Vaccine Oka Varicella Meningitis in Two Adolescents
Vaccine Oka Varicella Meningitis in Two Adolescents
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DOI：
10.1542/peds.2019-1522
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发表时间：
2019-12-01
期刊：
影响因子：
8
通讯作者：
Englund, Janet A.
中科院分区：
文献类型：
--
作者：
Harrington, Whitney E.;Mato, Sayonara;Englund, Janet A.
水痘减毒活疫苗是美国自1995年以来的常规免疫接种，既安全又有效。然而，像野生型水痘-带状疱疹病毒一样，Oka （vOka）水痘疫苗可以建立潜伏期并重新激活为带状疱疹，很少导致严重疾病，特别是在免疫功能低下的宿主中。以前曾报道过在接受单剂水痘疫苗的幼儿中再次激活的vOka导致脑膜炎的病例；在接种两剂疫苗系列后，大龄儿童的vOka再激活情况尚不清楚。我们报告了2例复发性沃卡脑膜炎的青少年，1例免疫正常，1例免疫功能低下，他们都在儿童时期接受了2剂水痘疫苗。儿科医生应该意识到水痘在接种疫苗的儿童和青少年中重新激活和引起临床显著中枢神经系统疾病的潜力。
The live-attenuated varicella vaccine, a routine immunization in the United States since 1995, is both safe and effective. Like wild-type varicella-zoster virus, however, vaccine Oka (vOka) varicella can establish latency and reactivate as herpes zoster, rarely leading to serious disease, particularly among immunocompromised hosts. Previous cases of reactivated vOka resulting in meningitis have been described in young children who received a single dose of varicella vaccine; less is known about vOka reactivation in older children after the 2-dose vaccine series. We present 2 adolescents with reactivated vOka meningitis, 1 immunocompetent and 1 immunocompromised, both of whom received 2 doses of varicella vaccine many years before as children. Pediatricians should be aware of the potential of vOka varicella to reactivate and cause clinically significant central nervous system disease in vaccinated children and adolescents.