Pathophysiology: Little is known about the route and the source of transmission of the virus. VZV is certainly transmissible through the airborne route and does not require close personal contact. The skin lesions are certainly full of infectious virus particles whilst in contrast, it is almost impossible to isolate virus from the upper respiratory tract. It is possible that aerial transmission originates from symptomless oral lesions.
Disease statistics: In a study performed in two neonatal units in Brazil, 150 of 215 (70%) workers had a history of varicella infection and all of them had VZ antibodies, which yielded a 100% sensitivity of the varicella history. Of the remaining 65 workers who did not remember having had varicella in the past, 60 (92%) proved to have serologic evidence of varicella infection, and 5 individuals were considered non-immune to varicella. The Brazilian authors have concluded that the positive history of varicella infection is areliable evidence of immunity against the disease.
Treatment: Several studies indicate that antiviral medications decrease the duration of symptoms and the likelihood of postherpetic neuralgia, especially when initiated within 2 days of the onset of rash. In typical cases that involve individuals who are otherwise healthy, oral acyclovir may be prescribed. An important study by Kubeyinje (1997) suggested that the use of acyclovir in healthy young adults with zoster is not clearly justified, especially in situations of limited economic resources.
Research: A seroepidemiologic survey of the prevalence of varicella-zoster virus in the pediatric population in two university hospitals in Brazil. A population composed of 160 children derived from two university hospitals in the state of Rio de Janeiro was included in the study. All patients completed a questionnaire regarding their socio-epidemiologic characteristics, and a complete physical examination was performed. All blood samples were screened using a commercial enzyme-linked fluorescent assay (ELFA) kit, specific for the detection of immunoglobulin G (IgG) antibodies to VZV.