THE EPIDEMIOLOGY OF VARICELLA-ZOSTER VIRUS INFECTIONS

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EPIDEMIOLOGY OF VARICELLA

Varicella is spread by droplet or airborne transmission. Although less readily transmitted than measles, it is nonetheless highly contagious, with secondary attack rates in susceptible household contacts of greater than 85%.22, 33 The usual incubation period is 14 to 16 days, with a range of 11 to 20 days. Second cases of chickenpox have been reported in immunocompetent persons26 but are rare. There is immunologic evidence, however, that subclinical reinfection with VZV is common.2 VZV has been

EPIDEMIOLOGY OF ZOSTER

Herpes zoster (HZ) represents reactivation of VZV that has established latency following primary infection. The increased risk of HZ in persons with malignancies and HIV infection is thought to be due to loss of cell-mediated immunity (CMI) for VZV. Decreasing CMI associated with aging is thought to be responsible for the increasing rates of HZ observed among the elderly.4 Primary varicella acquired in utero or before the first birthday is a risk factor for childhood HZ (see the article by

FUTURE ISSUES AND THE IMPACT OF VARICELLA VACCINE

Routine immunization of children at 12 to 18 months of age with live attenuated varicella vaccine is expected to dramatically reduce morbidity and severe complications due to varicella among vaccinated children. Because older persons are at greater risk of serious complications than children, failure to achieve high vaccine coverage among children could conceivably result in increased complications, if unvaccinated children reach adolescence or adulthood before contracting varicella (see the

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  • Cited by (220)

    • Evaluation of varicella vaccine effectiveness during outbreaks in schools or nurseries by cross-sectional study

      2021, Vaccine
      Citation Excerpt :

      Varicella is usually self-limited and resolves within a week but can cause severe complications with fatal outcomes [1]. Before the development of the vaccine, varicella was a universal infection acquired mainly in childhood [2]. The live attenuated varicella vaccine derived from attenuated VZV (Oka/Biken strain) was developed by Takahashi et al. in 1974 [3].

    • Pathobiology and treatment of viral keratitis

      2021, Experimental Eye Research
      Citation Excerpt :

      In many of these cases, early identification and treatment of CMV keratitis prevented permanent damage to the cornea. The alpha-herpesvirus VZV used to be an ubiquitous infection in childhood with approximately 4 million cases each year, causing about 100 deaths annually (Meyer et al., 2000, Wharton, 1996). As with HSV, there was a considerable decline in VZV cases precipitously from the year 1995–2000 (Seward et al., 2002).

    View all citing articles on Scopus

    Address reprint requests to Melinda Wharton, MD, MPH, Child Vaccine Preventable Diseases Branch, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333

    *

    From the child Vaccine Preventable Diseases Branch, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia

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