Varicella Zoster Virus

(VZV)
JACQU EL IN E, VAL ERIA , CA RLA

IMBS
• Member of herpes virus group
• 90% of people having been infected
• Capacity to persist in the body after the
first infection as a latent infection.
• Varicella-zoster virus (VZV) Etiologic agent
• Varicella (Chicken pox)
REACTIVATION
• Herpes zoster (shingles).
Varicella Zoster Virus (VZV)

• Group I (ds DNA)

• Family: Herpesviridae
• Subfamily: Alphaherpesvirinae
• Genus: Varicellovirus

• Enter the body through the

respiratory system
Structure and Genomic
• Enveloped 200 nm particle
• Tegument separates the capsid
from the lipid envelope, which
incorporates the major viral
glycoproteins.
• Icosahedral nucleocapsid of 100
nm
• Double-stranded DNA virus (inside
the nucleocapsid)
• DNA consists of approximately
125,000 bp
Epidemiology
• Varicella is one of the classic • Reservoir: Human
diseases of childhood prevalence
occurring in the 4 - 10 years old • Transmission
age group • Airborner droplet

• About 80-85% vaccine is effective • Direct contact with lesions

against all disease and highly • Temporal Patterner: Peak in winter

(more than 95%) effective in and early spring
prevention of severe disease.
• Communicability: days before /to
days after onset of rash

Mona Marin, John X. Zhang, Jane F. Seward

Pediatrics Aug 2011, 128 (2) 214-220; DOI: 10.1542/peds.2010-3385
Pathogenesis
Pathogenesis

• Incubation Period:
• 10 – 21 days
• Asintomatic
VZV Life Cycle and Replication
 VZV Life Cycle and Replication
• Baltimore:

Source: Leigh, Z. ; Nandini, S.; Stefan, O.; Ann, A. (2014) Molecular mechanisms of varicella zoster virus pathogenesis.
Nat Rev Microbiol. 2014 March ; 12(3): 197–210. doi:10.1038/nrmicro3215.
VZV Life Cycle and Replication
TROPISM
T Cell Tropism
Skin Tropism
Neurotropism
 The rash is generalized, pruritic and progresses
rapidly from macules to papules to vesicular
lesions before crusting.
. . .
..
. . . . .

Symptoms
Incubation period: 14 to 16 days after
exposure. Range: 10 to 21 days.
Other typical symptoms that may begin to appear 1-2 days before rash include:
 Diagnose chickenpox based
on the characteristic rash.

Diagnostic
Leukopenia
Relative or absolute lymphocytosis
Liver function test are mildly elevated
Laboratory evaluation has not been considered necessary

But, If there's any doubt about the diagnosis, chickenpox can be confirmed with
laboratory tests (blood tests or culture of lesion samples).

Varicella Laboratory Diagnosis

• ● Isolation of varicella virus from clinical specimen
• ● Rapid varicella virus identification using PCR
• ● ELISA and Latex Agglutination (LA) useful in screaning
Therapy
Chickenpox requires antiviral therapy and symptomatic.

Analgesics Antihistamines Calamine

• For people who have severe infections: acyclovir (shorten the
duration and severity of symptoms).

• Neonatal VZV infection may be treated with VZIG (varicella zoster

immune globulin) .
Immunization
Vaccine: prevent the spread of the disease.

Its complications and subsequent reinfection as herpes zoster.

up to 80 % of cases.

This is given to healthy children between 12 and 18 months old.

From the 13 years they can be immunized with two doses.

However, not be given to people with a weak

immune system or pregnant women.
 Varicella Zoster Virus (VZV)
Virus live attenuated varicella virus
Administration percutaneous
Immunity humoral and cellular
Efficacy 95%
Stability Storage 2-8 °C
Safe attenuation is not stable and
can revert to virulent forms
Schedule 1 dose (< 13 years)
Bibliography

• Leigh, Z. ; Nandini, S.; Stefan, O.; Ann, A. (2014) Molecular mechanisms of varicella
zoster virus pathogenesis. Nat Rev Microbiol. 2014 March ; 12(3): 197–210.
doi:10.1038/nrmicro3215
• Morbidity and Mortality Weekly Report, available at http://
www.cdc.gov/mmwr/preview/mmwrhtml/mm6112a4. htm?s_cid=mm6112a4_w.