Varicella - a potential threat to maternal and fetal health.

OBJECTIVES: The aim of the study was to evaluate the following: i) number of midwives and nurses at risk for contracting varicella; ii) effectiveness of infectious disease prevention among healthcare personnel; iii) attitude of healthcare person-nel towards immunization. MATERIAL AND METHODS: A total of 524 midwives and nurses from obstetric, neonatal, and pediatric wards were investigated. Quantitative data analysis was performed. RESULTS: Overall, 14.7% potentially seronegative respondents were identified. Out of those with a positive history of varicella, 6.56% contracted the disease after starting work, and > 70% had contact with the varicella-zoster virus. Overall, 9.54% of the respondents had a history of varicella, 3.12% were informed about the possibility of immunization, and 1.56% of those with a negative history of the disease were offered a state-funded vaccine. In the same group, the number of vaccinated people amounted to 13.28%, and 26.13% would accept a state-funded vaccine. CONCLUSIONS: Varicella may constitute a significant threat to maternal and fetal health at obstetric, neonatal, and pediatric wards, which must be considered when providing care to women in the reproductive age. Occupational health physicians should confirm the immunity status of the patients and suggest immunization to seronegative subjects. Regular workshops are necessary to update the knowledge of medical professionals and patients in order to shape their attitudes and beliefs about immunization.

Preventative Care in the Patient with Inflammatory Bowel Disease: What Is New?

Patients with inflammatory bowel disease (IBD) do not receive routine preventative care at the same rate as general medical patients. This patient population is at increased risk of vaccine preventable illness such as influenza and pneumococcal pneumonia. This review will discuss health maintenance needs and preventative care issues in patients with IBD.

[Viral vaccines in the national vaccination program--views of the near future]. / Virusrokotteet kansallisessa rokotus- ohjelmassa--lähitulevaisuuden näkymät.

Both conventional virus vaccines and those being introduced in the near future are either live attenuated viruses or nonliving inactivated viruses, mere virus-like particles (VLP) or purified proteins. Live vaccines yield a "more natural" immunity, but in many cases also a nonliving vaccine is sufficient to protect from viral infections. Influenza vaccines are of both types. The commencing HPV vaccination program will be conducted with a VLP vaccine comprising two serotypes. A live chickenpox vaccine will be introduced in the national vaccination program in the next few years. In addition, a shingles vaccine is needed. The live oral rotavirus vaccine works well.

Management of chickenpox with frozen mother's milk.

OBJECTIVES: If a mother has contracted chickenpox, the antibodies in her milk confer immunity against chickenpox to her breastfed babies. This passive immunization may avoid or spare the breastfed babies' symptoms of chickenpox. It is hypothesized that frozen breast milk may shorten chickenpox duration because specific antibodies against varicella zoster have been detected in human milk and they are resistant to digestion and are stable in frozen milk. DESIGN: The clinical outcomes of chickenpox in a 9-year-old boy and his father on frozen breast milk are reported. SETTINGS: The study comprised a varicella-vaccine-refusing family attending a private office of pediatrics. INTERVENTIONS AND RESULTS: The boy presented with a crusted varicella rash. The medical history revealed premature cessation of the typical varicella rash on day 3. It was coincidental with a supply of frozen human milk by his mother. Next, the father (41 years old) of this patient contracted chickenpox: he was on frozen breast milk from day 2, and no new pox emerged thereafter. CONCLUSIONS: The rash spread and numbered 50 to 150 lesions on day 2. Instead, the typical rash was expected to appear in three successive crops of lesions throughout the first week. The disease usually numbers approximately 250-500 lesions in unvaccinated healthy persons. Frozen breast milk may shorten chickenpox duration.

[Varicella-associated purpura fulminans and deep vein thrombosis: a pediatric case report]. / Purpura fulminans post-varicelleux et thrombose veineuse : à propos d'un cas pédiatrique.

Purpura fulminans (PF) and deep vein thrombosis are rare complications secondary to chicken pox disease. The presence of antibodies reflects an ongoing immunological process and requires specialized management. The present study reports a 4-year-old boy with no medical history who presented with purpura on the legs 10 days after chicken pox eruption. Laboratory tests showed a disseminated intravascular coagulation associated with low plasma protein C and S activities, and the presence of anti-protein S antibodies. A replacement therapy with protein C infusions and fresh frozen plasma was prescribed. The patient also underwent regular sessions of hyperbaric oxygen followed by the surgery. Fourteen days after the beginning of the purpuric lesions, he presented deep vein thrombosis (DVT) of the lower limbs and was treated with unfractionated heparin. This case report illustrates the pathophysiology of DVT occurring in a patient with chicken pox disease (i.e., acquired protein C and S deficiencies and anti-protein S autoantibodies) and emphasizes the utility of thrombophilia testing in order to better adapt treatment.

[Study on epidemiological effect of the freeze-dried attenuated live varicella vaccine].

OBJECTIVE: To evaluate the safety and epidemiological effect of the Freeze-dried Live attenuated varicella vaccine. METHODS: A random, double-blind control clinical trial was adopted. RESULTS: In the observation period, the incidence of varicella was 0.8 per thousand in the experimental group and 8.7 per thousand in control group. There was a significant difference (B.P=0.000017). Vaccine effectiveness (VE(%)) was 90.8%, the lower limit of 95%CI was 88.7%. CONCLUSION: The varicella vaccine produced by Changchun keygen biological products co., Ltd. was safe and effective.

Rhinovirus inhibits antigen-specific T cell proliferation through an intercellular adhesion molecule-1-dependent mechanism.

To determine whether binding of human rhinovirus (HRV) to intracellular adhesion molecule-1 might disrupt airway immune processes, effects of a major HRV group, HRV-16, on T cell proliferation and cytotoxicity were defined. HRV (1-10 TCID50/cell) significantly inhibited T cell proliferation induced by antigen but not proliferation secondary to mitogens, interleukin-2, or an irradiated allogeneic T cell line. Noninfectious (UV-irradiated) HRV had similar effects. Inhibition of T cell proliferation was dependent on HRV binding to intercellular adhesion molecule-1 on monocytes, indicating that the virus interferes with lymphocyte activation indirectly through effects on antigen-presenting cells. In addition, HRV inhibited T cell cytotoxic responses but not NK cell activity. If these effects also occur in vivo, the resulting disturbance in local airway immunity could increase the chances of successful viral replication, and might also be a factor in the pathogenesis of secondary viral or bacterial respiratory tract infections.

Detection of viral antigens in formalin-fixed specimens by enzyme treatment.

Enzyme treatment (protease or trypsin) was applied to formalin-fixed paraffin-embedded materials and virus-infected cultured cells to detect viral antigens by immunofluorescence. The viral antigens were demonstrated in several organs of autopsy or biopsy cases of which diagnoses had been established by immunofluorescence or virus isolation using frozen materials, or suspected on the basis of serology and/or histopathological findings. These included herpes simplex, varicella-zoster, cytomegalo, subacute sclerosing panencephalitis, progressive multifocal leukoencephalopathy, Japanese B encephalitis, measles, acute hemorrhagic conjunctivitis, Lassa and Korean hemorrhagic fever. Antigen could be recovered also in virus-infected cells (herpes simplex, measles, Lassa, Ebola, Marburg, Rift Valley, Congo and Korean Hemorrhagic fever) by enzyme treatment after periods of formalin fixation of four weeks and storage of three months. In herpes simplex virus-infected mouse brain, antigen was detected after fixation for three months in formalin.