Abnormal Development - Varicella Zoster Virus
|Embryology - 17 Feb 2018 Expand to Translate|
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|Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.|
Varicella Zoster Virus (VSV) or chickenpox maternal infection can be transmitted to the fetus. It is a herpesvirus belonging to the subfamily of Alphaherpesviridae that is transmitted by directly aerosol droplets or direct contact, or indirectly by touching freshly soiled contaminated items.
Fetal varicella syndrome (FVS), was first described in 1947 and is caused by transplacental infection by the varicella zoster virus following maternal infection.
Commonly called chickenpox or shingles in adults. The chickenpox vaccine is made from a weakened varicella virus producing an immune response that protects you against chickenpox infection. The United States has had a licensed chickenpox vaccine since 1995.
Fetal and Neonatal Risks
Risks are dependent on the infection timing.
- before 20 weeks (GA) - FVS can occur with an incidence of about 1%. The lesions can affect the skin, limbs, central and autonomous nervous systems, eyes, cause calcifications, and growth retardation; mortality is high. Lesions typically follow one or several nerve territories, suggesting that damage results from in utero zoster following primary fetal infection.
- during pregnancy - transmission can occur, but is usually asymptomatic; some infants develop zoster postnatally and a few have FVS.
- around delivery - often leads to disseminated neonatal varicella.
|Viral Links: TORCH Infections | Cytomegalovirus | Hepatitis Virus | HIV | Parvovirus | Polio Virus | Rubella Virus | Chickenpox | Lymphocytic Choriomeningitis Virus | Zika Virus | Vaccination | Environmental|
Some Recent Findings
|More recent papers|
This table shows an automated computer PubMed search using the listed sub-heading term.
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
Aaron Saguil, Shawn Kane, Michael Mercado, Rebecca Lauters Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Am Fam Physician: 2017, 96(10);656-663 PubMed 29431387
Cora Alexandra Voekt, Therese Rinderknecht, Hans Hellmuth Hirsch, Annette Blaich, Irene Mathilde Hösli Ultrasound indications for maternal STORCH testing in pregnancy. Swiss Med Wkly: 2017, 147;w14534 PubMed 29185251
Deborah Levine, Jacques C Jani, Ilse Castro-Aragon, Mieke Cannie How Does Imaging of Congenital Zika Compare with Imaging of Other TORCH Infections? Radiology: 2017, 285(3);744-761 PubMed 29155634
Shinichi Takeshima, Yuji Shiga, Takahiro Himeno, Keisuke Tachiyama, Teppei Kamimura, Ryuhei Kono, Makoto Takemaru, Jun Takeshita, Yutaka Shimoe, Masaru Kuriyama Clinical, epidemiological and etiological studies of adult aseptic meningitis: Report of 11 cases with varicella zoster virus meningitis. Rinsho Shinkeigaku: 2017, 57(9);492-498 PubMed 28804114
Justine Schoch, Tilman R Rohrer, Michael Kaestner, Hashim Abdul-Khaliq, Ludwig Gortner, Urban Sester, Martina Sester, Taina Schmidt Quantitative, phenotypical and functional characterization of cellular immunity in pediatric individuals with Down syndrome. J. Infect. Dis.: 2017; PubMed 28379413
The International Committee on Taxonomy of Viruses (ICTV) has developed a published code of classification for viruses (currently 2011 Release).
- Subfamily: Alphaherpesvirinae
- Genus: Varicellovirus
- Species: Human herpesvirus 3
- Genus: Varicellovirus
USA Policy Statement
The 2011 Policy statement by the Committee on Infectious Diseases published in the journal Pediatrics as "Prevention of varicella: update of recommendations for use of quadrivalent and monovalent varicella vaccines in children"
- "Two varicella-containing vaccines are licensed for use in the United States: monovalent varicella vaccine (Varivax [Merck & Co, Inc, West Point, PA]) and quadrivalent measles-mumps-rubella-varicella vaccine (MMRV) (ProQuad [Merck & Co, Inc]). It is estimated from postlicensure data that after vaccination at 12 through 23 months of age, 7 to 9 febrile seizures occur per 10,000 children who receive the MMRV, and 3 to 4 febrile seizures occur per 10,000 children who receive the measles-mumps-rubella (MMR) and varicella vaccines administered concurrently but at separate sites. Thus, 1 additional febrile seizure is expected to occur per approximately 2300 to 2600 children 12 to 23 months old vaccinated with the MMRV, when compared with separate MMR and varicella vaccine administration. The period of risk for febrile seizures is from 5 through 12 days after receipt of the vaccine(s). No increased risk of febrile seizures is seen among patients 4 to 6 years of age receiving MMRV. Febrile seizures do not predispose to epilepsy or neurodevelopmental delays later in life and are not associated with long-term health impairment. The American Academy of Pediatrics recommends that either MMR and varicella vaccines separately or the MMRV be used for the first dose of measles, mumps, rubella, and varicella vaccines administered at 12 through 47 months of age. For the first dose of measles, mumps, rubella, and varicella vaccines administered at ages 48 months and older, and for dose 2 at any age (15 months to 12 years), use of MMRV generally is preferred over separate injections of MMR and varicella vaccines."
- Links: CDC Factsheet
- E G LAFORET, C L LYNCH Multiple congenital defects following maternal varicella; report of a case. N. Engl. J. Med.: 1947, 236(15);534-7 PubMed 20293114
- Chandra Madhur Sharma, Deepti Sharma A classical case of neonatal varicella. J Clin Neonatol: 2013, 2(4);200 PubMed 24404537 | J Clin Neonatol.
- Laurent Mandelbrot Fetal varicella - diagnosis, management, and outcome. Prenat. Diagn.: 2012, 32(6);511-8 PubMed 22514124
- Committee on Infectious Diseases Policy statement—Prevention of varicella: update of recommendations for use of quadrivalent and monovalent varicella vaccines in children. Pediatrics: 2011, 128(3);630-2 PubMed 21873692 | Pediatrics
- Medical Microbiology. 4th edition. Baron S, editor. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 55 Togaviruses: Rubella Virus | Chapter 54Alphaviruses (Togaviridae) and Flaviviruses (Flaviviridae) | Table 55-1 Abnormalities Associated with Congenital Rubella Syndrome | Figure 55-3 Incidence rates of rubella USA 1966-1993
- Molecular Biology of the Cell. 4th edition. Alberts B, Johnson A, Lewis J, et al. New York: Garland Science; 2002. Viruses Exploit Host Cell Machinery for All Aspects of Their Multiplication
- Disease Control Priorities in Developing Countries. 2nd edition. Jamison DT, Breman JG, Measham AR, et al., editors. Washington (DC): World Bank; 2006. Chapter 20Vaccine-preventable Diseases
- Antenatal Care: Routine care for the healthy pregnant woman. NICE Clinical Guidelines, No. 62. National Collaborating Centre for Women's and Children's Health (UK). London: RCOG Press; 2008 Mar. 10.8. Rubella
Saba Javed, Syed A Javed, Stephen K Tyring Varicella vaccines. Curr. Opin. Infect. Dis.: 2012, 25(2);135-40 PubMed 22123665
Graciela Andrei, Robert Snoeck Emerging drugs for varicella-zoster virus infections. Expert Opin Emerg Drugs: 2011, 16(3);507-35 PubMed 21699441
Ronald F Lamont, Jack D Sobel, D Carrington, Shali Mazaki-Tovi, Juan Pedro Kusanovic, Edi Vaisbuch, Roberto Romero Varicella-zoster virus (chickenpox) infection in pregnancy. BJOG: 2011, 118(10);1155-62 PubMed 21585641
Arlan Cohen, Panagis Moschopoulos, Panagis Maschopoulos, Richard E Stiehm, Gideon Koren Congenital varicella syndrome: the evidence for secondary prevention with varicella-zoster immune globulin. CMAJ: 2011, 183(2);204-8 PubMed 21262937
John W Gnann Varicella-zoster virus: Prevention through vaccination. Clin Obstet Gynecol: 2012, 55(2);560-70 PubMed 22510639
A M Heuchan, D Isaacs The management of varicella-zoster virus exposure and infection in pregnancy and the newborn period. Australasian Subgroup in Paediatric Infectious Diseases of the Australasian Society for Infectious Diseases. Med. J. Aust.: 2001, 174(6);288-92 PubMed 11297117
R Cole, A G Kuttner THE PROBLEM OF THE ETIOLOGY OF HERPES ZOSTER. J. Exp. Med.: 1925, 42(6);799-820 PubMed 19869091
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- Department of Health and Ageing (Australia) Immunise Australia Program Website | The Australian Immunisation Handbook 9th Edition 2008
- Australia - Victoria Chickenpox (varicella zoster) in neonates
- World Health Organization (WHO) varicella
- CDC (USA) - Varicella (Chickenpox) Vaccination
- International Committee on Taxonomy of Viruses
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Cite this page: Hill, M.A. (2018, February 17) Embryology Abnormal Development - Varicella Zoster Virus. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Varicella_Zoster_Virus
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