Can I Get Chicken Pox Again as an Adults

• Journal List
• Med J Armed Forces Republic of india
• v.71(Suppl one); 2015 Jul
• PMC4529600

Med J Military machine India. 2015 Jul; 71(Suppl 1): S214–S216.

Reinfection of Varicella zoster in a vaccinated adult

Mona Dubey, Maj,^{a, ∗} Gurpreet Singh, Maj,^a V.K. Bhatti, Col,^b A. Mahen, Air Cmde,^c Renuka Kunte, Gp Capt,^d and S.One thousand. Katara, Maj^e

Mona Dubey

^aResident, Section of Customs Medicine, Armed Forces Medical College, Pune 411040, Republic of india

Gurpreet Singh

^aResident, Department of Community Medicine, Armed Forces Medical Higher, Pune 411040, Republic of india

V.K. Bhatti

^bCol Health, HQ Northern Command, C/o 56 APO, India

A. Mahen

^cDPMO, HQ Western Air Command, New Delhi, India

Renuka Kunte

^dManaging director Health (Air Strength), Army HQ, New Delhi, India

S.G. Katara

^eResident (Obst & Gynae), Base Hospital, Delhi Cantt, India

Received 2013 Jul 27; Accustomed 2014 Mar 17.

Keywords: Chickenpox, Varicella zoster, Varicella vaccine, Reinfection

Introduction

Chickenpox is an acute, highly infectious disease caused by Varicella-zoster virus. Approximately 90% of cases occur in children and lesser in adults. As per literature 55 percent of Varicella-associated deaths occur among adults.¹ One set on 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 course of the illness commonly occurs, with fewer symptoms. Diagnosis is usually made on clinical grounds, based on rash characteristics and on epidemiologic features, such as contact with other Varicella cases.² Laboratory tests are available to confirm diagnosis of Varicella, assess immune status, and genotype of VZV strains. Varicella vaccine (OKA strain) is available in Republic of india.

However, reports of Varicella outbreaks in highly immunized groups in Japan and USA take made effectiveness of Varicella vaccine questionable. Nosotros nowadays a case of Varicella in a young adult patient who gave history of chickenpox in babyhood and was previously immunized with Varicella vaccine, yet manifested a full blown disease.

Example study

A xix-year-old male patient, presented with peel rash of two days duration. He gave history of having fever on day one of appearance of skin rash. He denied history of any drug intake, respiratory or gastrointestinal symptoms prior to the onset of peel rash. He gave history of contact with a known case of chickenpox during his leave, 17 days before the onset of nowadays symptoms. He gave history that he had chickenpox at 5 years of age and also that he was vaccinated with 2 doses of Varicella vaccine at the age of fifteen years. Same was further confirmed by his female parent who is wellness care personnel by profession. On general physical examination on the 24-hour interval of presentation he had mild fever. Dermatological examination showed numerous symmetrical pleomorphic peel lesions in diverse stages of development like macules, papules, vesicles, pustules (Fig. 1) distributed over the scalp confront, neck, chest and abdomen (Fig. 2). Systemic test did not reveal any abnormality. He was diagnosed clinically as a example of Varicella and managed with calamine lotion, antipyretics & antiviral (Tab acyclovir). He recovered in 7 days without any complication. Polymerase concatenation reaction distension and subsequent Dna sequencing of the sample from the fresh fluid filled lesions confirmed the virus genome to exist VZV of wild blazon.

Close view of characteristic lesions.

Distribution of rash on trunk.

Discussion

This was a clinically and laboratory confirmed example of Varicella in a patient with prior history of similar episode and vaccination. Fever and rash actualization on the same 24-hour interval is characteristic feature of Varicella infection. It is well known that natural immunity post-obit chickenpox is largely protective against reinfection. Astringent symptoms were perchance prevented in this instance because of residual antibodies due to prior infection.² Unfortunately, it was not possible to check his VZV antibiotic titers in this case. Although reinfection of chickenpox is difficult to prove, a study from Japan in the year 2002 reported that 13% of children presenting with chickenpox had experienced a well-documented previous episode, thus suggesting that clinical recurrence may exist more common than previously idea.³ however there are no population-based data on the frequency of reported 2nd infections with Varicella in Indian population.

Breakthrough Varicella is an infection with wild-type VZV occurring in individuals afterward 42 days of Varicella vaccination characterized by shorter affliction and fewer than 50 skin lesions which are predominantly maculopapular rather than vesicular. However, 25%–30% of persons vaccinated with 1 dose with breakthrough Varicella have clinical features typical of Varicella in unvaccinated people.² Since the clinical features of breakthrough Varicella are often balmy, it tin be hard to make a diagnosis on clinical presentation lone. In that location is limited information about breakthrough Varicella in persons who have received two doses of vaccine compared to persons who have received a single dose of Varicella vaccine.⁴ This instance presented with a total diddled clinical picture despite previous vaccination. Studies have demonstrated vaccine effectiveness in the range of 85%–90% for prevention of clinical disease and 100% for severe disease.⁴ A chickenpox outbreak was reported from a school at Oregon, U.s.a. in 2000 in which 97% of students without a prior history of chickenpox were vaccinated. Students vaccinated more than than 5 years earlier the outbreak were at chance for breakthrough affliction. Vaccine effectiveness was plant to be 72% (95% confidence interval: iii%–87%).³

New variants of VZV take also been reported recently, including VZV-MSP, isolated in St. Paul–Minneapolis, MN, and VZV-BC, isolated in British Columbia.^5,vi We exercise not know whether at that place is a mutant strain of VZV in India; thus this case could farther assistance us to study epidemiological transition of VZV infection. There are no reported cases of reinfection in India along with quantum Varicella in to the best of our noesis. Widespread utilize of vaccine is probable to change the epidemiological pattern of this disease, shifting information technology from early childhood to adolescents or young adults.^ane

There is a need to behave out studies to establish the consequence of Varicella vaccination and reinfection on the disease design in Indian population.

Conflicts of interest

All authors have none to declare.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529600/

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