Insights into Varicella Infection: A Study from Ganzhou Fifth People’s Hospital
Table of Contents
Published on February 21, 2025
Study Overview
Between August 2021 and December 2022, a total of 39 patients diagnosed with varicella were admitted to Ganzhou Fifth People’s Hospital. The median age of these patients was 13 years, with a male-to-female ratio of 22:17.The cohort was divided into two age groups: children (0–17 years) and adults (18–55 years), comprising 26 (66.7%) children and 13 (33.3%) adults.
Differences in Varicella Presentation
meaningful differences were observed in the sources of varicella infections between the two groups. A striking 92.3% of adult varicella-zoster virus (VZV) infections were sourced from inpatient settings, while children were nearly equally represented by both outpatient and inpatient sources (P = 0.006).
Adults reported a higher incidence of discomfort,with 100% experiencing symptoms such as fever,sore throat,dizziness,headache,fatigue,or cough,compared to 57.7% of children (P = 0.007). Notably, the rate of complications post-infection was considerably higher in adults (69.2%) than in children (7.7%) (P < 0.001).
Among the complications, adults faced severe conditions including hepatitis, pneumonia, and myocarditis, while children experienced milder issues such as acute upper respiratory infections and skin infections. The likelihood of developing hepatitis was particularly pronounced in adults, with 46.2% affected compared to none in children (P = 0.001).
Laboratory Findings
Laboratory tests revealed that nearly half (45.8%) of the children developed leukopenia, with a median white blood cell count of 4.86 (3.71) × 109/L, slightly below the normal range. In contrast, adults exhibited various abnormal laboratory results, including elevated liver enzymes and inflammatory markers. Specifically, 53.8% of adults showed abnormal liver function, and 23.1% had hypocalcemia.
Genotyping and Phylogenetic Analysis
The study successfully amplified and sequenced the ORF22 and ORF62 fragments of VZV from 32 plasma samples, achieving a 94.1% success rate. Genotyping revealed that the isolates belonged to Clade 2, consistent with the reference strains pOka and vOka.
A phylogenetic tree constructed using maximum likelihood methods confirmed that the virulent strains clustered with pOka, further validating the classification of these clinical isolates.
Mutational Analysis of VZV Strains
Analysis indicated that six VZV strains were genetically distinct from the reference strain pOka,with mutations identified in their gene sequences. Among these, four strains were found in children and two in adults, with a predominance of male patients (83.3%).
In total, 12 base mutations were identified, with the majority being missense mutations (75%).Notably, the mutations resulted in significant amino acid changes, which could impact the virus’s pathogenicity.
Varicella Infection: new Study Reveals Key Differences in Adults vs. Children
Time.news spoke with Dr. eleanor Vance, a leading virologist with extensive experience in varicella-zoster virus (VZV) research, too discuss a recent study from Ganzhou Fifth People’s Hospital that sheds light on the varying presentations of varicella infection in children and adults. Dr. vance helps us unpack the details and discuss crucial takeaways.
Time.news: Dr. Vance, thank you for joining us. This study from Ganzhou Fifth People’s Hospital highlights some important differences in varicella infection between adults and children. What are your initial thoughts on the key findings?
Dr. Vance: Thank you for having me. I found the study quite insightful. The most striking finding is the difference in severity and complications between the two age groups. Adults experienced substantially more severe symptoms and a higher rate of complications compared to children. As a notable example, the study showed that 100% of adults experienced symptoms like fever, sore throat, and fatigue, compared to only 57.7% of children.
Time.news: The study also points out that adults are more likely to contract varicella in inpatient settings. Why is this significant?
Dr. Vance: That’s a critical observation. The study indicated that 92.3% of adult varicella infections stemmed from inpatient settings. This suggests a potential for nosocomial transmission – meaning the virus is being spread within healthcare facilities.This really highlights the importance of infection control protocols,especially in hospitals,to protect vulnerable adult patients who may not have had chickenpox or the varicella vaccine. It also suggests healthcare workers need to be extra vigilant of their own immunity and potential exposure.
Time.news: what types of complications were seen more frequently in adults in this study?
Dr. Vance: That’s another area of concern. The rate of post-infection complications was dramatically higher in adults: almost 70% compared to less than 8% in children. And the types of complications were also more severe. Adults experienced conditions like hepatitis (affecting nearly half of the adult patients),pneumonia,and myocarditis. Children,on the other hand,mostly had milder issues like upper respiratory infections and skin infections. This suggests the varicella-zoster virus can have a more aggressive impact on the adult body.
Time.news: The study also delves into the genetic side of the virus with genotyping and mutational analysis. What did they discover?
Dr. Vance: This is where the research gets even more captivating. The researchers found that the VZV isolates largely belonged to Clade 2, which aligns with known reference strains. But they also identified mutations in several viral strains, more frequently in children than adults, which could impact the virus’s pathogenicity.
Time.news: how could these mutations affect the disease?
Dr. Vance: That’s the million-dollar question and an area for further research. The study identified missense mutations in the viral gene sequences, leading to amino acid changes. These changes could perhaps alter how the virus interacts with cells, how easily it spreads, or how effectively the immune system can target it. It’s critically important to stay updated on varicella research and understand how the virus might potentially be evolving.. Further studies are needed to directly link these specific mutations to changes in virulence or disease severity.
Time.news: Given these findings, what are the key takeaways for our readers concerning varicella infection, notably in adults?
Dr. Vance: The main takeaway is that varicella infection is not just a childhood disease. Adults are at a significantly higher risk of severe complications. Thus, prevention is crucial. Make sure you’ve either had chickenpox or have been vaccinated against varicella. If you’re an adult working or receiving care in a healthcare setting,the need to confirm your immunity cannot be overstated.
Time.news: What about for parents of young children regarding varicella?
dr.vance: For parents, the study reinforces the importance of the varicella vaccine, part of the standard childhood immunization schedule. While children generally experience milder symptoms, vaccination prevents the spread of the virus and protects them from even those milder complications.Discuss any concerns about varicella and the vaccine with your pediatrician to ensure your child is protected. early vaccination can help build a better herd immunity amongst our communities.
Time.news: Any final thoughts on this study and its implications for future research?
Dr. Vance: This study is a valuable contribution.It highlights the need for targeted clinical approaches for varicella based on age. We need to consider the specific risks faced by adults and focus on preventative measures and early intervention. Furthermore, continued research into the genetic diversity of VZV is essential to understand how the virus is evolving and how that affects disease outcomes. Ongoing surveillance and genetic monitoring can help guide public health strategies and vaccine progress.
Time.news: dr.Vance, thank you so much for sharing your expertise and insights with us.
dr. Vance: My pleasure.