2001). Central Nervous System and Renal Vasculitis Associated With Primary Varicella Infection in a Child. Pediatrics 107: 9e-9 [Abstract] [Full Version]
Fischer;, H., Ploin, D., Floret, D. (2001). Aspirin and Reye's Syndrome. Pediatrics 107: 214-214 [Full Version]

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