Herpes Zoster with Skin Lesions and Meningitis Caused by 2 Different Genotypes of the Oka Varicella-Zoster Virus Vaccine

• Published in: The Journal of infectious diseases Vol. 198; no. 10; pp. 1444 - 1447
• Main Authors: Levin, Myron J., DeBiasi, Roberta L., Bostik, Vanda, Schmid, D. Scott
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.11.2008; University of Chicago Press
• Subjects: Alleles; Applied microbiology; Biological and medical sciences; Cerebrospinal fluid; Chickenpox; Chickenpox - prevention & control; Chickenpox vaccine; Chickenpox Vaccine - adverse effects; Child; DNA, Viral - analysis; DNA, Viral - cerebrospinal fluid; Fundamental and applied biological sciences. Psychology; Genetic Variation; Genotype; Genotypes; Herpes zoster; Herpes Zoster - etiology; Herpes Zoster - virology; Herpesvirus 3, Human - genetics; Herpesvirus 3, Human - isolation & purification; Human viral diseases; Humans; Infectious diseases; Lesions; Male; Medical sciences; Meningitis - virology; Microbiology; Miscellaneous; Sequence Alignment; Skin Diseases, Viral - virology; Vaccination; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Varicella zoster encephalitis; Varicella-zoster virus; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Viral meningitis; Virology; Viruses; Varicella zoster virus; Nervous system diseases; Skin disease; Herpes zoster; Microbiology; Herpesviridae; Alphaherpesvirinae; Genotype; Vaccine; Virus; Infection; Viral disease; Central nervous system disease; Meningitis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/592452

A previously healthy boy who had received varicella vaccine developed herpes zoster with meningitis. The vaccine strain recovered from scabs of 3 skin lesions had the wild-type allele at position 108111, a vaccine marker never previously associated with vaccine-associated adverse events. The vaccine strain from cerebrospinal fluid also contained mutations never previously observed at vaccine-associated single nucleotide polymorphisms that would alter amino acid sequences in ORF54 and ORF59. The presence of distinct strains in skin lesions and cerebrospinal fluid indicate that >1 variant strain may reactivate to cause herpes zoster.