Kavaliotis J, Loukou I, Trachana M, Gombakis N, Tsagaropoulou-Stigga H, Koliouskas D
Department of Paediatrics, Hospital for Infectious Diseases, Thessaloniki, Greece.
Med Pediatr Oncol. 1998 Sep;31(3):166-9. doi: 10.1002/(sici)1096-911x(199809)31:3<166::aid-mpo7>3.0.co;2-9.
Varicella-zoster virus (VZV) infection is usually benign but immunocompromised patients are at great risk for visceral dissemination and fatal outcome. During a nationwide varicella outbreak, several of our patients contracted the disease. We undertook studies of the epidemiology and the efficacy of antiviral treatment and immunoprophylaxis.
During a 9-month period, 52 patients were exposed to cases of active varicella. Twenty-seven of these children were reexposed to active varicella > 1 month after their initial exposure. The exposure concerned 7 VZV waves of varying intimacy. In all cases, prophylaxis with intravenous immunoglobulin (IVIG), varicella zoster globulin (VZIG), or both was given. The spread of the disease was limited and only 6 patients (all immunosuppressed) developed varicella (7.6%). Three of 6 had been given IVIG and 3 VZIG + IVIG. All patients with varicella received acyclovir 30 mg/kg/day for 14 days. The disease was mild and all patients were ultimately cured.
Our results show that prophylaxis was not 100% effective, but appearance to reduce the rate of spread. The differences in incidence among the regimens used were not significant.
For the moment, immunoprophylaxis and acyclovir administration appear to be quite satisfactory in managing immunocompromised children exposed to VZV. This may change with the wider use of the varicella vaccine.
水痘带状疱疹病毒（VZV）感染通常为良性，但免疫功能低下的患者有发生内脏播散和致命后果的巨大风险。在一次全国范围的水痘暴发期间，我们的几名患者感染了该病。我们对其流行病学以及抗病毒治疗和免疫预防的效果进行了研究。
在9个月的时间里，52名患者接触了水痘活动病例。其中27名儿童在初次接触后1个月以上再次接触了水痘活动病例。此次接触涉及7次亲密程度不同的VZV传播。在所有病例中，均给予静脉注射免疫球蛋白（IVIG）、水痘带状疱疹球蛋白（VZIG）或两者进行预防。疾病传播得到了控制，只有6名患者（均为免疫抑制患者）患了水痘（7.6%）。6名患者中有3名接受了IVIG，3名接受了VZIG + IVIG。所有患水痘的患者均接受了14天的阿昔洛韦治疗，剂量为30 mg/kg/天。疾病症状较轻，所有患者最终均治愈。
我们的结果表明，预防并非100%有效，但似乎降低了传播率。所用方案之间的发病率差异不显著。
目前，免疫预防和阿昔洛韦给药在管理接触VZV的免疫功能低下儿童方面似乎相当令人满意。随着水痘疫苗的更广泛使用，这种情况可能会改变。
