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Twelve Children with Varicella Vaccine Meningitis: Neuropathogenesis of Reactivated Live Attenuated Varicella Vaccine Virus
Journal article   Open access   Peer reviewed

Twelve Children with Varicella Vaccine Meningitis: Neuropathogenesis of Reactivated Live Attenuated Varicella Vaccine Virus

Ethan H Heusel and Charles Grose
Viruses, Vol.12(10), p.1078
09/25/2020
DOI: 10.3390/v12101078
PMCID: PMC7599892
PMID: 32992805
url
https://doi.org/10.3390/v12101078View
Published (Version of record) Open Access

Abstract

Varicella vaccine is a live attenuated varicella-zoster virus (VZV). Like its parental strain called VZV pOka, the vaccine virus vOka retains some neurotropic properties. To better understand vOka neuropathogenesis, we reassessed 12 published cases of vOka meningitis that occurred in once-immunized and twice-immunized children, all of whom had bouts of herpes zoster preceding the central nervous system infection. Eight of the 12 meningitis cases occurred in children who had received only one immunization. There was no pattern to the time interval between varicella vaccination and the onset of herpes zoster with meningitis. Four of the meningitis cases occurred in children who had received two immunizations. Since all four children were 14 years old when meningitis was diagnosed, there was a strong pattern to the interval between the first vaccination at age 1 year and onset of meningitis, namely, 13 years. Knowledge of pathogenesis requires knowledge of the location of herpes zoster; the majority of dermatomal rashes occurred at sites of primary immunization on the arm or thigh, while herpes zoster ophthalmicus was uncommon. Based on this literature review, currently there is no consensus as to the cause of varicella vaccine meningitis in twice-immunized children.
Adolescent Chickenpox Vaccine - adverse effects Child Child, Preschool Female Herpes Zoster - pathology Herpes Zoster - virology Herpesvirus 3, Human - growth & development Humans Infant Male Meningitis, Viral - pathology Trigeminal Ganglion - virology Vaccines, Attenuated - adverse effects Virus Activation - physiology Virus Latency - physiology

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