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Bolotin S, Osman S, Halperin S, Severini A, Ward BJ, Sadarangani M, Hatchette T, Pebody R, Winter A, De Melker H, Wheeler AR, Brown D, Tunis M, Crowcroft N. Immunity of Canadians and risk of epidemics workshop - Conference report. Vaccine 2023; 41:6775-6781. [PMID: 37827968 DOI: 10.1016/j.vaccine.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 06/07/2023] [Accepted: 07/10/2023] [Indexed: 10/14/2023]
Abstract
On November 18-19, 2019, the Immunity of Canadians and Risk of Epidemics (iCARE) Network convened a workshop in Toronto, Ontario, Canada. The objectives of the workshop were to raise the profile of sero-epidemiology in Canada, discuss best practice and methodological innovations, and strategize on the future direction of sero-epidemiology work in Canada. In this conference report, we describe the presentations and discussions from the workshop, and comment on the impact of the COVID-19 pandemic on serosurveillance initiatives, both in Canada and abroad.
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Affiliation(s)
- Shelly Bolotin
- Centre for Vaccine Preventable Diseases, University of Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, ON, Canada; Public Health Ontario, Toronto, ON, Canada.
| | | | - Scott Halperin
- Canadian Center for Vaccinology, Dalhousie University, Halifax, NS, Canada; Departments of Pediatrics and Microbiology & Immunology, Dalhousie University, Halifax, NS, Canada
| | - Alberto Severini
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MN, Canada; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Brian J Ward
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Todd Hatchette
- Canadian Center for Vaccinology, Dalhousie University, Halifax, NS, Canada; Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, NS, Canada
| | | | - Amy Winter
- University of Georgia, Athens, GA, United States
| | - Hester De Melker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Aaron R Wheeler
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada; Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, Ontario M5S 3E1, Canada
| | - David Brown
- Virus Reference Department, UK Health Security Agency, London, United Kingdom; Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil
| | - Matthew Tunis
- National Advisory Committee on Immunization Secretariat, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Natasha Crowcroft
- Centre for Vaccine Preventable Diseases, University of Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, ON, Canada
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Pan D, Wang W, Cheng T. Current Methods for the Detection of Antibodies of Varicella-Zoster Virus: A Review. Microorganisms 2023; 11:microorganisms11020519. [PMID: 36838484 PMCID: PMC9965970 DOI: 10.3390/microorganisms11020519] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Infection with the varicella-zoster virus (VZV) causes chickenpox and shingles, which lead to significant morbidity and mortality globally. The detection of serum VZV-specific antibodies is important for the clinical diagnosis and sero-epidemiological research of VZV infection, and for assessing the effect of VZV vaccine immunization. Over recent decades, a variety of methods for VZV antibody detection have been developed. This review summarizes and compares the current methods for detecting VZV antibodies, and discussed future directions for this field.
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Widgren K, Persson Berg L, Mörner A, Lindquist L, Tegnell A, Giesecke J, Studahl M. Severe chickenpox disease and seroprevalence in Sweden - implications for general vaccination. Int J Infect Dis 2021; 111:92-98. [PMID: 34380088 DOI: 10.1016/j.ijid.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To describe the current panorama of severe chickenpox disease and seroprevalence in Sweden, as a basis for the approaching decision on universal vaccination. METHODS We included patients discharged with an International Classification of Diseases, 10th revision-code for chickenpox (B01.1-9) in eight pediatric and infectious diseases departments in Stockholm and Gothenburg in 2012-2014 and reviewed their medical charts. Further, residual serum samples collected from 16 laboratories across Sweden were analyzed for varicella zoster IgG-antibodies to investigate the age-specific seroprevalences. RESULTS In all, 218 children and 46 adults were included in the hospital-based study, 87.2% of children and 63.0% of adults had complications. An underlying condition was not associated with an increased risk for complication. In children dehydration (31.7%), bacterial skin infections (29.8%) and neurological involvement (20.6%) were most frequent complications. Among adult cases, 63 % were born abroad. The seroepidemiological analysis included 957 patient samples. Seroprevalence was 66.7% at 5 years and 91.5% at 12 years. Infants and adolescents/adults were overrepresented among admitted patients compared to seroprevalence data. CONCLUSIONS Half of all complications in hospitalized chickenpox cases was seen in previously healthy children, which supports universal childhood vaccination. Adult migrants was a risk group for chickenpox hospitalization. Age-specific seroprevalence was similar to neighboring countries.
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Affiliation(s)
- K Widgren
- Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden; Department of Public Health Analysis and Data Management, the Public Health Agency of Sweden, Solna, Sweden.
| | - L Persson Berg
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A Mörner
- Department of Microbiology, the Public Health Agency of Sweden,Solna, Sweden
| | - L Lindquist
- Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden
| | - A Tegnell
- Department of Public Health Analysis and Data Management, the Public Health Agency of Sweden, Solna, Sweden
| | - J Giesecke
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - M Studahl
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
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von Linstow ML, Yde Nielsen A, Kirkby N, Eltvedt A, Nordmann Winther T, Bybeck Nielsen A, Bang D, Poulsen A. Immunity to vaccine-preventable diseases among paediatric healthcare workers in Denmark, 2019. ACTA ACUST UNITED AC 2021; 26. [PMID: 33928900 PMCID: PMC8086246 DOI: 10.2807/1560-7917.es.2021.26.17.2001167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Healthcare workers (HCW) have been identified as index cases in disease outbreaks of vaccine-preventable diseases (VPD) in hospitals. Aim We investigated whether Danish paediatric HCW were protected against selected serious VPD. Methods We included 90% of staff members from two paediatric departments. All 555 HCW (496 women) supplied a blood sample for serology and filled in a questionnaire. Antibodies were measured with enzyme immunoassay against measles, mumps, rubella (MMR), varicella zoster, pertussis toxin and diphtheria toxin. Results Protective levels of IgG were found for measles (90.3%), mumps (86.5%), rubella (92.3%), varicella (98.6%) and diphtheria (80.5%). We found seropositivity for all three MMR components in 421 (75.9%) HCW, lowest in those younger than 36 years (63.3%). Only 28 (5%) HCW had measurable IgG to pertussis. HCW with self-reported immunity defined as previous infection or vaccination, had protective levels of IgG against measles, mumps, rubella and varicella in 87.4–98.8% of cases, not significantly higher than in those not reporting immunity. Previous history of disease had a high positive predictive value (PPV) of 96.8–98.8%. The PPV for previous vaccination ranged from 82.5% to 90.3%. In contrast, negative predictive values of self-reported history of disease and vaccination were remarkably low for all diseases. Conclusion The immunity gaps found primarily in young HCW indicate a need for a screening and vaccination strategy for this group. Considering the poor correlation between self-reported immunity and seropositivity, efforts should be made to check HCW’s immune status in order to identify those who would benefit from vaccination.
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Affiliation(s)
- Marie-Louise von Linstow
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Alex Yde Nielsen
- Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nikolai Kirkby
- Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Anna Eltvedt
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark
| | - Thilde Nordmann Winther
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Allan Bybeck Nielsen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Didi Bang
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark
| | - Anja Poulsen
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Liu Q, Yu J, Wei J, Zhang H, Jin J, Zheng W, Ruan Y, Yu J, Chen Y. Uptrend prevalence of varicella parallel with low serum antibodies and low second-dose rate among children 10-14 years old in Wenzhou, China. Hum Vaccin Immunother 2021; 17:363-371. [PMID: 32614651 DOI: 10.1080/21645515.2020.1775458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
In recent years, the incidence of varicella cases is rising, and outbreaks of varicella are frequently being reported worldwide. Our study aims to analyze the association between the varicella incidence and serum antibody level in the post-vaccine era. We retrieved and analyzed the incidence and prevalence data for children age 1-14 years in Wenzhou, China during 2010-2018. A cross-sectional seroepidemiology analysis was carried out in a series of 168 general healthy children age 1-14 years as well as children at a varicella outbreak in Wenzhou. Our data showed a significant surge in the incidence and prevalence of varicella in children aged 10-14 years in 2017 and 2018 while they were kept relatively stable in 2010-2016. The seroepidemiological analysis revealed a 7.3-fold significantly higher level of serum varicella IgG in healthy control students who exposed at the outbreak than that in general healthy children (median 523.5 vs. 71.7 mIU/mL, p < .01). The children 10-14 years old had the lowest rate of second-dose vaccination among the three age classes (7%, 41%, and 65% in 10-14, 5-9, and 2-4 age class, respectively), and children 5-9 years old who received the second dose had a higher level of serum protective IgG than those who did not (254.7 vs 98 mIU/mL, p = .06). The findings from the present study warn a two-dose vaccine schedule to reduce the climbing incidence and prevalence observed in the older children and suggest a higher serum IgG threshold for effective protection of children from the varicella outbreak.
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Affiliation(s)
- Qi Liu
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jiake Yu
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jingjiao Wei
- Wenzhou Division, Zhejiang Center for Disease Control and Prevention , Wenzhou, Zhejiang, China
| | - Hu Zhang
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jie Jin
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Weikun Zheng
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Yufei Ruan
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jinsheng Yu
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Yiping Chen
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
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Feyssaguet M, Berthold V, Helle L, Povey M, Ravault S, Carryn S, Gillard P, Di Paolo E. Comparison of a glycoprotein E-based ELISA with a varicella-zoster whole-virus ELISA for the quantification of varicella vaccine immune responses in young children. Vaccine 2020; 38:3300-3304. [DOI: 10.1016/j.vaccine.2020.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/25/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022]
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Calibration and Evaluation of Quantitative Antibody Titers for Varicella-Zoster Virus by Use of the BioPlex 2200. J Clin Microbiol 2019; 57:JCM.00296-19. [PMID: 31167847 PMCID: PMC6663917 DOI: 10.1128/jcm.00296-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/28/2019] [Indexed: 01/30/2023] Open
Abstract
Most commercially available enzyme immunoassay-based methods have limited sensitivity to detect antibody responses to varicella-zoster virus (VZV) in vaccinated individuals, who produce lower antibody levels than those with natural infection. However, more sensitive methods are either not commercially available or less amenable to high-throughput testing. Most commercially available enzyme immunoassay-based methods have limited sensitivity to detect antibody responses to varicella-zoster virus (VZV) in vaccinated individuals, who produce lower antibody levels than those with natural infection. However, more sensitive methods are either not commercially available or less amenable to high-throughput testing. The BioPlex 2200 measles, mumps, rubella, and varicella (MMRV) IgG assay (Bio-Rad Laboratories, Hercules, CA) is an automated high-throughput platform based on the microsphere Luminex technology that measures antibodies against measles, mumps, rubella, and varicella viruses simultaneously. Although it has U.S. Food and Drug Administration approval as a qualitative diagnostic test for measles, mumps, rubella, and varicella virus immunity, in this study, we have validated the assay to produce quantitative titers (off label) against the VaccZyme VZV glycoprotein (VZVgp) low-level IgG kit (The Binding Site Ltd., Birmingham, UK) using the World Health Organization international standard. Here, we show that the BioPlex 2200 MMRV IgG assay has sensitivity superior to that of the Zeus enzyme-linked immunosorbent assay (ELISA) VZV IgG assay (Zeus Diagnostics, Branchburg, NJ). Using receiver operating characteristic (ROC) analysis and adjusting the cutoff levels, we improved the sensitivity of the quantitative BioPlex 2200 MMRV IgG assay to 97.4%, while maintaining 100% specificity.
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Medić S, Petrović V, Milosević V, Lozanov-Crvenković Z, Brkić S, Andrews N, de Ory F, Anastassopoulou C. Seroepidemiology of varicella zoster virus infection in Vojvodina, Serbia. Epidemiol Infect 2018; 146:1593-1601. [PMID: 29909816 PMCID: PMC9507937 DOI: 10.1017/s0950268818001619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/01/2018] [Accepted: 05/18/2018] [Indexed: 01/30/2023] Open
Abstract
The present cross-sectional serosurvey constitutes the first effort to describe the varicella zoster virus (VZV) seroepidemiology in Serbia. An age-stratified serum bank of 3570 residual samples collected between 2015 and 2016 in each of the seven districts of the Vojvodina Province was tested for IgG anti-VZV antibodies with an enzyme immunoassay. Results were standardised into common units according to the European Sero-Epidemiology Network (ESEN2) methodology. Univariable and multivariable analyses were used to examine the relationships between standardised anti-VZV positivity or logarithmically transformed antibody titres and demographic features of study subjects. Seropositivity (85% overall) increased with age, in parallel with geometric mean titres. By the time of school entry, 68% of children were immune. The slower subsequent acquisition of immunity leaves epidemiologically relevant proportions of adolescents (7%), young adults (6%) and especially females of reproductive age (6%) prone to more severe forms of varicella. In the ongoing pre-vaccine era, natural infection provides a high level of collective immunity, with the highest VZV transmission in children of preschool age. The detected gaps in VZV immunity of the Serbian population support the adoption of the official recommendations for varicella immunisation of non-immune adolescents and young adults, including non-pregnant women of childbearing age.
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Affiliation(s)
- S. Medić
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - V. Petrović
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - V. Milosević
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Z. Lozanov-Crvenković
- Department of Mathematics and Informatics, Faculty of Sciences, University of Novi Sad, Novi Sad, Serbia
| | - S. Brkić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Infectious Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - N. Andrews
- Statistics, Modelling, and Economics Department, National Infections Service, Public Health England, London, UK
| | - F. de Ory
- Laboratorio de Serología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - C. Anastassopoulou
- Division of Genetics, Cell and Developmental Biology, Department of Biology, University of Patras, Patras, Greece
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Gouveia-Alves F, Gouveia R, Ginani VC, Seber A, Kuramoto DA, Murad GFA, Spina FG, Petrilli AS, Zecchin VG, Granato C, Carlesse F, de Moraes-Pinto MI. Adherence and immune response to revaccination following hematopoietic stem cell transplantation at a pediatric onco-hematology reference center. Transpl Infect Dis 2018; 20:e12903. [PMID: 29668078 DOI: 10.1111/tid.12903] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 03/14/2018] [Accepted: 03/18/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Revaccination after hematopoietic stem cell transplantation (HSCT) is necessary to compensate for the loss of immunological memory. The aims of this study were to evaluate the adherence to revaccination schedule and the humoral immune response to different vaccine antigens in HSCT pediatric and young adult patients. METHODS Patients submitted to HSCT for over 3 years were recruited. After written informed consent, a questionnaire was filled in, the vaccination card was analyzed, a blood sample was collected and tested by ELISA for diphtheria, Haemophilus influenzae type b (Hib), hepatitis A, hepatitis B, tetanus, measles, rubella, and varicella antibodies. RESULTS Sixty-three patients (mean age at HSCT, 10.7 years) were evaluated. Forty-one (65%) were male; 34 (54%) had allogeneic and 29 (46%), autologous HSCT. Complete adherence to diphtheria revaccination was found in 79.4% patients and seropositivity was found in 92% of those who completed the revaccination schedule; for Hib, 68.3% adherence and 95.3% seropositivity were observed; for hepatitis A, 63.5% adherence and 92.5% seropositivity; for 3 doses of hepatitis B, 86.8% adherence and 79.2% seropositivity; for tetanus, 79.4% adherence and 100% seropositivity; for measles and rubella, 17.5% adherence and 100% seropositivity; for varicella, 7.9% adherence and 100% seropositivity. The existence of a Vaccination Center for Special Immunobiologicals in patients' municipality was positively associated with completed vaccine schedule; on the other hand, chronic GVHD was negatively associated with revaccination adherence. CONCLUSION Hematopoietic stem cell transplantation patients showed good seropositivity rates after complete vaccination schedule. However, a low coverage rate was observed for live attenuated antigens.
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Affiliation(s)
| | | | | | | | - Danielle A Kuramoto
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriel F A Murad
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fernanda G Spina
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Antonio S Petrilli
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Victor G Zecchin
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Celso Granato
- Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.,Fleury Group, São Paulo, Brazil
| | - Fabianne Carlesse
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
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Medić S, Katsilieris M, Lozanov-Crvenković Z, Siettos CI, Petrović V, Milošević V, Brkić S, Andrews N, Ubavić M, Anastassopoulou C. Varicella zoster virus transmission dynamics in Vojvodina, Serbia. PLoS One 2018; 13:e0193838. [PMID: 29505590 PMCID: PMC5837184 DOI: 10.1371/journal.pone.0193838] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/19/2018] [Indexed: 01/29/2023] Open
Abstract
This study aimed at establishing baseline key epidemiological parameters for varicella zoster virus (VZV) infection in Vojvodina, Serbia, with the ultimate goal to quantify the VZV transmission potential in the population. Seroprevalence data generated during the first large cross-sectional VZV serosurvey were modelled, using a two-tiered modelling approach to calculate age-specific forces of infection (FOI), the basic reproduction number (R0) and herd immunity threshold (H). Seroprevalence and modelling data were compared with corresponding pre-vaccination epidemiological parameters from 11 countries participating in the European Sero-Epidemiology Network 2 (ESEN2) project. Serbia fits into the general dynamic VZV transmission patterns in Europe in the pre-vaccine era, with estimated R0 = 4.12, (95% CI: 2.69–7.07) and H = 0.76 (95% CI: 0.63–0.86). The highest VZV transmission occurs among preschool children, as evidenced by the estimation of the highest FOI (0.22, 95% CI: 0.11–0.34) in the 0.5–4 age group, with a peak FOI of 0.25 at 2.23 years. Seroprevalence was consistently lower in 5–14 year-olds, resulting in considerable shares of VZV-susceptible adolescents (7.3%), and young adults (6%), resembling the situation in a minority of European countries. The obtained key epidemiological parameters showed most intense VZV transmission in preschool children aged <4 years, justifying the consideration of universal childhood immunization in the future. National immunization strategy should consider programs for VZV serologic screening and immunization of susceptible groups, including adolescents and women of reproductive age. This work is an important milestone towards the evaluation of varicella immunization policy options in Serbia.
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Affiliation(s)
- Snežana Medić
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- * E-mail:
| | - Michalis Katsilieris
- School of Applied Mathematics and Physical Sciences, National Tehnical University of Athens, Athens, Greece
| | - Zagorka Lozanov-Crvenković
- Department of Mathematics and Computer Science, Faculty of Science, University of Novi Sad, Novi Sad, Serbia
| | - Constantinos I. Siettos
- School of Applied Mathematics and Physical Sciences, National Tehnical University of Athens, Athens, Greece
| | - Vladimir Petrović
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vesna Milošević
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Snežana Brkić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Infectious Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Nick Andrews
- Statistics, Modelling, and Economics Department, National Infections Services, Public Health England, London, United Kingdom
| | | | - Cleo Anastassopoulou
- Division of Genetics, Cell and Developmental Biology, Department of Biology, University of Patras, Patras, Greece
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Ferreira CSM, Perin MCAA, Moraes-Pinto MID, Simão-Gurge RM, Goulart AL, Weckx LY, dos Santos AMN. Humoral immune response to measles and varicella vaccination in former very low birth weight preterm infants. Braz J Infect Dis 2018; 22:41-46. [PMID: 29306654 PMCID: PMC9425665 DOI: 10.1016/j.bjid.2017.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 12/19/2017] [Indexed: 11/01/2022] Open
Abstract
Introduction Objectives Methods Results Conclusions
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12
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De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World J Virol 2016; 5:97-124. [PMID: 27563537 PMCID: PMC4981827 DOI: 10.5501/wjv.v5.i3.97] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/08/2016] [Accepted: 07/22/2016] [Indexed: 02/05/2023] Open
Abstract
Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.
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Nobre FA, Gonzalez IGDS, de Moraes-Pinto MI, Costa-Carvalho BT. PROTECTIVE LEVELS OF VARICELLA-ZOSTER ANTIBODY DID NOT EFFECTIVELY PREVENT CHICKENPOX IN AN X-LINKED AGAMMAGLOBULINEMIA PATIENT. Rev Inst Med Trop Sao Paulo 2016; 57:455-7. [PMID: 26603238 PMCID: PMC4660460 DOI: 10.1590/s0036-46652015000500017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/27/2015] [Indexed: 12/18/2022] Open
Abstract
We describe the case of an eight-year-old boy with X-linked agammaglobulinemia who developed mild varicella despite regular intravenous immunoglobulin (IVIG) therapy. He maintained protective antibody levels against varicella and the previous batches of IVIG that he received had adequate varicella-specific IgG levels. The case illustrates that IVIG may not prevent VZV infection.
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Affiliation(s)
- Fernanda Aimée Nobre
- Departmento de Pediatria, Universidade Federal de São Paulo, São Paulo, SP, Brasil, ; ; ;
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Minden K, Speth F, Huppertz HI, Borte M. [Immunization in children and adolescents with rheumatic and musculoskeletal diseases]. Z Rheumatol 2015; 73:878-89. [PMID: 25479932 DOI: 10.1007/s00393-014-1396-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children and adolescents with inflammatory rheumatic diseases have a disease and treatment-related increased risk of infections. This risk includes vaccine-preventable diseases; therefore, vaccinations represent an important preventive measure against infection in these patients. However, approximately one in three patients with a juvenile rheumatic disease is nowadays still inadequately vaccinated, mostly due to uncertainty regarding the efficacy and safety of vaccination in these patients. OBJECTIVES This paper summarizes the available evidence regarding the efficacy and safety of vaccinations in children and adolescents with rheumatic diseases and gives recommendations for the clinical practice. RESULTS AND PERSPECTIVES Almost 2000 children and adolescents with rheumatic diseases were examined in the more than 30 previously published vaccination studies, comprising nearly all standard vaccinations in the immunization schedule. The immunogenicity was usually sufficient and there was no evidence of a relevant aggravation of the underlying disease. Recommendations for the clinical practice are given also considering data beyond pediatric rheumatology; however, a final benefit-risk assessment is not yet possible.
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Affiliation(s)
- K Minden
- Universitätskinderklinik Charité, Campus Virchow, Otto-Heubner-Centrum, SPZ, Deutsches Rheuma-Forschungszentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland,
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Maternally acquired IgG immunity in neonates born to renal transplanted women. Vaccine 2015; 33:3104-9. [DOI: 10.1016/j.vaccine.2015.04.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/17/2015] [Accepted: 04/30/2015] [Indexed: 01/18/2023]
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Abdel-Aziz M, Azab NA, Khalifa B, Rashed M, Naguib N. The association of Varicella zoster virus reactivation with Bell's palsy in children. Int J Pediatr Otorhinolaryngol 2015; 79:328-31. [PMID: 25599860 DOI: 10.1016/j.ijporl.2014.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/03/2014] [Accepted: 12/09/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Bell's palsy is considered the most common cause of facial nerve paralysis in children. Although different theories have been postulated for its diagnosis, reactivation of the Varicella zoster virus (VZV) has been implicated as one of the causes of Bell's palsy. The aim of the study was to evaluate the association of Varicella-zoster virus infection with Bell's palsy and its outcome in children. METHODS A total of 30 children with Bell's palsy were recruited and were assayed for evidence of VZV infection. The severity of facial nerve dysfunction and the recovery rate were evaluated according to House-Brackmann Facial Nerve Grading Scale (HB FGS). Paired whole blood samples from all patients were obtained at their initial visit and 3 weeks later, and serum samples were analyzed for VZV IgG and IgM antibodies using ELISA. RESULTS A significantly higher percentage of Bell's palsy patients were seropositive for VZV IgM antibodies than controls (36.6% of patients vs 10% of controls) while for VZV IgG antibodies the difference was statistically nonsignificant. HB FGS in Bell's palsy patients with serologic evidence of VZV recent infection or reactivation showed a statistiacally significant less cure rate than other patients. CONCLUSIONS VZV reactivation may be an important cause of acute peripheral facial paralysis in children. The appropriate diagnosis of VZV reactivation should be done to improve the outcome and the cure rate by the early use of antiviral treatment.
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Affiliation(s)
| | - Noha A Azab
- Department of Rheumatology and Rehabilitation, Cairo University, Cairo, Egypt
| | - Badwy Khalifa
- Department of Otolaryngology, Cairo University, Cairo, Egypt
| | - Mohammed Rashed
- Department of Otolaryngology, Beni Suef University, Beni Suef, Egypt
| | - Nader Naguib
- Department of Otolaryngology, Beni Suef University, Beni Suef, Egypt
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Estimating seroprevalence of vaccine-preventable infections: is it worth standardizing the serological outcomes to adjust for different assays and laboratories? Epidemiol Infect 2014; 143:2269-78. [PMID: 25420586 DOI: 10.1017/s095026881400301x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The aim of the European Sero-Epidemiology Network 2 (ESEN2) project was to estimate age-specific seroprevalence for a number of vaccine-preventable diseases in Europe. To achieve this serosurveys were collected by 22 national laboratories. To adjust for a variety of laboratory methods and assays, all quantitative results were transformed to a reference laboratory's units and were then classified as positive or negative to obtain age-specific seroprevalence. The aim of this study was to assess the value of standardization by comparing the crude and standardized seroprevalence estimates. Seroprevalence was estimated for measles, mumps, rubella, diphtheria, varicella zoster and hepatitis A virus (HAV) and compared before and after serological results had been standardized. The results showed that if no such adjustment had taken place, seroprevalence would have differed by an average of 3·2% (95% bootstrap interval 2·9-3·6) although this percentage varied substantially by antigen. These differences were as high as 16% for some serosurveys (HAV) which means that standardization could have a considerable impact on seroprevalence estimates and should be considered when comparing serosurveys performed in different laboratories using different assay methods.
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Nobre FA, Gonzalez IGDS, Simão RM, de Moraes Pinto MI, Costa-Carvalho BT. Antibody levels to tetanus, diphtheria, measles and varicella in patients with primary immunodeficiency undergoing intravenous immunoglobulin therapy: a prospective study. BMC Immunol 2014; 15:26. [PMID: 24952415 PMCID: PMC4074853 DOI: 10.1186/1471-2172-15-26] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/09/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Patients with antibody deficiencies depend on the presence of a variety of antibody specificities in intravenous immunoglobulin (IVIG) to ensure continued protection against pathogens. Few studies have examined levels of antibodies to specific pathogens in IVIG preparations and little is known about the specific antibody levels in patients under regular IVIG treatment. The current study determined the range of antibodies to tetanus, diphtheria, measles and varicella in IVIG products and the levels of these antibodies in patients undergoing IVIG treatment. METHODS We selected 21 patients with primary antibody deficiencies who were receiving regular therapy with IVIG. Over a period of one year, we collected four blood samples from each patient (every 3 months), immediately before immunoglobulin infusion. We also collected samples from the IVIG preparation the patients received the month prior to blood collection. Antibody levels to tetanus, diphtheria, measles and varicella virus were measured in plasma and IVIG samples. Total IgG levels were determined in plasma samples. RESULTS Antibody levels to tetanus, diphtheria, varicella virus and measles showed considerable variation in different IVIG lots, but they were similar when compared between commercial preparations. All patients presented with protective levels of antibodies specific for tetanus, measles and varicella. Some patients had suboptimal diphtheria antibody levels. There was a significant correlation between serum and IVIG antibodies to all pathogens, except tetanus. There was a significant correlation between diphtheria and varicella antibodies with total IgG levels, but there was no significant correlation with antibodies to tetanus or measles. CONCLUSIONS The study confirmed the variation in specific antibody levels between batches of the same brand of IVIG. Apart from the most common infections to which these patients are susceptible, health care providers must be aware of other vaccine preventable diseases, which still exist globally.
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Affiliation(s)
- Fernanda Aimée Nobre
- Federal University of Sao Paulo, Rua dos Otonis, 731, CEP: 04025-002 São Paulo, Brazil.
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Kim YH, Hwang JY, Shim HM, Lee E, Park S, Park H. Evaluation of a commercial glycoprotein enzyme-linked immunosorbent assay for measuring vaccine immunity to varicella. Yonsei Med J 2014; 55:459-66. [PMID: 24532518 PMCID: PMC3936636 DOI: 10.3349/ymj.2014.55.2.459] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To evaluate a recently marketed commercial glycoprotein enzyme-linked immunosorbent assay (gpEIA) kit, the VaccZyme™ VZV gpEIA, for measuring the immunity of varicella-vaccinated children. MATERIALS AND METHODS We investigated the accuracy and reproducibility of the VaccZyme™ VZV gpEIA kit for the detection of antibodies to VZV. We also examined the sensitivity, specificity, and correlation between antibody titers calculated with gpEIA versus fluorescent antibody to membrane antigen (FAMA) by using sera of 349 children, ranging from 1 to 6 years old. RESULTS VaccZyme™ VZV gpEIA gave precise and reproducible intra- and inter-assay results. FAMA and gpEIA titers showed a linear correlation (Pearson correlation coefficient=0.987). The sensitivity and specificity of the VaccZyme™ gpEIA was 31.4% and 100%, respectively, when the guidelines of the gpEIA (<100 mIU/mL) and FAMA 1:4 were adopted as cutoff values. However, the maximum sensitivity and specificity were 88.9% and 95.1%, respectively, with the highest correlation (κ=0.840), if the cutoff values were set with gpEIA at 49.7 mIU/mL and FAMA 1:16. CONCLUSION These results demonstrate that the VaccZyme™ VZV gpEIA kit gave precise and reproducible data for measuring antibody titer after varicella vaccination. The results also showed that the antibody titer calculated with the VaccZyme™ gpEIA kit strongly correlated with the FAMA titer. However, cutoff values should be re-optimized for the evaluation of vaccine immunity.
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Affiliation(s)
- Yun Hwa Kim
- Department of Microbiology, College of Medicine, Yeungnam University, 170 Hyeonchung-ro, Nam-gu, Daegu 705-703, Korea.
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Abstract
This study was designed to assess the immune status of the Korean population against varicella-zoster virus (VZV) through a seroepidemiologic study. Residual blood samples were collected from diagnostic laboratories throughout Korea. Samples were collected in October 2009 to March 2010 from persons 0-79 yr of age and were tested by ELISA (Enzygnost®; Dade Behring, Schwalbach, Germany). Total seroprevalence in subjects 1-79 yr of age was 89.6%. Seroprevalence increased as age increased from 67.3% in subjects 1-4 yr of age to 94.2% in subjects 10-14 yr of age and in subjects over 20 yr of age seroprevalence ranged from 98.0% to 100%. In children under 1 yr of age, passive immunity waned after birth with none of the subjects having antibodies from 7 months of age and over. Among subjects 1-79 yr of age, susceptible subjects to VZV were mainly under 20 yr of age. These results provide information in understanding the dynamics of varicella disease in Korea, which is important in building up strategies for disease control.
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Affiliation(s)
- Hyunju Lee
- Department of Pediatrics, School of Medicine, Ewha Womans University, and Center for Vaccine Evaluation and Study, Ewha Medical Research Institute, Seoul, Korea
| | - Hye Kyung Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, and Center for Vaccine Evaluation and Study, Ewha Medical Research Institute, Seoul, Korea
| | - Kyung-Hyo Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, and Center for Vaccine Evaluation and Study, Ewha Medical Research Institute, Seoul, Korea
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Ward K, Dey A, Hull B, Quinn HE, Macartney K, Menzies R. Evaluation of Australia's varicella vaccination program for children and adolescents. Vaccine 2013; 31:1413-9. [DOI: 10.1016/j.vaccine.2012.12.052] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 12/13/2012] [Accepted: 12/17/2012] [Indexed: 11/24/2022]
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Guido M, Tinelli A, De Donno A, Quattrocchi M, Malvasi A, Campilongo F, Zizza A. Susceptibility to varicella-zoster among pregnant women in the province of Lecce, Italy. J Clin Virol 2011; 53:72-6. [PMID: 22074933 DOI: 10.1016/j.jcv.2011.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/21/2011] [Accepted: 10/14/2011] [Indexed: 01/30/2023]
Abstract
BACKGROUND Varicella is predominantly a childhood disease, considered a mild self-limiting disease that can have serious complications for a pregnant woman and her developing fetus. OBJECTIVES We investigated the susceptibility to varicella-zoster Virus (VZV) among pregnant women in the province of Lecce. STUDY DESIGN A cross-sectional study was carried out in Departments of Gynecology and Obstetrics of the Province of Lecce, where 539 pregnant women were recruited, and face-to-face interviews were conducted. Varicella IgG tests were performed. RESULTS The prevalence of varicella susceptibility among pregnant mothers was 10.6%. The prevalence of IgG antibodies increases significantly with increasing age, from 62.5% in the age group 15-19 years to 94.4% in the age group 40-49 years. DISCUSSION In the Italian National Vaccination Plan 2005-2007, varicella vaccine is only recommended for childbearing women. A safe and effective vaccine is available and no abnormalities have been observed among infants born to susceptible women who received varicella vaccines during pregnancy. Such a high number of susceptible women indicates that preventive and informative programs should be introduced, even among those who do not plan to become pregnant. Routine counselling, varicella IgG antibody screening and varicella vaccination should be considered if they have no history of the infection, to reduce the risk of fetal complications and the cost of healthcare associated with the infection.
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Affiliation(s)
- M Guido
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
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Comparative study of the standard fluorescent antibody to membrane antigen (FAMA) assay and a flow cytometry-adapted FAMA assay to assess immunity to varicella-zoster virus. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1194-7. [PMID: 21613463 DOI: 10.1128/cvi.05130-11] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A flow cytometry-adapted fluorescent antibody to membrane antigen (FAMA) assay to detect IgG antibodies against varicella-zoster virus (VZV) was developed and tested in 62 serum samples, showing 90.32% accuracy obtained from a receiver operating characteristic (ROC) curve with a 0.9125 (95% confidence interval [CI], 0.829 to 1.00) area below the curve compared to the result with standard FAMA.
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Kim YH, Hwang JY, Lee KM, Choi JH, Lee TY, Choi JS, Park HS. Seroepidemiologic survey of varicella-zoster virus in korean adults using glycoprotein enzyme immuno assay and fluorescent antibody to membrane antigen test. Ann Dermatol 2011; 23:39-43. [PMID: 21738361 DOI: 10.5021/ad.2011.23.1.39] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 10/05/2010] [Accepted: 10/05/2010] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Herpes zoster (HZ) occurs mainly in the elderly and Korea is rapidly becoming an aging society. Therefore, it is important to know the immune status against varicella-zoster virus (VZV) in Korean adults to prevent the disease. OBJECTIVE The aim of this study was to survey the immune status of Korean adults over 40 years of age against VZV. METHODS Antibody titer was measured using a VaccZyme™ VZV glycoprotein enzyme immunoassay (gpEIA) (Binding Site, UK). Fluorescent antibody to membrane antigen (FAMA) test was performed to measure the seropositive rate. RESULTS HZ incidence in the 214 adults enrolled in this study was 10.3%. The gpEIA geometric mean titer (GMT) was 490 mIU/ml and 90.2% of the subjects had a protective level of gpEIA antibody titer against varicella. The average gpEIA GMT of adults who previously had HZ was 1,122 mIU/ml, which was higher than the average gpEIA GMT of 457 mIU/ml in adults who had not had HZ. The FAMA positive rate was 98.6%. CONCLUSION Most (90.2%) Korean adults ≥40-years-of-age have a protective level of gpEIA antibody against varicella and 98.6% were FAMA seropositive. The GMT of gpEIA antibody was significantly increased with age, and was higher in adults with a history of HZ.
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Affiliation(s)
- Yun Hwa Kim
- Department of Microbiology, College of Medicine, Yeungnam University, Daegu, Korea
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Pileggi GS, de Souza CBS, Ferriani VPL. Safety and immunogenicity of varicella vaccine in patients with juvenile rheumatic diseases receiving methotrexate and corticosteroids. Arthritis Care Res (Hoboken) 2010; 62:1034-9. [PMID: 20235203 DOI: 10.1002/acr.20183] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the safety and immunogenicity of varicella vaccine (VV) in susceptible patients with juvenile rheumatic diseases receiving methotrexate and corticosteroids. METHODS Twenty-five patients with juvenile rheumatic diseases (ages 2-19 years) and 18 healthy children and adolescents (ages 3-18 years) received a single dose of VV. All 25 patients were receiving methotrexate; 13 were also receiving prednisone and 5 were also receiving other disease-modifying antirheumatic drugs. None of the vaccinated patients or controls had a previous history of varicella. Anti-varicella-zoster virus IgG antibody (anti-VZV-IgG) titers were measured by enzyme-linked immunosorbent assay immediately before, 4-6 weeks after, and 1 year after vaccination. The patients were monitored prospectively for adverse reactions related to the vaccine, exposure, and occurrence of varicella. Disease activity was assessed 3 months before and 3 months after VV. RESULTS Twenty patients and all of the controls had negative preimmunization titers of VZV-IgG, and 5 patients had equivocal levels. Positive VZV-IgG titers were detected in 10 (50%) of 20 seronegative patients and 13 (72.2%) of 18 controls 4-6 weeks after VV (P = 0.2). One year after vaccination, 8 of 10 patients maintained positive VZV-IgG titers. No overt varicella episodes and no severe adverse reactions were observed during the followup period. No worsening of clinical parameters and no flares of juvenile rheumatic diseases or changes in doses of medications used were detected after vaccination. In fact, the number of active joints in patients with juvenile idiopathic arthritis was significantly lower after VV (P = 0.009). CONCLUSION VV appears to be safe in patients with juvenile rheumatic diseases receiving methotrexate, as long as continuous prospective vigilance for side effects is performed.
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Ceroni A, Sibani S, Baiker A, Pothineni VR, Bailer SM, LaBaer J, Haas J, Campbell CJ. Systematic analysis of the IgG antibody immune response against varicella zoster virus (VZV) using a self-assembled protein microarray. MOLECULAR BIOSYSTEMS 2010; 6:1604-10. [PMID: 20514382 DOI: 10.1039/c003798b] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Varicella zoster virus (VZV) is a human herpesvirus encoding at least 69 distinct viral proteins which causes chickenpox after primary infection and shingles during reactivation and which is particularly important in pregnancy and immunocompromised patients. Current serodiagnostic tests are either based on whole cell lysates or glycoprotein preparations. In order to investigate the humoral immune response to VZV infection or vaccination in more detail, and to improve the currently available diagnostic assays, we developed a nucleic acid programmable protein array (NAPPA) containing all 69 VZV proteins and performed a detailed analysis of 68 sera from individuals with either no, a previous or an acute VZV infection. In addition to the known reactive glycoprotein antigens (ORF 5, ORF 14, ORF 31, ORF 37, ORF 68), we discovered IgG antibodies against a variety of other membrane (ORF 2, ORF 24), capsid (ORF 20, ORF 23, ORF 43) and tegument (ORF 53, ORF 9, ORF 11) proteins, as well as other proteins involved in virus replication and assembly (ORF 25, ORF 26, ORF 28) and the transactivator proteins ORF 12, ORF 62 and ORF 63. All of these antigens were only reactive in a subset of VZV-positive individuals. A subset of the newly identified VZV antigens was validated by western blot analysis. Using these seroreactive new VZV antigens, more sensitive assays and tests distinguishing between different clinical entities may be developed.
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Affiliation(s)
- Alessandro Ceroni
- Division of Pathway Medicine, University of Edinburgh, 49 Little France Crescent, Edinburgh, UK EH16 4SB
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Chris Maple PA, Gunn A, Sellwood J, Brown DWG, Gray JJ. Comparison of fifteen commercial assays for detecting Varicella Zoster virus IgG with reference to a time resolved fluorescence immunoassay (TRFIA) and the performance of two commercial assays for screening sera from immunocompromised individuals. J Virol Methods 2008; 155:143-9. [PMID: 18996415 DOI: 10.1016/j.jviromet.2008.09.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 09/23/2008] [Accepted: 09/29/2008] [Indexed: 01/30/2023]
Abstract
The performance of fifteen, commercially available, VZV IgG assays and an "in house" indirect immunofluorescence (IF) assay has been compared to a reference VZV IgG time resolved immunofluorescence assay (VZV TRFIA). A panel of 273 VZV TRFIA IgG positive serum samples and 136 VZV TRFIA IgG susceptible sera, collected from a number of UK hospitals was used. Irrespective of the interpretation of equivocal results the most sensitive assays were Dade Behring EIA (97.4%), "in house" IF (95.2%), Human EIA (92.3%) and Becton Dickinson latex agglutination (94.1%). The least sensitive assays were Virion EIA (69.6%), Diesse EIA (68.9%) and Diasys EIA (68.5%). The least sensitive (<70%) assays all had >99.0% specificity whereas the most sensitive assays had lower specificities; for example, Dade Behring EIA had a specificity of 69.9% when equivocals were treated as VZV IgG negative. For some assays e.g. Dade Behring EIA there were major discrepancies between our findings and those reported by the manufacturer which may reflect the constitution of the panel(s) of sera used for evaluation or the reference method adopted or the choice of cut-off criteria (particularly relevant to our findings for the Behring EIA). Care must be taken to choose an assay with high specificity in order to accurately assess the need for vaccination or immunoprophylaxis; however, high sensitivity is preferable to prevent inappropriate and expensive treatment.
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Affiliation(s)
- P A Chris Maple
- Virus Reference Department, Health Protection Agency Centre for Infections, Colindale, London NW9 5HT, UK.
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Abstract
Varicella-zoster virus (VZV) is a herpesvirus and is the causative agent of chicken pox (varicella) and shingles (herpes zoster). Active immunization against varicella became possible with the development of live attenuated varicella vaccine. The Oka vaccine strain was isolated in Japan from a child who had typical varicella, and it was then attenuated by serial passages in cell culture. Several manufacturers have obtained this attenuated Oka strain and, following additional passages, have developed their own vaccine strains. Notably, the vaccines Varilrix and Varivax are produced by GlaxoSmithKline Biologicals and Merck & Co., Inc., respectively. Both vaccines have been well studied in terms of safety and immunogenicity. In this study, we report the complete nucleotide sequence of the Varilrix (Oka-V(GSK)) and Varivax (Oka-V(Merck)) vaccine strain genomes. Their genomes are composed of 124,821 and 124,815 bp, respectively. Full genome annotations covering the features of Oka-derived vaccine genomes have been established for the first time. Sequence analysis indicates 36 nucleotide differences between the two vaccine strains throughout the entire genome, among which only 14 are involved in unique amino acid substitutions. These results demonstrate that, although Oka-V(GSK) and Oka-V(Merck) vaccine strains are not identical, they are very similar, which supports the clinical data showing that both vaccines are well tolerated and elicit strong immune responses against varicella.
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The European Sero-Epidemiology Network 2 (ESEN2): standardization of assay results for hepatitis A virus (HAV) to enable comparisons of seroprevalence data across 15 countries. Epidemiol Infect 2008; 137:485-94. [DOI: 10.1017/s0950268808001155] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYThe European Sero-Epidemiology Network 2 (ESEN2) aimed to compare serological results of vaccine-preventable diseases across Europe. To ensure direct inter-country comparability of hepatitis A virus antibody (anti-HAV) measurements, a standardization panel of 150 sera was developed by a designated reference laboratory and tested by participating national laboratories using assays of choice; each country's results were subsequently regressed against those of the reference laboratory. Quantitatively, the assays were generally highly correlated (R2>0·90). Nevertheless, qualitative comparisons indicated that results obtained with different assays may differ despite the usage of well-established international and local standards. To a great extent standardization successfully alleviated such differences. The generated standardization equations will be used to convert national serological results into common units to enable direct international comparisons of HAV seroprevalence data. The results of this study are expected to contribute to the evaluation and potential improvement of the currently employed immunization strategies for hepatitis in Europe.
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European Sero-Epidemiology Network 2: standardisation of immunoassay results for pertussis requires homogeneity in the antigenic preparations. Vaccine 2008; 26:4486-93. [PMID: 18602434 DOI: 10.1016/j.vaccine.2008.06.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Revised: 05/30/2008] [Accepted: 06/13/2008] [Indexed: 11/22/2022]
Abstract
A standardisation process, already developed during the earlier European Sero-Epidemiology Network (ESEN) project, was employed with a more robust algorithm to harmonise results of pertussis serological assays performed in 12 European and non-European countries. Initially, results from each country's own assay were compared with those obtained at the reference laboratory by means of an in-house pertussis toxin (PT)-based ELISA: seven countries used in-house or commercial PT-ELISAs; the other countries used assays based on Bordetella pertussis whole cell extracts (WCE) (three countries) or on combined PT-FHA (filamentous haemagglutinin) antigenic preparations (two countries). The WCE assays, although admitted for diagnostic purposes, confirmed their low correlation with the PT-ELISAs and their results could not be used for standardisation; the PT-FHA ELISAs gave results that were suitable for standardisation in one country but unsatisfactory in the other; the use of purified PT in serological assays confirmed its better reliability than other preparations and all PT-ELISAs results could be calibrated against those of the reference centre. In the standardisation process two high-titre cut-offs indicative of likelihood of recent infection (from within 4 weeks of disease onset up to 1 year after) were included for evaluations as they are suggested to be more useful, for the sero-epidemiological assays of immunity to pertussis, than the cut-off of protection, commonly employed, but still not defined for pertussis. Providing PT-ELISAs are used, standardisation of pertussis assay results is always possible and, when standardisation is performed, evaluation and comparison of the impact of different interventions can be also allowed, by measuring at the distribution of high antibody titres in the populations.
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Grotto I, Balicer RD, Smetana Z, Davidovitch N, Bar-Zeev Y, Mendelson E, Zarka S, Huerta M. Immunity to varicella zoster virus among young adults: a decline prior to widespread uptake of varicella vaccines. Infection 2008; 36:130-4. [PMID: 18379727 DOI: 10.1007/s15010-007-7192-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Accepted: 08/16/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND The epidemiology of chickenpox in Israel is changing, mainly due to the increasing - but not universal - uptake of varicella vaccine. PATIENTS AND METHODS We conducted a seroprevalence study of varicella zoster virus (VZV) antibodies among 536 Israeli military recruits 18 years of age, on the basis of a representative sample of sera collected in 2003. RESULTS The overall seroprevalence rate was 94.6%, which was significantly lower than that observed in a similar population in 1992 (98.4%, p < 0.001). The rate was lower among subjects whose fathers had less than 12 years of schooling (89.8%, p = 0.033). No statistically significant differences were observed when data were stratified by sex, subject's level of education, or origin. CONCLUSION This decline in the level of immunity must be considered when determining pre- and post-exposure vaccination policy among young adults in crowded environments.
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Affiliation(s)
- I Grotto
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Breuer J, Schmid D, Gershon A. Use and Limitations of Varicella‐Zoster Virus–Specific Serological Testing to Evaluate Breakthrough Disease in Vaccinees and to Screen for Susceptibility to Varicella. J Infect Dis 2008; 197 Suppl 2:S147-51. [DOI: 10.1086/529448] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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dos Santos AMN, Ono E, Lobato RT, do Prado SI, Kopelman BI, Cavalcanti CM, Monomi MKI, Weckx LY, de Moraes-Pinto MI. Diphtheria, tetanus, and varicella immunity in health care workers in neonatal units. Am J Infect Control 2008; 36:142-7. [PMID: 18313517 DOI: 10.1016/j.ajic.2007.04.283] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Revised: 04/25/2007] [Accepted: 04/25/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Susceptible health care workers are at risk of acquiring and transmitting vaccine-preventable diseases to or from patients. The objective of this study was to assess antibody levels against diphtheria, tetanus, and varicella in healthcare workers. METHODS Antibody levels against diphtheria, tetanus, and varicella were measured in health care professionals in 2 neonatal units at the Federal University of São Paulo, Brazil. RESULTS Between September and November 2002, 215 of 222 (96.8%) health care workers were studied. Of those, 122 (56.7%) gave oral information regarding their vaccination status against diphtheria and tetanus and only 9 (4.2%) had their vaccination cards. Geometric mean antibody levels against diphtheria, tetanus, and varicella were 0.89 IU/mL (95%CI, 0.73 to 1.08), 0.86 IU/mL (95%CI, 0.68 to 1.07) and 1.10 IU/mL (95%CI, 0.98 to 1.24), respectively. Using internationally accepted definitions, 200 (93.0%) and 182 (84.7%) individuals had full protection against diphtheria and tetanus, respectively. Regarding varicella, 213 (99.1%) individuals were immune and 2 (0.9%) had equivocal immunity against varicella. Of 65 (30.2%) individuals without previous history of the illness, 63 (96.9%) were immune against varicella zoster virus. CONCLUSIONS Based on serologic screening, most professionals were immune to diphtheria, tetanus, and varicella. Absence of previous history of varicella was an unreliable identifier of susceptibility to varicella zoster virus in the health care workers studied.
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Nardone A, de Ory F, Carton M, Cohen D, van Damme P, Davidkin I, Rota MC, de Melker H, Mossong J, Slacikova M, Tischer A, Andrews N, Berbers G, Gabutti G, Gay N, Jones L, Jokinen S, Kafatos G, de Aragón MVM, Schneider F, Smetana Z, Vargova B, Vranckx R, Miller E. The comparative sero-epidemiology of varicella zoster virus in 11 countries in the European region. Vaccine 2007; 25:7866-72. [PMID: 17919788 DOI: 10.1016/j.vaccine.2007.07.036] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 05/30/2007] [Accepted: 07/15/2007] [Indexed: 10/23/2022]
Abstract
The European sero-epidemiology network (ESEN2) aims to standardise serological surveillance of varicella zoster virus (VZV) in 11 participant countries. In each country, serum banks were collected between 1996 and 2003 and tested for VZV antibodies. Assay results were standardised so that international comparisons could be made. Age-specific forces of infection were calculated for three age groups (<5, 5-9 and >or=10 years of age) and used to estimate the base reproduction number (R(0)) and the herd immunity threshold (H). Most VZV infection occurred in childhood, but there was a wide variation in transmissibility, with R(0) ranging from 16.9 in the Netherlands to 3.3 in Italy. Herd immunity thresholds varied from 70% in Italy to 94% in the Netherlands. There are substantial differences in VZV sero-epidemiology within the European region, which will need to be taken into account in designing national policies regarding VZV vaccination.
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Affiliation(s)
- A Nardone
- Health Protection Agency, Centre for Infections, London, UK.
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Alfonsi V, Montomoli E, Manini I, Alberini I, Gentile C, Rota MC, Ciofi degli Atti ML. Susceptibility to varicella in childbearing age women, Central Italy: is there a need for vaccinating this population group? Vaccine 2007; 25:6086-8. [PMID: 17629374 DOI: 10.1016/j.vaccine.2007.05.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Revised: 05/07/2007] [Accepted: 05/12/2007] [Indexed: 11/24/2022]
Abstract
We conducted a cross-sectional seroprevalence study of varicella-zoster virus (VZV) antibodies in childbearing age women aged 17-42 years. Sera were collected in Central Italy in years 2001-2002 and were tested by a commercial VZV IgG enzyme immunoassay. Overall VZV seroprevalence was 80.9% and it showed a significant increase by age, confirming a considerable circulation of VZV also in the older age groups not commonly considered at high risk. This study further supports the importance of vaccinating susceptible adolescents and women of childbearing age in order to reduce both maternal and foetal complications associated with varicella in pregnancy.
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Affiliation(s)
- Valeria Alfonsi
- Istituto Superiore di Sanità, National Center for Epidemiology Surveillance and Health Promotion, Italy
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Svahn A, Berggren J, Parke A, Storsaeter J, Thorstensson R, Linde A. Changes in seroprevalence to four herpesviruses over 30 years in Swedish children aged 9–12 years. J Clin Virol 2006; 37:118-23. [PMID: 16971177 DOI: 10.1016/j.jcv.2006.07.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Revised: 07/11/2006] [Accepted: 07/17/2006] [Indexed: 11/18/2022]
Abstract
BACKGROUND Changing social conditions and life-styles in Sweden may have affected the spread of varicella-zoster virus (VZV), herpes simplex virus (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). OBJECTIVES To study possible changes over 30 years in prevalence of antibodies against VZV, HSV, CMV, and EBV in Swedish children, using modern serological methods. STUDY DESIGN Serum samples from 819 Swedish children who were 9-12 years old in 1967-1968, in 1977-1978 (two cohorts), and in 1997, respectively, were examined. IgG antibodies against VZV, HSV, and CMV were measured by well validated enzyme-linked immunosorbent assays and against EBV by indirect immunoflourescense. RESULTS The seropositivity for VZV for 9-12 years old children was 50% in 1967-1968, 74-82% in 1977-1978, and 98% in 1997. The corresponding figures were 31%, 53%, 50%, and 58% for CMV, 35%, 35%, 32%, and 38% for HSV, and 64% in 1967-1968 and in 1977-1978 (both cohorts), and 62% in 1997 for EBV. CONCLUSIONS The seroprevalence for VZV increased significantly from 1967-1968 to 1997, and there was also a significant but smaller increase in the CMV seroprevalence, while seroprevalence to HSV and EBV remained relatively stable.
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Affiliation(s)
- Anita Svahn
- Department of Virology, Swedish Institute for Infectious Disease Control, Solna, Sweden.
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