Varicella outbreak in a women's prison - Kentucky

Article Abstract:

Varicella, commonly known as chickenpox, is a highly contagious infectious disease frequently occurring in childhood and especially serious in adults, infants, pregnant women, and people with compromised immune systems, such as HIV-positive individuals and people with AIDS. The infection is identified by the detection of the VZ (varicella-zoster) virus through the presence of the viral antibody. The diagnosis is made by measuring the concentration of VZ antibody in the bloodstream. An outbreak of varicella occurred in a Kentucky women's prison in early 1989. The spread of the virus was recorded while measures were instituted to contain the virus. The prison population of 1,276 contained members who may have had extremely adverse reactions to the virus. Thirty-six were pregnant, 32 tested HIV-positive and 6 had AIDS. About 25 percent of the inmates were Hispanic, mostly from Central and South America. The virus is less common in rural tropical and subtropical areas. Individuals from these regions would be less likely to have contracted the disease in childhood and, therefore, more susceptible. The first case was diagnosed in a woman who had recently returned from a visit to her daughter who had an active case of chickenpox. The second case occurred in a women who had been in close contact with the first woman 24 hours prior to the observation of initial symptoms. The third and last case was a woman who was residing in the chronic-care unit of the prison because of a severe arthritic condition. The exposure of the third individual was attributed to her presence in the same classroom as the second woman. The infection of the third women made the rapid containment of this infection an even greater concern: the chronic-care unit included two women with AIDS. Testing was promptly performed on all inmates and staff and appropriate precautions were taken based upon these results. All incidents of exposure were considered and precautionary quarantines were enforced. The spread of the disease was successfully checked and no additional infections were diagnosed.

Health aspects, Statistics, Demographic aspects, Prisoners, Prisons for women, Women's prisons

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Comparison of Tzanck smear, viral culture, and DNA diagnostic methods in detection of herpes simplex and varicella-zoster infection

Article Abstract:

The polymerase chain reaction (PCR) may be more effective than the Tzanck smear or viral cultures for detecting herpes simplex virus (HSV) or varicella-zoster virus (VZV) in tissue samples. A Tzanck smear involves scraping material from skin lesions and staining them to detect the virus. DNA for PCR analysis was extracted from Tzanck smears taken from 30 patients suspected of having HSV infection and 32 suspected of having VZV infection. PCR detected HSV DNA in 83% of unstained smears and VZV DNA in 97% of unstained smears. PCR confirmed all the cases of VZV infection that tested positive by viral culture and 88% of the HSV infections positive by viral culture. In addition, it detected four cases of HSV infection and 18 cases of VZV infection that had been negative by viral culture. The Tzanck smear alone detected only 60% of HSV infections and 75% of VZV infections that were positive by viral culture.

Diagnosis, Polymerase chain reaction, Herpes simplex

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Management of varicella exposure in a neonatal intensive care unit

Article Abstract:

Premature and critically ill infants have surprisingly low levels of antibodies to chicken pox due to shortened gestation periods and the large number of blood transfusions necessary to treat the infants. The information in this study results from research at the University of Texas Health Science Center, where 22 infants were exposed to chicken pox by a nurse working in the neonatal intensive care unit. After discovery of the exposue, the infants were tested for the antibody. Ten of the 22 infants tested negative for the antibody. In a similar study of normal-term infants, only one of 38 tested negative. The ten infants who tested negative were injected with varicella- zoster immune globulin; the level of antibody was directly related to the dose administered.

Analysis, Hospitals, Infants (Newborn), Newborn infants, Neonatal intensive care, Communicable diseases, Disease transmission, Hospitalization, Infants, Immunization, Immunization of infants

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