Varicella Zoster

Virus
(VZV)
J AC QUEL I N E, VAL ERI A , CA RL A

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

Group I (ds DNA)

Family: Herpesviridae
Subfamily:
Alphaherpesvirinae
Genus: Varicellovirus

Enter the body through the

respiratory system

(VZV)

Structure and Genomic

Enveloped 200 nm particle
Tegument
separates
the
capsid from the lipid envelope,
which incorporates the major
viral glycoproteins.
Icosahedral
100 nm

nucleocapsid

of

Double-stranded DNA virus

(inside the nucleocapsid)
DNA consists of approximately
125,000 bp

Epidemiology

Reservoir: Human

Varicella is one of the classic

diseases of childhood
prevalence occurring in the 4 10 years old age group

Transmission

About 80-85% vaccine is

effective against all disease
and highly (more than 95%)
effective in prevention of
severe disease.

Temporal Patterner: Peak in

winter and early spring

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

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

Airborner droplet
Direct contact with lesions

Communicability: days
before /to days after onset
of rash

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): 197210.
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
Analgesics
Calamine

Chickenpox requires antiviral therapy and

symptomatic.

Antihistamines

 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

Administrat percutaneous
ion
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): 197210. doi:10.1038/nrmicro3215
Morbidity
and
Mortality
Weekly
Report,
available
www.cdc.gov/mmwr/preview/mmwrhtml/mm6112a4.
s_cid=mm6112a4_w.

at

http://
htm?