Lessons From an Outbreak of Varicella Infection in Pediatric Hemato-oncology Patients
| Autor: | Galia Grisaru-Soen, Sivan Berger-Achituv, Hila Rosenfeld Keidar, Yehuda Carmeli, Rina Dvir, Michal Manistarski, Dror Levin, Ronit Elhasid |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Microbiology (medical) Herpesvirus 3 Human Pediatrics medicine.medical_specialty viruses Antiviral Agents Disease Outbreaks Immunocompromised Host 03 medical and health sciences Chickenpox 0302 clinical medicine Neoplasms 030225 pediatrics medicine Humans 030212 general & internal medicine Israel Disease management (health) Child Retrospective Studies business.industry Immune Sera Mortality rate Disease Management Immunoglobulins Intravenous virus diseases Outbreak Retrospective cohort study Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Infectious Diseases Child Preschool Varicella infection Pediatrics Perinatology and Child Health Female Oncology patients Rituximab business medicine.drug |
| Zdroj: | Pediatric Infectious Disease Journal. 37:649-653 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0000000000001920 |
| Popis: | Immunocompromised patients exposed to varicella may experience significant morbidity and a 7% mortality rate. Management and outcome of an outbreak of varicella infection among hospitalized pediatric hemato-oncology patients using the guidelines of the American Academy of Pediatrics Committee on Infectious Diseases are presented.This retrospective study describes an outbreak of varicella infection between February 2011 and June 2011. Data were retrieved from the patients' files. Positive polymerase chain reaction results for varicella zoster virus from vesicular skin lesions were used for the diagnosis of varicella infection.Twelve pediatric hemato-oncology patients experienced 13 episodes of varicella infection, 11 underwent 1 episode each and 1 patient had 2 episodes. All exposed patients without immunity received varicella zoster immune globulins or intravenous immunoglobulin and were isolated as recommended by the guidelines. Infected patients received intravenous acyclovir. One patient with acute lymphoblastic leukemia at induction chemotherapy died. All the other patients survived.Our experience in the management of hospitalized immunocompromised patients exposed to varicella was that a positive IgG serology did not confer protection after exposure to varicella infection and thus can not serve as a marker for immunity. Unlike the isolation period sufficient for immunocompetent patients, crusted lesions can be contagious and thus require extended isolation for immunocompromised patients. Patients receiving rituximab are at greater risk of having persistent or recurrent disease. Studies with a larger sample size should be performed to better assess the management of immunocompromized patients exposed to varicella. |
| Databáze: | OpenAIRE |
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