MyMedR

Review of varicella zoster seroepidemiology in India and Southeast Asia

Lee BW

Trop Med Int Health, 1998 Nov;3(11):886-90.

Varicella zoster virus (VZV) predominantly affects children in temperate countries, with near-universal seroconversion occurring by late childhood. However, in tropical regions, VZV infection is common in adolescents and adults. This review identifies age-related VZV seroprevalence patterns in a number of Asian countries which indicate that seroconversion in tropical countries occurs at a later age than in temperate countries. Seasonal and regional variations in acute disease within some Asian countries suggest that temperate climates might favour transmission of the varicella virus, with incidence peaking during cooler months and in cooler, more temperate regions. VZV infection is often more severe in adults than in children, suggesting that tropical countries may be at risk of greater morbidity and mortality as a result of later-age seroconversion. Susceptibility of pregnant women and their infants, and of people infected with HIV/AIDS is also cause for concern. Vaccination may be beneficial in reducing the impact of VZV in Asian populations.

Matched MeSH terms: Chickenpox/epidemiology*

Fulltext Varicella-zoster infection with secondary bacteremia and extensive facial abscesses

Lee KG, Cheng MO

Med J Malaysia, 2012 Oct;67(5):529.

PMID: 23770874 MyJurnal

Varicella-zoster (chickenpox) infection is a common infectious disease and generally considered to be selflimiting. However, severe bacterial complications associated with the disease have been reported. We describe a case of varicella-zoster infection with secondary Staphylococcus aureus bacteremia, preseptal orbital cellulitis and extensive facial abscesses. She was aggressively treated with intravenous antibiotics and repeated surgical drainage, and eventually made good recovery.

Matched MeSH terms: Chickenpox*

Fulltext Knowledge, attitude and vaccination status of varicella among students of Universiti Kebangsaan Malaysia (UKM)

Hesham R, Cheong JY, Mohd Hasni J

Med J Malaysia, 2009 Sep;64(3):257-62.

PMID: 20527284 MyJurnal

Varicella is a highly infectious disease that can lead to severe complications such as pneumonia, encephalitis and death. Vaccination is the best method to prevent the disease. The objective of this study was to assess the level of knowledge, attitude and vaccination status of varicella among UKM students. A cross sectional study involving pre-tested questionnaires was undertaken between February and April, 2005. Questionnaires were distributed and filled by the first and second year students from four faculties in UKM (n=879). The faculties included were divided into two categories: medical fields and non-medical fields. The results showed that the overall level of knowledge on varicella among respondents was intermediate. The score of knowledge was significantly higher among medical students (t = 10.9, p < 0.05) compared to non-medical students. The varicella vaccination coverage was low among UKM students (19.3%). The vaccination status was significantly higher among medical students compared to non-medical students (chi2 = 8.6, p < 0.05). Vaccination status of varicella among respondents had no association with the level of knowledge (chi2 = 2.42, p > 0.05).

Matched MeSH terms: Chickenpox Vaccine/immunology*

Fulltext Varicella-zoster virus seroprevalence in healthcare workers in Kuala Lumpur, Malaysia

Sam IC, Tariman H, Chan YF, Bador MK, Yusof MY, Hassan H

Med J Malaysia, 2008 Dec;63(5):429-30.

PMID: 19803311 MyJurnal

Varicella-zoster virus (VZV) infections are a particular problem in healthcare settings. A survey of chickenpox was carried out amongst healthcare workers (HCWs) following potential ward exposures. A prior history of chickenpox was given by 61/98 (62.2%). Of 64 HCWs tested for VZV IgG, 10 (15.6%) were seronegative, indicating susceptibility. The sensitivity, specificity, positive predictive value, and negative predictive value of a history of prior chickenpox were 57.4%, 90%, 96.4%, and 31.0%, respectively. VZV screening of HCWs without a history of chickenpox, and vaccination of susceptible HCWs should be undertaken in this hospital.

Matched MeSH terms: Chickenpox/blood*; Chickenpox/epidemiology*; Chickenpox/virology

Fulltext Adult varicella pneumonia that responded to combined acyclovir and steroid therapy

Lau LG

Med J Malaysia, 1999 Jun;54(2):270-2.

PMID: 10972042

We describe a case of adult chickenpox which was complicated by severe varicella pneumonia, mild hepatitis and thrombocytopenia. The hepatitis and the thrombocytopenia were asymptomatic clinically and were diagnosed on biochemistry and blood count results. These eventually improved without specific interventions. The pneumonia, however, deteriorated rapidly despite the early commencement of oxygen supplementation, acyclovir and antibiotic. Subsequently, systemic corticosteroid therapy was initiated and the patient was ventilated in the intensive care unit. The patient eventually recovered.

Matched MeSH terms: Chickenpox/complications; Chickenpox/drug therapy*

Fulltext Life threatening pancreatitis following varicella vaccination: cause, association or co-incidence?

Chan PWK, Goh AYT

Med J Malaysia, 2000 Dec;55(4):527-8.

PMID: 11221171

Matched MeSH terms: Chickenpox/prevention & control*

Fulltext Fatal haemorrhagic chickenpox complicating nephrotic syndrome

Gangaram HB, Cheong IK

Med J Malaysia, 1993 Dec;48(4):446-8.

PMID: 8183171

We report a 14 year old Indian-Muslim girl who developed a fulminant, disseminated and fatal varicella infection while receiving steroids for nephrotic syndrome. The terminal phase of her illness was complicated by a bleeding dyscrasia and circulatory collapse. Varicella infection in healthy children is a benign disease. However in neonates and immunosuppressed patients it may be severe and often fatal. There are many reports of fatalities occurring in cancer patients receiving chemotherapy, patients on immunosuppressives for asthma, haemolytic anaemia, rheumatic fever, and renal and bone marrow transplantation. Patients with nephrotic syndrome receiving cyclophosphamide treatment are at particular risk of developing severe chickenpox infection. To our knowledge, there has been only one report of fatal chickenpox infection in a child who received steroids for nephrotic syndrome. We report here a case of fatal haemorrhagic chickenpox complicating nephrotic syndrome.

Matched MeSH terms: Chickenpox/etiology*

Fulltext Varicella in children with haematological malignancy--outcome of treatment and prevention

Ho CM, Khuzaiah R, Yasmin AM

Med J Malaysia, 1994 Mar;49(1):29-35.

PMID: 8057987

Primary varicella-zoster virus infection in children with haematological malignancy is a life threatening disease. In one year, there were 10 cases of varicella and 2 cases of zoster among these children as well as 5 mothers who were accompanying their children who developed varicella in the oncology ward. Two children died of fulminating disease despite aggressive antiviral and supportive treatment. Acyclovir can be used in treatment and prophylaxis in exposed susceptible children. Varicella -zoster immune globulin is not available in this country. Vaccination with live virus has been shown to be protective in immunocompromised children and needs consideration.

Matched MeSH terms: Chickenpox/etiology; Chickenpox/epidemiology; Chickenpox/therapy*; Chickenpox Vaccine

Concomitant dengue fever in Varicella zoster infection - A rare presentation

Shaiful Ehsan SM, Iskandar FO, Mohd Ashraf AR

Med J Malaysia, 2019 08;74(4):347-348.

PMID: 31424049

Varicella zoster infection is one of the self-limiting viral infections during childhood and dengue fever is an endemic infection in Malaysia, which commonly occurs in the form of nonspecific febrile illness at the initial stage. It is rare for the two viral infections to occur simultaneously. A case of dengue fever without warning sign in a five-year old girl was reported, with early symptoms of fever and vesicular rashes. She was clinically diagnosed with varicella zoster infection during the first visit. Surprisingly, she remained febrile even on day six of illness despite no new vesicular lesions on her skin. Due to suspicion of another infection, follow-up investigation was done and revealed isolated thrombocytopenia. This finding was confirmed with positive NS1Ag. A case of rare dengue fever concomitant with varicella zoster infection was reported.

Matched MeSH terms: Chickenpox/complications; Chickenpox/diagnosis*

Adult varicella zoster infection complicated with streptococcal retrosternal abscess

Yap FBB, Kiung ST

South. Med. J., 2009 Jun;102(6):653-5.

PMID: 19434036 DOI: 10.1097/SMJ.0b013e3181a49a71

A 43-year-old lady with type 2 diabetes mellitus and bronchial asthma presented with varicella zoster infection, dyspnea, and neck fullness. An urgent computed tomography scan revealed a mediastinal abscess with superior vena cava thrombus. Blood, mediastinal pus, and swab from a vesiculopustule on the neck cultured group A beta hemolytic Streptococcus. She recovered with a combination of broad spectrum antimicrobials, antivirals, and surgical drainage. This case illustrates the rare occurrence of mediastinal abscess and acute superior vena cava obstruction caused by group A beta hemolytic Streptococcus complicating adult varicella zoster.

Matched MeSH terms: Chickenpox/complications*; Chickenpox/drug therapy; Chickenpox/microbiology

Vision loss in an immunocompetent child post varicella infection: A case report

Lee SC, Ng M, Tan CL, Ting SL

Malays Fam Physician, 2020;15(1):54-57.

PMID: 32284807

Chickenpox may lead to several neurological complications. Optic neuritis is one of the complications which has rarely been described, especially in immunocompetent individuals. We report a case of an 11-year-old immunocompetent girl who presented with sudden onset bilateral vision loss three weeks after varicella eruption. Ophthalmic examination revealed bilateral optic disc edema. Diagnosis of bilateral optic neuritis secondary to varicella was established based upon the preceding medical history, supported with clinical and radiological findings.

Matched MeSH terms: Chickenpox

Fulltext Varicella zoster causing preseptal cellulitis - uncommon but possible

Qualickuz Zanan NH, Zahedi FD, Husain S

Malays Fam Physician, 2017;12(3):37-39.

PMID: 29527280

Background: Varicella has been known to be a harmless childhood disease. However, it has been reported that severe complications have taken place following Varicella infection, in both immunocompetent, as well as immunocompromised, individuals. Cutaneous complications of Varicella may manifest as preseptal cellulitis, albeit rarely.

Report: We present a case of a 4-year-old boy who presented with symptoms and signs of preseptal cellulitis following Varicella infection. He was referred to the otorhinolaryngology team for a nasoendoscopy to rule out sinusitis, in view of the fear that a child presenting with a swollen red eye may be a case of true orbital cellulitis. He was treated successfully with intravenous antibiotics and surgical drainage of the preseptal collection.

Conclusion: It is imperative for clinicians to be aware that a simple Varicella infection may lead to cutaneous complications in the pediatric age group, especially in children who are 4 years and younger. They may develop preseptal cellulitis, whose presentation might mimic that of orbital cellulitis. Empirical treatment with antibiotics would be advantageous for the patient. A nasoendoscopic examination may also be warranted in these cases to rule out sinusitis as a cause of orbital cellulitis.

Matched MeSH terms: Chickenpox

Fulltext Lethal complication of a common disease-varicella pneumonitis

Neesha Sundramoorthy, Khaiteri R., Low J. M.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):68-68.

MyJurnal

Introduction: Varicella pneumonitis is a rare but lethal complication of varicella zoster infection. Case description:We report a case of a 42 year old gentleman who presented with fever, rash, cough and worsening shortness of breath after exposure to his daughter who just recovered from varicella zoster infection. He is an active smoker with no comorbidities. He presented on day 4 of illness with generalised vesicular eruption and respiratory examination revealed reduced vesicular breath sounds bilaterally. He was intubated in view of worsening respiratory distress and was transferred to ICU. Chest X-ray and ABG was suggestive of acute respiratory distress syndrome(ARDS). He was treated with IV Acyclovir and broad spectrum antibiotics in view of subsequent hospital acquired infection. He was discharged well after 3 weeks of hospitalisation. Discussion: Varicella zoster infection is caused by Human alpha-herpesvirus 3, one of eight herpes viruses known to infect humans. Diagnosis of varicella pneumonitis with ARDS was made on the basis of rash, respiratory symptoms and contact with a child who just recovered from varicella zoster infection and rapid worsening of radiological changes. The risk factor of developing severe pneumonitis can be attributed to active smoking. Conclusion: High degree of suspicion and timely diagnosis is crucial for a favourable outcome in a patient with this rare complication.

Matched MeSH terms: Chickenpox

Spectrum of flood-related diseases encountered during flood disaster in Johore, Malaysia

Badrul Hisham, A.S., Nor Azian Shaharom, C.M.D., Marzukhi, M.I., Norli, R., Fatimah, O., Kee, KF, et al.

Malaysian Journal of Community Health, 2009;15(3):15-23.

MyJurnal

The state of Johore, Malaysia had been hit by the worst flood in the Malaysian modern history on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) affecting all the eight districts. A total number of 157,018 and 155,368 Johore population had been displaced by the first and the second wave event respectively. The Johore State Health Department activated the Flood Action Plan which include mobilising medical teams to conduct daily clinical examinations on the flood victims and health teams to inspect flood relief centres, food premises and homes at flood-hit areas with regard to prevent and control communicable diseases. The spreadsheet format was used to collect data on diseases, injury and death throughout the Johore flood disaster period starting from the 19th December 2006 until 19th February 2007. Analyses showed that 19,670 flood victims (36.3%) had communicable diseases and 34,530 (67.0%) had non-communicable diseases. As for the communicable diseases and symptoms/syndromes related to communicable disease, 41.3% were acute respiratory infections (ARI) followed by 25.9% skin infections, 19.1% fever, 10.1% acute gastroenteritis (AGE) and 3.0% acute conjunctivitis. Other infectious diseases include 61 notifiable diseases (46 food poisoning, 14 dengue fever and one tuberculosis), 20 leptospirosis (with two deaths), 20 chicken pox and two melioidosis cases. The Batu Pahat district had the highest incidence for the majority of the communicable diseases because of the prolonged flooding period. No cholera, typhoid, malaria, measles or hand-foot-mouth disease (HFMD) cases were detected among the Johore flood victims. Trends of disease incidence follow the number of evacuees placed in the relief centres corresponding to respective wave. A total of 507 flood victims had physical injuries related to flood mostly due to fall onto wet floor at the relief centres. Fifteen deaths due to drowning were mainly caused by accidental fall into the flood water. The incidence of communicable diseases encountered had been appropriately anticipated and managed attributed to enhanced public health control programmes augmented by syndromic and laboratory surveillance on potentialy fatal infectious diseases. Equal emphasis should be given to the surveillance and control of chronic diseases.

Matched MeSH terms: Chickenpox

Congenital varicella syndrome

Lee, Eric K.H., Cheah, Irene G.S.

Malaysian Journal of Child Health, 1997;9(1):97-101.

MyJurnal

Congenital varicella syndrome is a rare outcome of early primary maternal varicella zoster infection. The neuromuscular anomalies, skeletal defects and skin lesions of such a case are described in our case report. The diagnosis of congenital varicella syndrome, the prenatal risk and management of primary maternal varicella infection in pregnancy are also discussed.

Matched MeSH terms: Chickenpox

Fulltext A case of congenital chicken pox

Cosgrave AK, Samuel J

Malayan Medical Journal, 1934;9(1):68.

Matched MeSH terms: Chickenpox

Fulltext A case of herpes zoster coincident with chickenpox

O'Connor MP, Ponnampalam P

Malayan Medical Journal, 1931;6(1):25.

Matched MeSH terms: Chickenpox

Fulltext Varicella herpetica

Lowe GH, Somasundaram A

Malayan Medical Journal, 1936;11:227.

Matched MeSH terms: Chickenpox

Fulltext A note on the racial incidence of chicken-pox in Kuala Lumpur during the years 1936-1940

Milne JC

Journal of the Malaya Branch of the British Medical Association, 1941;5(1):9-13.

Matched MeSH terms: Chickenpox

Fulltext Herpes Zoster Ophthalmicus, Central Retinal Artery Occlusion, and Neovascular Glaucoma in an Immunocompetent Individual

Ahmad SS, Suan ALL, Alexander SM

J Ophthalmic Vis Res, 2019 3 2;14(1):97-100.

PMID: 30820294 DOI: 10.4103/jovr.jovr_65_17

Purpose: To report the unusual case of an immunocompetent individual with herpes zoster ophthalmicus who developed central retinal artery occlusion and subsequent neovascular glaucoma.

Case Report: A 40-year-old, immunocompetent patient was diagnosed with herpes zoster ophthalmicus and central retinal artery occlusion on initial presentation. Subsequently, he developed neovascular glaucoma.

Conclusion: There are a few case reports of central retinal artery occlusion developing after varicella zoster virus infection. However, a literature search found no reports of neovascular glaucoma following central retinal artery occlusion secondary to varicella zoster virus infection. The present case report indicates that neovascular glaucoma is a possible complication in such a scenario.

Matched MeSH terms: Chickenpox

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