China
Africa
Explore chapters and articles related to this topic
Viral Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Final comment: Overall, varicella is a common and contagious infection with characteristic pruritic dermatologic manifestations. Therapy is indicated for certain populations and is ideally started promptly. Counseling about viral transmission and emphasizing prevention through vaccination is key in reducing incidence and complications. The incidence of varicella has decreased with the varicella vaccine.
Varicella
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
VZV-seronegative pregnant women should avoid exposure to individuals with chickenpox. A live attenuated varicella vaccine (Varivax®, Merck, NJ, U.S.) has been demonstrated to be safe in preventing chickenpox in adults. In the United States, seronegative women presenting for preconception counseling or women undergoing infertility treatment should be offered vaccination. The vaccine is not available in the United Kingdom for these indications. Varicella vaccine is contraindicated in pregnant women. If a woman accidentally receives VZV vaccine within one month of conception or in pregnancy, the incidence of fetal infection and complications does not appear to be increased from baseline, and termination should not be recommended. In one registry, among 131 live births to VZV-seronegative women, there was no evidence of CVS, and the major birth defect rate was not statistically increased [13]. Nonimmune health workers exposed to VZV should minimize patient contact from days 8 to 21 post-contact.
The Child with Recurrent Infections
Published in Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan, Diagnosing and Treating Common Problems in Paediatrics, 2017
Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan
Exposure to varicella must be avoided in those with immunodeficiency states, as they are at of increased risk of severe disease. Significant exposure includes (a) continuous household contact, (b) being indoors for more than 1 hour with a person with varicella, (c) having more that 15 minutes face-to-face contact with an infected person with varicella and (d) touching a varicella lesion. Varicella zoster immunoglobulin is effective if administered within 96 hours of exposure and provides protection for 3 weeks (varicella zoster immunoglobulin dosing is 125 IU/10 kg; to a maximum dose of 625 IU and with a minimum dose of 125 IU). Varicella vaccine within 3–5 days of exposure can prevent or reduce infection severity.
Assessing vaccine effectiveness for varicella in Wuxi, China: a time-series analysis
Published in Annals of Medicine, 2023
Lingling Wang, Xu Yang, Xuwen Wang, Ping Shi, Xuhui Zhang
In China, only a few provinces introduced a two-dose varicella vaccine schedule as a routine childhood immunization for children. The implementation of the two-dose varicella vaccination program in Wuxi clearly provided evidence to quantify the impact of the program. In the time-series approach, 0.8% fewer cases were associated with a 1% increase in the two-dose varicella vaccination rate, but according to an analysis of the vaccination situation, the immunization effectiveness of the two-dose program was 55.1%, which indicated a limited effect on the control of varicella. One reason for this may be the low immunization coverage rate [21]. A study found that the estimated coverage rate of varicella based on Jiangsu Province’s vaccine management system (approximately 55–65%) was low, varicella outbreaks still occurred frequently in southern Jiangsu Province due to the lower antibody positive rate [9]. Nonetheless, our study demonstrated that the immunization effect of varicella vaccine could blocked the transmission of varicella. Moreover, it has been only 3 years since the addition of the two-dose schedule to the Expanded Programme on Immunization, which means that vaccine performance may be underestimated. Thus, further surveillance remains warranted on the effectiveness following the immunization of two-dose VarV.
Harming Children to Benefit Others: A Reply
Published in The American Journal of Bioethics, 2020
Heidi Malm, Mark Christopher Navin
First, what is being asked of NYINYV children isn’t easy in the way that tossing a life-preserver, performing the Heimlich Maneuver, lifting a child’s head out of a puddle, or summoning professional aid would be easy. And this is true even if we ignore, for a moment, the long-term risks of varicella infection because the short-term burdens are significant themselves. In addition to the “routine” costs of a 7–10 day infection, some children suffer greatly. The CDC reports that prior to widespread uptake of varicella vaccine, approximately 100 children in the US died of chickenpox each year and 11,000 more required hospitalization for that disease (CDC 2003). We think that if 100 persons in the US died each year and 11,000 more required hospitalization as a result of trying to provide an “easy” rescue such as performing the Heimlich Maneuver, applying a tourniquet, or lifting a child’s head out of a puddle, then we would be hearing about these costs in the news and society would reconsider whether these kinds of rescues were actually “easy.”4
Clinical practice guidance for juvenile idiopathic arthritis (JIA) 2018
Published in Modern Rheumatology, 2019
Nami Okamoto, Shumpei Yokota, Syuji Takei, Yuka Okura, Tomohiro Kubota, Masaki Shimizu, Tomo Nozawa, Naomi Iwata, Hiroaki Umebayashi, Noriko Kinjo, Tomoko Kunishima, Junko Yasumura, Masaaki Mori
Because some JIA patients have not completed their immunization program, they are susceptible to natural infections with these pathogens. It is advisable to verify histories of immunization and the presence of specific antibodies before initiating therapy. Inactivated vaccines are generally effective and safe in patients on GC, DMARDs, and immunosuppressive drugs and/or biologics such as TNF inhibitors and IL-6 inhibitors [65]. Thus, it is recommended that inactivated vaccines are administered to JIA patients during the time when their underlying disease is stable. On the other hand, live vaccines are contraindicated for patients on high-dose GC, immunosuppressive agents, and biologics [65]. However, the efficacy and safety of booster vaccines has recently been reported in patients with JIA [66,67]. Thus, live vaccines should be withheld, but if indicated, may be considered in Japan as a clinical trial after approval by the Institutional Review Board. Varicella vaccine should be considered in sensitive patients ideally 2–4 weeks or longer prior to commencement of immunosuppressive agents. Palivizumab prophylaxis should be considered to prevent exacerbation of respiratory syncytial virus in infants aged 24 months or younger under treatment with immunosuppressive agents [68].