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Transmission of varicella zoster virus from individuals with herpes zoster or varicella in school and day care settings.

Abstract

BACKGROUND
Because the varicella incidence has declined following varicella vaccine licensure, herpes zoster (HZ) cases may play a larger role in varicella zoster virus (VZV) transmission. We investigated how HZ and varicella cases contribute to the varicella incidence in schools and day care centers.
METHODS
Surveillance data collected in Philadelphia during September 2003-June 2010 were analyzed. A varicella case was considered to be sporadic if it was reported from a school or day care facility >6 weeks after or ≥10 days before other reports of VZV transmission. A varicella case was considered to be secondary if it occurred 10-21 days after report of a case of HZ or sporadic varicella. Analysis compared VZV transmission from individuals with HZ or sporadic varicella, stratified by varicella vaccination status and disease severity.
RESULTS
Of 290 HZ cases reported, 27 (9%) resulted in 84 secondary varicella cases. Of 1358 sporadic varicella cases reported, 205 (15%) resulted in 564 secondary varicella cases. Approximately half of the HZ and sporadic varicella cases resulted in single secondary cases. The proportion of individuals who had secondary cases with mild disease was similar for those exposed to HZ and those exposed to varicella (70% and 72%, respectively). VZV transmission was highest from unvaccinated individuals with sporadic varicella (P < .01).
CONCLUSIONS
VZV transmission from individuals with HZ contributes to varicella morbidity. More research is needed to understand risk factors and guide recommendations for preventing VZV transmission from individuals with HZ.

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  • FREE Publisher Full Text
  • Authors

    Viner K, Perella D, Lopez A, Bialek S, Newbern C, Pierre R, Spells N, Watson B

    Source

    The Journal of infectious diseases 205:9 2012 May 1 pg 1336-41

    MeSH

    Chickenpox
    Child
    Child Day Care Centers
    Child, Preschool
    Herpes Zoster
    Herpesvirus 3, Human
    Humans
    Incidence
    Philadelphia
    Retrospective Studies
    Risk Factors
    Schools
    Vaccination

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    22454467