• Clinical and Experimental Pediatrics
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• 제49권3호
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• pp.229-234
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• 2006

Varicella, which is mostly a benign disease, but also can cause considerable health burden in the community, can be prevented by immunization with live attenuated varicella vaccine. Higher uptake of varicella vaccine by universal immunization in North America has apparently been associated with decline in the number of reported cases of varicella, varicella-related hospitalizations, and the number of deaths caused by complications of varicella. On the contrary, there has been some reluctance in endorsing varicella vaccine for universal immunization in most of European countries. Concerns include unanticipated outbreaks of varicella among vaccine recipients, risk of varicella among unvaccinated adults, risk of herpes zoster among vaccinees as well as unvaccinees. Recently developed measles, mumps, rubella, and varicella combination vaccine and herpes zoster vaccine that may be licensed in the upcoming years may be the solution for varicella vaccine to be utilized in a greater scale. In Korea several varicella vaccine products have been utilized since late 1980. The adoption of varicella vaccine for universal immunization since 2005 along with the changing view in varicella prevention strategy mandates more studies for immunogenecity and efficacy of varicella vaccines as well as more surveillance to delineate the changes in epidemiology of varicella in Korea.

• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.12-19
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• 2008

Varicella is a highly infectious disease caused by the varicella zoster virus. The varicella vaccine was developed by Michiaki Takahashi in Japan in 1974. Despite the worldwide distribution of efficient vaccines, varicella vaccination policy is extremely variable from country to country. Although varicella vaccine is not currently recommended for universal vaccination in Japan, most countries throughout Europe, and developing countries, it had been introduced into Korea in 1988 and 20 years have elapsed since its use. Currently, varicella vaccine has been most extensively used in the United States where routine 2-dose vaccination program has been recently implemented for children. Recent 2-dose schedule in the United States and the availability of combination measles-rubella-varicella vaccines may lead to future varicella vaccination policy changes in many countries. With this background, this article summarizes the current status of varicella vaccination policies worldwide and presents provisional updated recommendation of varicella vaccination in Korea.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.222-230
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• 2017

Background: Varicella is the most common infectious disease reported despite the high vaccination rate. Interventions that target humans are particularly effective for varicella because humans are its only natural host. On the other hand, the existing national varicella surveillance systems lack the information to identify an outbreak. Therefore, a new index to assess varicella outbreaks was developed. Methods: The residential addresses of 2,718 varicella cases reported in Daegu in 2016 were converted to geographic coordinates and the distances between new varicella case and previous cases within 21 days were calculated from the date analyzed. Two cases were considered to be adjacent if the distance between them was less than 1 km. Finally, a proximity index was introduced by dividing the number of adjacent cases by the number of new cases on the date analyzed. Results: First, time-series charts and scatter plots were used to verify that the proximity index reflected the spatial closeness of the different varicella cases. The proximity index is helpful in identifying outbreaks from a list of single varicella cases. In addition, in this study, a new epidemic characteristic of varicella based on the proximity index was shown. Conclusion: The proximity index introduced in this study can be used to determine the likelihood of an outbreak from a single case of varicella, and it can be embedded in a web-based national varicella surveillance system that is currently in operation.

• Clinical and Experimental Pediatrics
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• 제46권10호
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• pp.1047-1050
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• 2003

저자들은 분만 10일 전 herpes zoster 진단받은 산모에서 출생한 환아에서 피부 병변 없이 신경학적 이상 증세만을 보이는 perinatal varicella infection 1례를 경험하였기에 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제29권2호
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• pp.110-117
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• 2022

대상포진은 소아에서 흔하지 않은 질환이며, 국외의 자료에서는 수두 백신 접종 정책 시행 후 대상포진의 발생률이 감소되었다. 저자들은 건강한 어린 소아에서 수두 백신 접종 후 발생한 대상포진 2예를 경험하였다. 특히 이중 1예에서는 피부 검체를 검사하여 대상포진이 백신주 varicella-zoster virus (VZV)에 의한 것을 확인하였다. 2예 모두 발진이 번지는 양상이어서 항바이러스제를 투여하였고 호전되었다. 수두 백신을 접종 받은 어린 소아가, 수두에 이환 되거나 노출된 적이 없으며, 대상포진이 발병하였을 경우 백신주에 의한 대상포진의 가능성을 고려해야 한다.

• Pediatric Infection and Vaccine
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• 제14권2호
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• pp.188-193
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• 2007

대상포진 수막염은 대상포진 후 발생할 수 있는 신경학적 합병증으로 주로 면역 기능이 저하된 상태의 환자에게서 발생한다. 저자들은 면역 기능이 정상인 환아에서 피부 병변 없이, 수두 백신 접종을 한 경우 드물게 발생하는 대상포진 수막염 2례를 경험하였기에 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.339-343
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• 2007

Varicella is a contagious infection in childhood disease typically affecting children aged 2-8 years and usually follows benign outcome. In the adult, clinical presentation is more severe and more commonly associated with complications. Varicella pneumonia, although rare, is a potentially life-threatening complication that should be suspected in any adult with varicella and respiratory symptoms. We report a case of varicella pneumonia in immunocompetent patient. The characteristic radiographic findings consisted of diffuse scattered coarse nodular infiltrations, less than 1cm sized, with ground glass opacity and consolidation in both lung fields. The patients was started on intravenous acyclovir. The chest radiograph performed 2 weeks later showed complete resolution of the pulmonary lesions.

• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.607-610
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• 2009

수두 바이러스는 두 가지 임상 증후군을 유발하는 데, 초회 감염되면 수두를, 지각 신경절에 잠복해 있다가 재발하면 대상포진을 일으킨다. 수두백신이 널리 이용되면서 수두 이후의 대상포진 뿐만 아니라 수두백신 접종 후 발생한 대상포진도 관찰되고 있다. 수두바이러스에 의한 합병증으로는 2차 세균감염에 의한 농가진, 연조직염 등의 피부감염이 가장 흔하며 이외에도 호흡기계와 신경계의 합병증이 잘 알려져 있다. 또 수두 바이러스 감염 후의 합병증으로 심부정맥혈전증이 매우 드물게 보고되고 있다. 주로 혈관벽의 손상과 관련된 것으로 여겨지며 하지 정맥을 침범한다. 수두 감염된 심부정맥혈전증 증상을 보이는 환자에서 합병증을 의심하고 조기 진단하여 항응고치료를 하는 것이 추천된다. 이에 저자들은 수두 백신만 1회 접종한 환아에서 심부정맥혈전증을 동반한 대상포진이 발생하여 acyclovir 정맥주사와 저분자량 헤파린 피하주사로 회복되어 보고한다.

• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.1-7
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• 2016

The two distinctive clinical features of varicella-zoster virus (VZV) are varicella (chickenpox) by primary infection and zoster (singles) by the reactivation of latent infection. In addition to the two typical clinical symptoms mentioned above, diverse clinical manifestations have been reported as a result of VZV reactivation, including chronic radicular pain without rash, visual loss, facial palsy, dysphagia, sore throat, odynophagia, otalgia, hearing loss, dizziness, headache, hemiplegia, etc. Most of these symptoms are derived from neuropathy and vasculopathy of affected nerves and arteries. Diagnosis of VZV disease can be difficult if there is no appearance of a skin rash during development of atypical symptoms. In addition to natural infection, vaccination and anti-viral agent treatment have influenced the changes of epidemics and clinical presentations of varicella and zoster. In this article, diverse clinical manifestations caused by VZV reactivation, particular without skin rash, are reviewed.

• Clinical and Experimental Pediatrics
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• 제57권12호
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• pp.538-541
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• 2014

Varicella is usually considered to be a benign disease in healthy children; however, serious complications can occur such as necrotizing fasciitis and toxic shock syndrome. We describe a 38-month-old girl with necrotizing fasciitis and streptococcal toxic shock syndrome following varicella. She was previously healthy and vaccinated against varicella at 12 months of age. She had been diagnosed with varicella three days prior to presenting at our facility; she developed fever, vomiting, and painful swelling on her left flank. Her skin lesions worsened, she became lethargic, and had episodes of hypotension and coagulopathy. Necrotizing fasciitis on the left abdominal wall, buttocks, and left thigh was diagnosed by magnetic resonance imaging, and group A Streptococcus was isolated from a tissue culture. She was diagnosed as necrotizing fasciitis and streptococcal toxic shock syndrome, and successfully treated with repeated surgical debridement and fasciotomy, in addition to intensive antibiotics. Our experience suggests that necrotizing fasciitis in patients with varicella should be considered to be a rare complication even with widespread vaccine use. Early diagnosis and intensive treatment are required to prevent a fatal outcome.