水痘期间发生带状疱疹

带状疱疹由水痘-带状疱疹病毒(VZV)引起,VZV主要潜伏在脊神经后根或颅神经的神经节内。大约有15％的水痘患者发生带状疱疹,但是儿童比成人少见。自VZV感染之后到发生带状疱疹的潜伏期为数周到数年不等。以往的观察表明,1岁内患水痘是儿童发生带状疱疹的危险因素。本文作者首次报道了1例发生在水痘期间的带状疱疹。     

水痘－带状疱疹病毒感染的研究现状

水痘是儿童常见的一种急性、高传染性的呼吸道传染病,带状疱疹是患水痘后潜伏病毒的再激活所致,其病原为水痘－带状疱疹病毒（VZV）,即人类疱疹病毒3型。原发感染可引起不同严重程度的典型疾病,健康儿童感染VZV后多数症状轻微,预后良好。但在某些特殊人群,如免疫功能缺陷及使用免疫抑制剂治疗的儿童,会导致严重后果,甚至死亡。成人感染VZV后症状也甚为严重。对VZV的分子生物学特征、流行病学、实验室诊断、治疗及预防对策等做了详细阐述。     

水痘是一种什么病

<正>水痘是一种传染性很强的出疹性呼吸道传染病，病原体为水痘-带状疱疹病毒（VZV）。人是其唯一宿主，VZV具有潜伏-活化特性，也就是说初次感染VZV后，临床表现为水痘；水痘痊愈后病毒可潜伏在三叉神经节或脊髓背神经节内，在身体免疫低下时病毒激活，可引起带状疱疹。     

水痘疫苗及其免疫策略

水痘是由水痘-带状疱疹病毒(VZV)引起的儿童期高度传染性疾病。世界各地都有发生。VZV初次感染后可在体内建立潜伏感染,以后可被激活引起带状疱疹。1974年研制成功的水痘减毒活疫苗对预防和控制水痘有着重要作用。该文介绍了水痘疫苗的由来、安全性、免疫效果和免疫策略等。     

抗水痘-带状疱疹病毒药物的耐药研究进展

水痘-带状疱疹病毒(VZV)初次感染人可引起水痘, 病毒在成人时期可能再次激活并引起带状疱疹。广谱抗病毒药物是治疗水痘和带状疱疹的手段之一, 但耐药现象的出现对该治疗方法带来了诸多挑战, 同时也增加了患者的疾病负担。本文对抗VZV药物的耐药机制、耐药位点及耐药检测方法等方面进行论述, 以期为进一步开展抗VZV新靶点、新药的研究及对现有药物的耐药性监测提供帮助。     

无环鸟苷预防免疫受损儿童的水痘播散

健康儿童的水痘-带状疱疹病毒(VZV)感染常是自限性的。然而,在免疫受损的儿童中,VZV 感染可引起内脏播散,死亡率达20%。双盲实验表明,干扰素和阿糖腺苷能减轻 VZV 感染的病情,但两者常伴有明显的副作用。现已证明,无环鸟苷用于治疗免     

春季小心水痘

正水痘是由水痘带状疱疹病毒(Varicella Virus,VZV)引起的急性呼吸道传染病。水痘感染痊愈后,病毒可能会潜伏神经细胞内,进入中老年后如重新激活会引起带状疱疹。水痘的主要发病人群为5~14岁的儿童和青少年,易感儿童接触后容易发病,6个月以下婴儿较少见。水痘以冬春季高发,学校、幼托机构等比较容易出现暴发疫情。     

成人水痘45例临床分析

<正>水痘是由水痘—带状疱疹病毒(VZV)感染所引起的急性传染病,我国大多数水痘患者发生在儿童时期,20岁以后发病者不到2%[1]。为了解成人水痘患者的临床特征,现将2009—2011年我院诊治的成人水痘患者的临床资料与儿童水痘患者进行对比分析,结果报告如下。     

聚合酶链反应检测水痘带状疱疹病毒DNA

水痘带状疱疹病毒（VZV）是引起人类水痘、带状疱疹的病原体。前几年我们曾建立了VZV蚀斑减少中和试验，VZV抗体ELISA及IFA等检测方法。本文使用PCR检测VZV—DNA，取得了较好的结果，现报告如下：     

儿童两剂水痘疫苗接种的研究进展

<正>水痘是儿童常见的急性呼吸道传染病,由水痘-带状疱疹病毒(Varicella-Zoster Virus,VZV)引起,经呼吸道和日常接触传播,具有高度传染性,常在幼托机构儿童中发生爆发流行,严重危害儿童身心健康。预防控制水痘最有效、最可靠的措施是接种水痘减毒活疫苗(varicella attenuated live vaccine,VarV)。目前,我国大部分省市仍实行1剂次水痘疫苗的接种     

水痘流行病学与临床特征的相关研究

水痘是由水痘,带状疱疹病毒感染引起的急性出疹性传染病,其传染性较强,尤其在托婴室、幼儿园、小学等儿童密集区域,其传播迅速,易引起暴发流行.目前水痘疫苗已经广泛使用,水痘已成为一种可预防的疾病.此文对水痘的病原、流行病学、临床特征及防治的相关研究作了综述.     

Optic neuritis following Varicella zoster vaccination: Report of two cases

Two women presented at our clinic with vision blurring following Varicella zoster virus (VZV) vaccination, 3 weeks and 1 week ago. Ophthalmologic examination and magnetic resonance imaging revealed bilateral and unilateral optic neuritis, respectively. One patient had a history of optic neuritis in the fellow eye 33 years ago without recurrence since then. Both patients completely recovered after treatment with high dose intravenous methylprednisolone followed by a tapered dose of oral prednisolone. This is the first report of optic neuritis occurring in relation to VZV vaccination.     

Summary of the multidisciplinary guideline 'Varicella'

The multidisciplinary guideline 'Varicella' provides guidelines for diagnosis, therapy, and prevention of chickenpox. At the first pregnancy check, patients should be questioned about previous chickenpox; in case of a negative or doubtful history varicella zoster virus (VZV) serology is indicated. VZV antibody determination is also indicated in patients considered for immunosuppressive therapy and for healthcare workers with a negative VZV history who are in contact with immunocompromised patients. Administration of VZV immunoglobulin within 96 hours following VZV contact can mitigate the infection in pregnant women and patients with T-cell deficiency. VZV immunoglobulin treatment should be considered for newborn infants of mothers who developed chickenpox in the period from five days before to two days after delivery. Antivirals can reduce the severity of infection and are safe during pregnancy. Varicella vaccine protects against chickenpox, but is contraindicated in immunocompromised patients and pregnant women.     

Monitoring virus strain variation following infection with VZV: is there a need and what are the implications of introducing the Oka vaccine?

Varicella zoster virus (VZV) is a stable virus showing relatively little variation. Nevertheless, recent data have shown there to be at least four distinct viral strains. For the most part these are geographically segregated, but in areas of the world such as the UK, where mixed populations live, there is evidence for spread of all the genotypes. Little is known about the biological differences, if any, between these strains, yet recent data have shown that even a single nucleic acid change can affect the biological behaviour of the virus. The Oka vaccine has been licensed for mass vaccination in the US and for limited use in the UK, particularly in seronegative healthcare workers. Virological surveillance is needed to support these programmes and study the effect on virus spread. Evidence for VZV superinfection of latently infected individuals with different strains, and the increasing detection of VZV in association with clinical conditions such as viral meningitis, suggest more data are needed on the transmissibility and biological properties of the virus.     

2010—2012年广东省发热伴出疹症候群的病原学研究

目的分析2010年8月至2012年8月期间广东省发热伴出疹性疾病（rash and fever illness,RFIs）的病原谱构成及流行特征,为临床诊断、治疗和RFIs的预防控制提供科学依据。方法应用实时荧光定量聚合酶链反应（real-time quantitative polymerase chain reaction,real-time PCR）方法和酶联免疫吸附测定（enzyme-linked immu-nosorbent assay,ELISA）方法对519例临床标本进行风疹、麻疹、肠道病毒、水痘-带状疱疹、人类小DNA病毒B19、伤寒副伤寒等病原学检测,并进行统计分析。结果 519例样本中检出314例RFIs病原体阳性标本,阳性率为60.50%。病原谱构成前3位为肠道病毒、水痘病毒和风疹病毒。不同年龄组感染的病原谱构成也不同：0～和5～岁年龄组以肠道病毒71型（human enterovirus 71,EV71）为主,风疹在15～岁年龄组的检出率高于其他年龄组,而水痘在60岁以上年龄组的检出率高于其他年龄组;不同性别患者之间病原体检出率差异无统计学意义。不同病原体在不同年龄组阳性率差异均有统计学意义（均有P〈0.05）。结论肠道病毒是本地RFIs感染的主要病原体。部分病原体的感染与年龄有一定的关联,应长期监测RFIs病原体的活动水平。加速肠道病毒疫苗的研制,积极推行水痘、麻疹等疫苗的接种是控制RFIs发病的主要措施。     

Homology modelling and docking studies on Varicella Zoster Virus Thymidine kinase

Thymidine kinase (TK) is the key enzyme in antiviral and suicide gene therapies. While herpes simplex virus type 1 thymidine kinase has been widely studied and crystallised less is known on Varicella Zoster Virus thymidine kinase (VZV TK) and its three-dimensional structure. In this paper we report the model of the three-dimensional structure of VZV TK resulting from a homology modelling study. Subsequent docking studies of the natural substrate deoxythymidine (dT) and known antiviral drugs were performed and shaded new light on the binding characteristics of the enzyme.     

Superiority of varicella skin test antigen over purified varicella-zoster virus glycoproteins in monitoring booster response to Oka varicella vaccine

Varicella skin test antigen has been developed based on the induction of delayed-type hypersensitivity (DTH) to varicella-zoster virus (VZV). The booster immune response to Oka varicella vaccine was assessed by cutaneous reactivity to purified VZV glycoprotein complexes, gB, gE:gI, gH:gL, and varicella skin test antigen. Skin tests with these antigens significantly augmented antibody production to glycoproteins and VZV antigen resulting in no further augmentation by the subsequent vaccination. All glycoprotein complexes induced the cutaneous reaction similarly to varicella skin test antigen. Cutaneous reaction to glycoproteins and varicella skin test antigen was boosted after vaccination. However, the magnitude of cutaneous reaction to each glycoprotein complex before and after vaccination was rich in variety. These results indicated that skin test with varicella skin test antigen is a more suitable indicator in monitoring cell-mediated immunity to VZV than that using purified glycoproteins.     

水痘及其免疫预防研究进展

水痘 (Varicella)是由水痘 -带状疱疹病毒 (Varicella zostervirus,VZV)引起的急性传染病。水痘的病原体(VZV)可以通过喷嚏、咳嗽飞沫等经呼吸道传播 ,或直接接触传播。病人通常在发病前几天至疱疹干燥结痂为止 ,具有很强的传染性。一旦在易感人群中出现 1例水痘病人 ,就很难预防水痘在该群体中的爆发。现对水痘的病原学、流行病学、临床特征及免疫预防的研究进展进行了综述。认为目前水痘疫苗可以用于作为个体水平的预防接种 ,以保护易感青少年和成人免受VZV感染 ,也可以用于群体水平作为国家免疫规划的一部分 ,对所有儿童进行预防接种。但对个体水平的接种是不能够改变水痘的流行病学特征的 ,只有通过大面积的儿童常规免疫接种 ,水痘的流行病学特征才能发生根本性的变化 ,疾病的传播才能得到有效的阻止乃至最终消灭     

Bioinformatics of varicella-zoster virus: Single nucleotide polymorphisms define clades and attenuated vaccine genotypes

Varicella zoster virus (VZV) is one of the human herpesviruses. To date, over 40 complete VZV genomes have been sequenced and analyzed. The VZV genome contains around 125,000 base pairs including 70 open reading frames (ORFs). Enumeration of single nucleotide polymorphisms (SNPs) has determined that the following ORFs are the most variable (in descending order): 62, 22, 29, 28, 37, 21, 54, 31, 1 and 55. ORF 62 is the major immediate early regulatory VZV gene. Further SNP analysis across the entire genome has led to the observation that VZV strains can be broadly grouped into clades within a phylogenetic tree. VZV strains collected in Singapore provided important sequence data for construction of the phylogenetic tree. Currently five VZV clades are recognized; they have been designated clades 1 through 5. Clades 1 and 3 include European/North American strains; clade 2 includes Asian strains, especially from Japan; and clade 5 includes strains from India. Clade 4 includes some strains from Europe, but its geographic origins need further documentation. Within clade 1, five variant viruses have been isolated with a missense mutation in the gE (ORF 68) glycoprotein; these strains have an altered increased cell spread phenotype. Bioinformatics analyses of the attenuated vaccine strains have also been performed, with a subsequent discovery of a stop-codon SNP in ORFO as a likely attenuation determinant. Taken together, these VZV bioinformatics analyses have provided enormous insights into VZV phylogenetics as well as VZV SNPs associated with attenuation.