Chickenpox: epidemiological risks in modern conditions and immunization tactics


DOI: https://dx.doi.org/10.18565/epidem.2021.11.4.14-9

Smirnova S.S., Vyatkina L.G., Stepanova E.A.

1) Yekaterinburg Research Institute of Viral Infections, State Research Center of Virology and Biotechnology «Vector», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; 2) Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia
The modern feature of the course of chickenpox (CP) is that the representatives of different age groups are involved in the epidemic process and initially healthy individuals develop complications and lesions of the central nervous system.
Objective. To study the current epidemiological risks for spread of CP and to determine approaches to choosing immunization strategies.
Materials and methods. The investigators analyzed the data available in federal statistical monitoring form №. 23 «Information on outbreaks of infectious diseases»; in the epidemiological investigation reports on the foci of infectious diseases; in the 2018–2020 state reports submitted by the Directorates of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, in the Russian Federation’s subjects included in the Ural Federal Districts and Siberian Federal District; in the 2018–2020 state reports «On the state of sanitary and epidemiological welfare of the population in the Russian Federation» and in the 2011–2018 annual reports of healthcare facilities of the Sverdlovsk Region. Epidemiological and statistical studies were used.
Results. The epidemiological risks of CP are determined by the possibility of its carrying into social groups, by the emergence of group and outbreak morbidity in organized groups, and by the epidemic spread among the population of municipalities. The key aspect of epidemiological risk management is immunization against CP virus, the tactics of which can be defined as selective, post-exposure and universal.
Conclusion. Planned universal vaccination against CP is the most effective preventive measure. At the same time, in anticipation of the National Immunization Program against CP, it is necessary to implement regional immunization programs for risk groups and post-exposure prophylaxis in organized groups.

Literature


1. World Health Organization. Varicella and herpes zoster vaccines: WHO position paper, June 2014. Week Epidem Rec. 2014; 89: 265–87. https://www.who.int/wer/2014/wer8925.pdf


2. Сабитов А.У., Фомин В.В., Шарова А.А. Иммуно­патогенез ветряной оспы (обзор литературы). Уральский медицинский журнал 2013; (6): 8–14


Sabitov A.U.. Fomin V.V.. Sharova A.A. [Immunopathogenesis of chickenpox (literature review)]. Ural Medical Journal 2013; (6): 8–14. (In Russ.).


3. Baird N.L., Xiaoli Yu, Randall J.C., Don G. Varicella zoster virus (VZV) -human neuron interaction. Viruses 2013; 5(9): 2106–15.


4. Freer G., Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018; 41(2): 95–105.


5. Gershon A.A., Breuer J., Cohen J.I., Cohrs R.J., Gershon M. D., Gilden D. et al. Varicella zoster virus infection. Nat. Rev. Dis. Prim. 2015; 1: 150–60.


6. Gershon A. A., Gershon M. D. Pathogenesis and current approaches to control of varicella-zoster virus infections. Clin. Microbiol. Rev. 2013; 26(4): 728–43


7. Namazova-Baranova L., Md Ahsan Habib, Povey M., Efendieva K., Fedorova O., Fedoseenko M. et al. A randomized trial assessing the efficacy, immunogenicity, and safety of vaccination with live attenuated varicella zoster virus-containing vaccines: ten-year follow-up in Russian children. Human Vaccines & Immunotherapeutics. DOI: 10.1080/21645515.2021.1959148


8. Зрячкин Н.И., Бучкова Т.Н., Чеботарева Г.И. Осложнения ветряной оспы (обзор литературы). Журнал инфектологии 2017; 9(3): 117–28. DOI: 10.22625/2072-6732-2017-9-3-117-128


Zryachkin N.I., Buchkova T.N., Chebotareva G.I. [Complications of chickenpox (literature review)]. J. Infectology 2017; 9(3): 117–28. (In Russ.). DOI: 10.22625/2072-6732-2017-9-3-117-128


9. Nagel M.A. Varicella zoster virus vasculopathy: clinical features and pathogenesis. J. Neurovirol. 2014; 20(2): 157–63.


10. Chiang F., Panyaping T., Tedesqui G., Sossa D., Costa Leite C., Castillo M. Varicella zoster CNS vascular complications. A report of four cases and literature review. Neuroradiol. J. 2014; 27(3): 327–33.


11. Gilden D., Nagel M.A. Varicella zoster virus and giant cell arteritis. Curr. Opin. Infect. Dis. 2016; 29(3): 275–9.


12. Corti M., Trione N., Villafañe M.F., Risso D., Yampolsky C., Mamanna L. Acute meningoencephalomyelitis due to Varicella-zoster virus in an AIDS patient: report of a case and review of the literature. Rev. Soc. Bras. Med. Trop. 2011; 44(6): 784–6.


13. Ibrahim W., Elzouki A.N., Husain A., Osman L. Varicella Zoster Aseptic Meningitis: Report of an Atypical Case and Literature Review. Am. J. Case Rep. 2015; 16: 594–7.


14. Ellis D.L., Barsell A., Riahi R.R., Stumpf B. Varicella zoster virus encephalitis in a patient with disseminated herpes zoster: report and review of the literature. Dermatol.Online J. 2014; 21(3). DOI:10.5070/D3213022994


15. Amlie-Lefond C., Gilden D.. Varicella Zoster Virus: A Common Cause of Stroke in Children and Adults. J. Stroke Cerebrovasc Dis. 2016; 25(7): 1561–9. doi: 10.1016/j.jstrokecerebrovasdis.2016.03.052. PMID: 27138380; PMCID: PMC4912415


16. Petrun B., Williams V., Brice S. Disseminated varicella-zoster virus in an immunocompetent adult. Dermatol. Online J. 2015; 21(3): 13030/qt3cz2x99b. PMID: 25780980


17. Baljic R., Hadzovic M., Mehanic S., Lukovac E., Koluder-Cimic N., Baljic I., Imsirovic B. Varicella Pneumonia in a 39-year-old Female in Third Trimester Twin Pregnancy. Mater. Sociomed. 2012; 24(Suppl. 1): 16–7.


18. Bialas K.M., Swamy G.K., Permar S.R. Perinatal cytomegalovirus and varicella zoster virus infections: epidemiology, prevention, and treatment. Perinatol. 2015; 42(1): 61–75. doi: 10.1016/j.clp.2014.10.006


19. Lamont R.F., Sobel J.D., Carrington D., Mazaki-Tovi S., Kusanovic J.P., Vaisbuch E., Romero R. Varicella zoster virus (chickenpox) infection in pregnancy. BJOG 2011; 118(10): 1155–62.


20. March Roselló G.A., Eiros Bouza J.M. Nosocomial respiratory viral infection. An. Sist. Sanit. Navar. 2014; 37(2): 265–79.


21. Смирнова С.С., Южанина Т.С., Степанова Е.А., Степанова Е.А., Рупышева Т.А. Ветряная оспа: риск-ориентированная модель управления эпидемическим процессом. Дальневосточный журнал инфекционной патологии 2020; (39): 63–8.


Smirnova S.S., Yuzhanina T.S., Stepanova E.A., Rupysheva T.A. [Chickenpox: a risk-based model for managing the epidemic process]. Far Eastern Journal of Infectious Pathology 2020; (39): 63–8. (In Russ.).


22. Смирнова С.С., Южанина Т.С., Вяткина Л.Г., Голуб­кова А.А., Алимов А.В. Вспышки инфекционных заболеваний в медицинских организациях. Вопросы эпидемиологической диагностики. Преданалитический этап. Эпидемиол. и инф. бол. 2019; 24(5–6): 204–12.


Smirnova S.S., Yuzhanina T.S., Vyatkina L.G., Golubkova A.A., Alimov A.V, [Outbreaks of infectious diseases in healthcare facilities: issues of epidemiological diagnostics and preanalytical stage]. Epidemiligy and Infectious Diseases 2019; 24( 5–6): 204–12. (In Russ.).


23. Kim S.-H., Park S.H., Choi S.-M., Lee D. Implementation of Hospital Policy for Healthcare Workers and Patients Exposed to Varicella Zoster Virus. J. Korean Med. Sci. 2018; 33(36): 252. DOI:10.3346/jkms.2018.33.e252


24. Lachiewicz A.M., Srinivas M.L. Varicella zoster virus post-exposure management and prophylaxis: A review. Prev. Med. Rep. 2019; 16: 101–6. DOI:10.1016/j.pmedr.2019.101016


25. Papaloukas O., Giannouli G., Papaevangelou V. Successes and challenges in varicella vaccine. Ther. Adv. Vaccines 2014; 2(2): 39–55. DOI:10.1177/2051013613515621


26. Shaw J., Gershon A.A. Varicella Virus Vaccination in the United States. Viral Immunol. 2018; 31(2): 96–103. doi: 10.1089/vim.2017.0136


27. Varela F. H., Pinto L.A., Scotta M.C. Global impact of varicella vaccination programs. Hum. Vaccin. Immunother. 2019; 15(3): 645– 57. doi: 10.1080/ 21645515.2018.1546525


About the Autors


Svetlana S. Smirnova, Cand. Мed. Sci., Associate Professor, Department of Epidemiology, Social Hygiene and Organization of Sanitary-Epidemiological Service, Ural State Medical University, Ministry of Health of Russia; Head, Ural-Siberian Research and Guidance Center for Prevention of Healthcare-Associated Infections, Yekaterinburg Research Institute of Viral Infections «Vector», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; smirnova_ss69@mail.ru; http://orcid.org/0000-0002-9749-4611
Lyudmila G. Vyatkina, Medical Statistician, Ural-Siberian Research and Guidance Center for Prevention of Healthcare-Associated Infections, Yekaterinburg Research Institute of Viral Infections «Vector», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; ismp@eniivi.ru; http://orcid. org/0000-0002-1944-3827
Ekaterina A. Stepanova, Medical Epidemiologist, Ural-Siberian Research and Guidance Center for Prevention of Healthcare-Associated Infections, Yekaterinburg Research Institute of Viral Infections «Vector», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; ismp@eniivi.ru; http://orcid.org/0000- 0002-4487-1348


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