HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 29 No. 1, January 2008 A correction has been published Rapid Responses: Submit a response Rapid Responses: View responses Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gershon, A. A. Search for Related Content PubMed PubMed Citation Articles by Gershon, A. A.

(Pediatrics in Review. 2008;29:5-11.)
© 2008 American Academy of Pediatrics

Varicella-Zoster Virus Infections

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Describe the natural history and pathogenesis of varicella and zoster and how these diseases are related.
   
2. Explain to patients and parents the complex role of this virus in causing disease and how the virus spreads.
   
3. Describe how best to manage patients who have these infections.
   
4. Discuss how varicella vaccine works, how effective it is in preventing disease, and why two doses of vaccine are now recommended.
   

	The Pathogen

 
Varicella-zoster virus (VZV), a close but distinct relative of the other seven human herpesviruses, including herpes simplex virus (HSV), causes two diseases. Varicella (chickenpox), a generalized illness, is its primary infection, and zoster (shingles) is its secondary infection, caused by reactivation of VZV from latency. Varicella infection occurs in almost all people over their lifetimes. VZV becomes latent after varicella and usually persists silently and indefinitely. VZV reactivates, however, to cause zoster in roughly 20% of individuals, with higher reactivation rates in immunocompromised patients and the elderly.

	Epidemiology

 
In the prevaccine era in the United States prior to 1995, approximately 4 million cases of varicella and 1 million cases of zoster occurred annually. Varicella was primarily a disease of children younger than age 10 years and zoster an illness of adulthood. Childhood varicella infection, however, is less common than adult infection in countries that have tropical climates. Varicella occurs in children who have no humoral or cellular immunity to VZV, termed "susceptibles." Zoster occurs in individuals who previously have had varicella; they usually have detectable specific antibody titers, but have low or absent cell-mediated immunity (CMI) to VZV.

VZV spreads primarily from the skin vesicles of persons who have varicella or zoster to the respiratory tract of susceptible persons, who then become infected. Electron microscopic studies have shown a high concentration of well-formed, cell-free VZV in . . . [Full Text of this Article]

Rapid Responses: