Shingles Can Occur At Chickenpox Vaccination Site in Healthy Children

MedicalResearch.com Interview with:

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.
“Dew-drop on a rose petal pattern” CDC image

Hannah Song, BA
Medical studen
Harvard Medical School and
Jennifer T. Huang, MD
Division of Immunology, Dermatology Program
Boston Children’s Hospital
Boston, MA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infection with the varicella-zoster virus leads to chickenpox, or primary varicella. The virus then lies dormant and can later reactivate as shingles, or herpes zoster.  Varicella-zoster vaccine is made of an attenuated live virus that prevents most people from getting chicken pox, but rarely can reactivate and cause shingles.

There were several pediatric patients who presented to our clinics with shingles/herpes zoster that was localized to one extremity. My hunch was that the extremity where the patients had shingles could be the same limb where they had received vaccination. We called the patient’s pediatricians because pediatricians typically document the extremity where the vaccination is given, and confirmed the theory that shingles in vaccinated children may be more likely to occur at the site of vaccination. Importantly, vaccination may modify the classic appearance of shingles, and you might see pink and red papules and pseudovesicles, rather than classic grouped fluid-filled vesicles on a red base.  Continue reading

Nanoparticles From Pollution Can Awaken Dormant Herpes Viruses in Lungs

MedicalResearch.com Interview with:

Dr. Tobias Stöger Group Leader, Dynamics of Pulmonary Inflammation Comprehensive Pneumology Center Institute of Lung Biology and Disease (iLBD) Helmholtz Zentrum München

Dr. Tobias Stöger

Dr. Tobias Stöger
Group Leader, Dynamics of Pulmonary Inflammation
Comprehensive Pneumology Center
Institute of Lung Biology and Disease (iLBD)
Helmholtz Zentrum München 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Particulate air pollution is common in urban areas and the inhalation of nanoparticles is known to trigger inflammatory effects in humans potentially altering the immune system.

Herpes viruses are ubiquitous and well adapted pathogens hiding in host cells and persist thus continuing in a greater part of our population.

Under certain stress conditions and if the immune system becomes weakened, the viruses can become active again, begin to proliferate and destroy the host cell.

Thus we raised the question whether NP-exposure of persistently herpesvirus-infected cells as a second hit might provoke reactivation of latent virus and eventually lead to an inflammatory response and tissue damage.

Our main finding is that NP-exposure of persistently herpesvirus-infected cells – murine or human – restores molecular signatures found in acute virus infection and boosts production of lytic viral proteins.

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US Task Force Recommends Against Routine Screening for Herpes Simplex

MedicalResearch.com Interview with:

Ann Kurth, Ph.D., C.N.M., R.N.

Dr. Ann Kurth

 

MedicalResearch.com: What is the background for this study?  What are the main findings?

Genital herpes is a sexually transmitted infection that is caused by one of two subtypes of the herpes simplex virus (HSV-1 and HSV-2). The condition is common in the United States, as the CDC estimates that almost one in six people between the ages of 14 and 49 are afflicted.

Unfortunately, there are no good screening tests for herpes and it cannot be cured. After a systematic review of the evidence, the U.S. Preventive Services Task Force determined that, for adolescents and adults who have no signs or symptoms, including pregnant women, the harms of screening for genital herpes outweigh the benefits. These harms include high rates of false-positive screening tests, potential concerns around unnecessary antiviral medication use, and anxiety and relationship issues related to diagnosis. Additionally, the benefits of screening proved small, in part because early identification and treatment do not alter the course of the condition.

In the end, due to the lack of benefits in the face of serious harms, the Task Force recommended against routine serologic screening for genital herpes simplex virus (HSV) infection.

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Pubic Hair Grooming Linked To Increased Risk of STDs

MedicalResearch.com Interview with:

E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital

Dr. Osterberg

E. Charles Osterberg, M.D.
Assistant Professor of Surgery
Genitourinary Reconstruction and Trauma
University of Texas- Dell Medical School
Dell-Seton Medical Center / University Hospital

MedicalResearch.com: What is the background for this study?

Response: Pubic hair grooming has become an increasingly common practice among men and women. Perceptions of genital normalcy have changed as modern society’s definition of attractiveness and feelings of femininity and masculinity have changed. Pubic hair grooming has been shown to increase morbidity such as genital injuries, however little is known about the relationship between grooming practices and sexually transmitted infections.

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NYU Study To Evaluate Long-Term Treatment of Painful Shingles of the Eye

MedicalResearch.com Interview with:
Elisabeth J. Cohen, MD
NYU Langone Medical Center

MedicalResearch.com Editor’s note: Elisabeth J. Cohen, MD, of NYU Langone Medical Center, will head a five year study to evaluate new treatment protocols for herpes zoster ophthalmicus (HZO).
Herpes zoster ophthalmicus is a form of shingles that can cause prolonged pain and permanently damage the eye. Dr Cohen and NYU have received a grant from the National Institutes of Health to investigate the longer-term use of suppressive antiviral medication to reduce complications of HZO,

MedicalResearch.com: What is the background for this study? Can you tell us a little about herpes zoster/shingles?

Response: The rationale for the study is two-fold:

First: the accumulating evidence that zoster is followed by chronic active infection caused by the varicella zoster virus (VZV) that contributes to complications including vision threatening eye disease and life threatening stroke.

Second: the proven efficacy of suppressive antiviral treatment in reducing recurrent herpes simplex virus eye disease, caused by a different herpes virus, but with similar disease manifestations.

Zoster/shingles is caused by localized, unilateral reactivation of varicella zoster virus (VZV) in people who have had varicella/chicken pox resulting in a painful blistering rash that can be followed by chronic pain/postherpetic neuralgia. There are over one million new cases of zoster per year, and the incidence has increased over the past 6 decades for unknown reasons. Although the rate of zoster increases with age, the largest number of cases occur in people in their fifties.

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Little Known Herpes Virus Linked To Some Unexplained Fertility

MedicalResearch.com Interview with:

Roberta Rizzo PhD Department of Medical Sciences Section of Microbiology University of Ferrara Ferrara, Italy

Dr. Roberto Rizzo

Roberta Rizzo PhD
Department of Medical Sciences
Section of Microbiology
University of Ferrara
Ferrara, Italy

MedicalResearch.com: What is the background for this study?

Response: Infertility affects approximately 6% of 15-44 year old women or 1.5 million women in the US, according to the CDC. Approximately 25% of female infertility cases are unexplained, leaving women with few options other than expensive fertility treatments. Researchers are trying to identify factors and mechanisms at the basis of this condition.
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Ocular Herpes Zoster Can Be Chronic and Recurrent

MedicalResearch.com Interview with:
Kimberly D Tran, MD
Bascom Palmer Eye Institute

MedicalResearch.com: What is the background and purpose for this study? 

Dr. Tran: Approximately 30% of the population will suffer from herpes zoster (also known as shingles) at some point in their lifetime, with an estimated 1 million cases in the U.S. each year (1).  The most common long term complication of  herpes zoster is postherpetic neuralgia (PHN), or persistent neuropathic pain lasting beyond three months after initial presentation of  herpes zoster. PHN can negatively affect quality of life to a degree similar to congestive heart failure, depression, acute myocardial infarction,diabetes.

Postherpetic neuralgia is a leading cause of suicide in patients over 70 with chronic pain.(3,4) Of all the cases of herpes zoster, an estimated 10-20% will have herpes zoster ophthalmicus (HZO), which is defined as shingles in the area of the face near the eye, and sometimes the eye itself becomes involved.  Approximately 50% of individuals with HZO will develop ocular complications without antiviral treatment, while antiviral induction within the first 72 hours of rash onset reduces this number to 20-30% (2). Randomized control trial has demonstrated the efficacy antiviral therapy in the treatment of herpes zoster on first presentation.(6) What is less understood is the course of HZ after its initial presentation. Traditionally studied and treated in the acute phase,(5-7) recent data suggest that some patients experience a chronic or recurrent disease course. Based on this data, it is clear that more information is needed on the long term clinical course of herpes zoster ophthalmicus. The purpose of this study was to characterize the epidemiology of recurrent and chronic HZO in a unique South Florida population, with an ethnically and racially mixed, predominately male population.
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First Therapeutic Vaccine For Genital Herpes Shows Promise

MedicalResearch.com Interview with:

Zeena Y. Nawas, MD Clinical Research Fellow Center for Clinical Studies Houston, TX, 77004

Dr. Zeena Nawas

Zeena Y. Nawas, MD
Clinical Research Fellow
Center for Clinical Studies
Houston, TX, 77004

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Nawas: T cell immunity is believed to be particularly critical to the control of genital herpes, an incurable, lifelong sexually transmitted disease that affects roughly 500 million people worldwide. Genital herpes is characterized by recurrent, painful genital lesions and can be transmitted to sexual partners, even when there is no visible sign of the infection. Current genital herpes therapies only partially control the infection in some patients. These individuals continue to experience clinical symptoms and viral shedding, which drives disease transmission. Incomplete control of genital lesions and transmission risk, and the inconvenience of taking a daily medication are hurdles for effective long-term disease management.

GEN-003, is a first-in-class immunotherapy developed by Genocea Biosciences and is intended to treat genital herpes by inducing both a T cell and B cell (antibody) immune response. GEN-003 has demonstrated promising results to date by showing statistically significant reductions in the clinical signs of genital herpes and viral shedding, as well as safety and tolerability in its Phase 1/2 and Phase 2 clinical studies.

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Wrestlers Face High Risk of Skin Infections

MedicalResearch.com Interview with:

High School Wrestling Wikipedia

High School Wrestling
Wikipedia Image

Kurt Ashack
Fourth year medical student at Michigan State University, Michigan
Kyle Burton
University of Central Florida College of Medicine, Orlando, Florida

Medical Research: What is the background for this study? What are the main findings?

Response: Skin infections associated with high school athletics have been reported in literature since the late 20th century and while many skin infections are relatively minor, others can cause serious morbidity. Prior reports on skin infections among high school athletes have focused on specific sports or have evaluated relatively small numbers of athletes. No prior report has evaluated skin infections in a large national sample of United States (US) high school athletes across multiple sports.

During the study period, 474 skin infections were reported among 20,858,781 athlete exposures (AE); a rate of 2.27 infections per 100,000 AE. The largest number of skin infections occurred in wrestlers (73.6%), followed by boys’ football (17.9%) and boys’ basketball (1.9%). Baseball and swimming had much fewer cases. The most common infections were bacterial (60.6%), tinea (28.4%) and herpetic (5.2%) infections. Body parts most often affected were the head/face (25.3%), forearm (12.7%) and upper arm (8%). The average time for return to play was 3-6 days (45.5%). It was also interesting to note how many more infections there were in boys than girls. Girls’ volleyball had the most of girls’ sports, but all girl reports did not near the boy’s number.

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Ocular Herpes Can Rarely Occur After Varicella Vaccine

Frederick W. Fraunfelder, MD MBA Chairman and Roy E. Mason and Elizabeth Patee Mason Distinguished ProfessorDepartment of Ophthalmology Missouri University School of Medicine Director of the Missouri University Health Care’s Mason Eye Institute

Dr. Rick Fraunfelder

MedicalResearch.com Interview with:
Frederick W. Fraunfelder, MD MBA
Chairman and Roy E. Mason and Elizabeth Patee Mason Distinguished ProfessorDepartment of Ophthalmology
Missouri University School of Medicine
Director of the Missouri University Health Care’s Mason Eye Institute

Medical Research: What is the background for this study? What are the main findings?

Dr. Fraunfelder: The background starts with a paper by Hwang et al (Cornea. 2013 Apr;32(4):508-9.Reactivation of herpes zoster keratitis in an adult after varicella zoster vaccination. Hwang CW Jr1Steigleman WASaucedo-Sanchez ETuli SS.) After reading this paper, I started keeping track of keratitis cases that were reported to my registry (www.eyedrugregistry.com) and also to the FDA and WHO spontaneous reporting databases. We found case reports in adults and children of keratitis occurring soon after vaccination, and we presented this at the American Academy of Ophthalmology’s annual meeting that we just held in Las Vegas in November 2015.

The main findings are that in rare instances, relatively speaking, herpes infection can occur in the cornea of the eye within days to weeks after vaccination. This may especially be true in adults who have had shingles in the past which caused a keratitis in the past. This keratitis may reoccur after the vaccination, and primary care providers should inquire about this past medical/ocular history and advise of the risk of recurrent keratitis after the vaccination for shingles.

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