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Varicella-zoster immunoglobulin treatment in pregnant women in Denmark from 2005 to 2015: descriptive epidemiology and follow-up

  • C. JESPERSEN (a1), I. G. HELMUTH (a1) (a2) and T. G. KRAUSE (a1)
Summary

Primary infection with varicella-zoster virus in pregnancy poses a risk of severe infection and embryopathies. Upon exposure, seronegative women are candidates for varicella-zoster immunoglobulin (VZIG). The aim of this paper was to describe risk factors for VZIG treatment including sources of varicella exposure and to study how many women developed clinical infection and received postpartum vaccination. We identified all pregnant women who received VZIG from December 2005 to March 2015. Additional information was obtained from Danish registers and a follow-up questionnaire. A total of 104 women were included and 88 completed the questionnaire. Significantly more women had ‘other country of origin’ than Denmark. They were more often second para (57%) and had most commonly been exposed to varicella by their own child (58%). Five women developed clinical varicella infection, and only 26·5% were vaccinated after delivery. The study concludes that few women developed infection after VZIG and none developed pneumonia. General practitioners should be particularly aware of obtaining varicella anamnesis in parous women from non-temperate countries in order to perform selective vaccination prior to pregnancy. In case of varicella exposure during pregnancy in a seronegative woman, postpartum vaccination is crucial.

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Copyright
Corresponding author
*Author for correspondence: Dr C. Jespersen, Frederiksvej 44, 3th, 2000-DK, Denmark. (Email: cecilie.jespersen@gmail.com)
References
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1. Heininger, U, Seward, JF. Varicella. Lancet 2006; 368: 13651376.
2. Lamont, RF, et al. Varicella-zoster virus (chickenpox) infection in pregnancy. British Journal of Obstetrics & Gynaecology 2011; 118: 11551162.
3. Statens Serum Institut. Chicken pox (http://www.ssi.dk/Service/Sygdomsleksikon/S/Skoldkopper.aspx). Accessed 7 January 2015.
4. Public Health England. Varicella: the green book, chapter 34, 2012 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/456562/Green_Book_Chapter_34_v3_0.pdf).
5. Marin, M, Meissner, HC, Seward, JF. Varicella prevention in the United States: a review of successes and challenges. Pediatrics 2008; 122: e744751.
6. Liese, JG, et al. The burden of varicella complications before the introduction of routine varicella vaccination in Germany. Pediatric Infectious Disease Journal 2008; 27: 119124.
7. Svahn, A, et al. Changes in seroprevalence to four herpesviruses over 30 years in Swedish children aged 9–12 years. Journal of Clinical Virology 2006; 37: 118123.
8. Alanen, A, et al. Seroprevalence, incidence of prenatal infections and reliability of maternal history of varicella zoster virus, cytomegalovirus, herpes simplex virus and parvovirus B19 infection in South-Western Finland. British Journal of Obstetrics & Gynaecology 2005; 112: 5056.
9. Lee, . Review of varicella zoster seroepidemiology in India and South-east Asia. Tropical Medicine & International Health 1998; 3: 886890.
10. Nardone, A, et al. The comparative sero-epidemiology of varicella zoster virus in 11 countries in the European region. Vaccine 2007; 25: 78667872.
11. Helmuth, I, et al. Varicella in Europe – a review of the epidemiology and experience with vaccination. Vaccine 2015; 33: 24062413.
12. Fairley, CK, Miller, E. Varicella-zoster virus epidemiology – a changing scene? Journal of Infectious Diseases 1996; 174: S314319.
13. Seward, J, Galil, K, Wharton, M. Epidemiology of varicella. In: Varicella-Zoster Virus Cambridge University Press, 2000 (http://dx.doi.org/10.1017/CBO9780511601194.012).
14. Stagno, S, Whitley, RJ. Herpesvirus Infections of Pregnancy. New England Journal of Medicine 1985; 313: 13271330.
15. Marin, M, et al. Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report 2007; 56: 140.
16. Harger, JH, et al. Risk factors and outcome of varicella-zoster virus pneumonia in pregnant women. Journal of Infectious Diseases 2002; 185: 422427.
17. Gnann, JW. Varicella-zoster virus: atypical presentations and unusual complications. Journal of Infectious Diseases 2002; 186: S9198.
18. Enders, G, Miller, E. Varicella and herpes zoster in pregnancy and the newborn. In: Varicella-Zoster Virus. Cambridge University Press, 2000, pp. 317318 (http://dx.doi.org/10.1017/CBO9780511601194.018).
19. Tan, MP, Koren, G. Chickenpox in pregnancy: revisited. Reproductive Toxicology 2006; 21: 410420.
20. Enders, G, et al. Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases. Lancet 1994; 343: 15481551.
21. Birthistle, K, Carrington, D. Fetal Varicella syndrome – a reappraisal of the literature: A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. Journal of Infection 1998; 36: 2529.
23. Miller, E, Cradock-Watson, TE, Ridehalgh, MS. Outcome in newborn babies given anti-varicella-zoster immunoglobulin after perinatal maternal infection with varicella-zoster virus. Lancet 1989; 334: 371373.
24. CDC. Chickenpox and pregnancy, infections (http://www.cdc.gov/pregnancy/infections-chickenpox.html). Accessed 24 August 2015.
25. Gershon, AA, Takahashi, M, Seward, JF. Varicella vaccine. In: Plotkin, SA, Orenstein, WA, Offit, PA, eds. Vaccines, 6th edn. Philadelphia, PA: Elsevier Saunders, 2013, pp. 837869.
26. Varilrix Product resumé. (http://www.produktresume.dk/docushare/dsweb/GetRendition/Document-10210/html). Accessed 27 August 2015.
27. Bohlke, K, et al. Postpartum varicella vaccination: is the vaccine virus excreted in breast milk? Obstetrics and Gynecology 2003; 102: 970977.
28. Statens Serum Institut. EPI-NEWS. 2015 (No. 41) (http://www.ssi.dk/English/News/EPI-NEWS/2015/No%2041%20-%202015.aspx).
30. Statistics Denmark. Statistikbanken (http://www.statistikbanken.dk/statbank5a/default.asp?w=1920). Accessed 20 August 2015.
31. Manikkavasagan, GM, et al. Antenatal screening for susceptibility to varicella zoster virus (VZV) in the United Kingdom. 2009 (http://www.screening.nhs.uk/varicella).
32. Pinot de Moira, A, Edmunds, W, Breuer, J. The cost-effectiveness of antenatal varicella screening with post-partum vaccination of susceptibles. Vaccine 2006; 24: 12981307.
33. Gershon, AA, Gershon, MD. Pathogenesis and current approaches to control of Varicella-zoster infections. Clinical Microbiology Reviews 2013; 26: 728743.
34. INFPREG. Varicella. Internet database of multidisciplinary information concerning infectious diseases during pregnancy (http://www.medscinet.se/infpreg/healthcareinfoMore.aspx?topic=32). Accessed 18 March 2016.
35. Johansen, J, Westergren, T, Lingaas, E. Post-exposure varicella prophylaxis. Tidsskrift for Den Norske Legeforening 2011; 131: 16451648.
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Epidemiology & Infection
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