Up to one-third of individuals with primary herpes simplex virus HSV infections who have experienced prior VZV infection show a heterotypic antibody response to VZV antigen making a differential diagnosis between VZV and HSV difficult in the absence of clear-cut clinical findings.
IgG-class antibodies to VZV may be present in serum specimens from individuals who have received blood products within the past several months, but have not been immunized or experienced past infection with this virus. Serum specimens drawn early during acute phase of infection or soon after vaccination may be negative for IgM- or IgG-class antibodies to this virus, respectively.
The results are summarized below:. Sensitivity: Specificity: Overall percent agreement: Yankowitz J, Grose C: Congenital infections. In: Storch GA, ed. Essentials of diagnostic virology. Churchill Livingstone; N Engl J Med. Med Pregl. Elsevier; Immunoglobulin M:. The presence or absence of IgM-class antibody to varicella-zoster virus VZV is determined by an indirect immunofluorescence assay.
Serum is incubated with VZV antigen that is adhered to a glass microscope slide. Antibodies, if present, will bind to the antigen forming stable antigen-antibody complexes. If no antibodies are present, the complexes will not be formed and the serum components will be washed away.
Fluorescein-labeled antihuman-IgM antibody is added to the reaction side and binds to IgM antibodies, if present. This results in a positive reaction of bright apple-green fluorescence when viewed with a fluorescence microscope.
Immunoglobulin G:. Briefly, serum samples are mixed and incubated at 37 degrees C with sample diluent and dyed beads coated with VZV antigen. After a wash cycle, antihuman IgG antibody conjugated to phycoerythrin PE is added to the mixture and incubated at 37 degrees C. Excess conjugate is removed in another wash cycle and the beads are resuspended in wash buffer. The bead mixture then passes through a detector that identifies the bead based on dye fluorescence and determines the amount of antibody captured by the antigen based on the fluorescence of the attached PE.
Raw data is calculated in relative fluorescence intensity. Three additional dyed beads, an internal standard bead, a serum verification bead, and a reagent blank bead are present in each reaction mixture to verify detector response, the addition of serum to the reaction vessel and the absence of significant nonspecific binding in serum.
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Search Cancel. If varicella, or chickenpox, has been traditionally considered a childhood disease, nowadays, an increased number of adults are affected by primary infections. On the contrary, more and more children present the secondary form of the infection, which appears as herpes zoster, a disease usually diagnosed in adults.
Material and methods: We studied the observation papers of adult patients with varicella, hospitalized in our clinic during and we analyzed the herpes zoster manifestations in non-HIV children, diagnosed with the disease during the same period of time. Results: During , 34 adult patients were diagnosed with varicella, while 10 children presented herpes zoster.
One of the children with herpes zoster was less than one year old. The second case occurred on February 1 in a year-old Central American woman; she had given a hair permanent to the first case-patient within 24 hours before the first patient developed a rash. The third case was identified on February 19 in a year-old U.
The latter two women attended the same class during late January. The third case-patient lived in the chronic-care unit of the prison hospital with 17 other women, including two with AIDS and one receiving low-dose steroids for treatment of systemic lupus erythematosis. She potentially exposed two groups of contacts. The first group comprised other inmates in the chronic-care unit, the unit's medical staff, and inmate workers.
To prevent further transmission, persons with uncertain histories of previous chickenpox infection were not permitted to enter the unit. Three nurses who were uncertain of their histories were excluded from the unit pending results of their varicella-zoster VZ antibody titer tests. In addition, 12 patients and four inmate workers from the chronic-care unit were identified from histories as possibly not immune.
The second group of contacts comprised all other identifiable social and classroom contacts of the third case-patient and included greater than inmates who attended the same programs or classes during the 3 days before she developed symptoms. Of this group, were uncertain about histories of previous varicella infection, including 40 with self-identified risk behaviors for HIV infection and one who may have been pregnant.
Serum specimens were obtained from of these inmates and three staff members to measure VZ antibody titers. Because of the time required to process the specimens, all potentially susceptible inmates in this second group of contacts were quarantined in a separate unit within the prison until their serologic results became available.
All pregnant women, AIDS patients, and staff were immune. No cases of varicella have occurred since the third case. Editorial Note: In the United States, exposure to and infection with the highly communicable VZ virus is virtually unavoidable 1. VZ virus causes both varicella the manifestation of primary infection in a susceptible person and zoster the result of reactivation of latent virus ; patients with either disease may transmit the virus to susceptible persons An estimated 3.
Varicella can be life threatening, particularly in adults, pregnant women, neonates, and immunocompromised persons. VZ infection in pregnancy may also produce fetal infection and an array of congenital abnormalities characterized as "congenital varicella syndrome" 4.
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