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Introduction: Vaccination is considered as one of the most promising strategies to overcome the COVID-19 pandemic. However, it could be associated with rare but serious complications. In the present study, we aimed to review the clinical course and etiology of post COVID-19 vaccination meningitis. Methods: After a systematic search in PubMed, Scopus, and Web of Sciences online databases as well as Google Scholar, documents were screened and qualified. Then data extraction was performed and the most frequent underlying agent of meningitis was found based on the reported cases. Results: Overall, 35 cases of post COVID-19 vaccination meningitis from 33 articles were included in the review. Among them, 12 cases had proven viral diagnosis and 23 of them were reported to be vaccine-induced. The most frequent viral pathogen among the cases was VZV. The most prevalent symptom was headache, and the most common time of appearance symptoms was one week after vaccination. Conclusion: Overall, our study suggested meningitis as a critical but not devastating complication of COVID-19 vaccination. Almost all patients responded well to common agents used to manage viral or vaccine-induced meningitis. It is recommended to monitor patients with a history of chickenpox after COVID-19 vaccination regarding the development of meningitis. [ABSTRACT FROM AUTHOR]

Background: In May 2024, a chickenpox outbreak was reported at Xiasha Primary School located in Nanshan District, Shenzhen City, China, with a total of 12 cases identified. Despite thorough on-site investigations, the source of infection remained undetected. The purpose of our study was to infer the timing and duration of the infectious period of the initial case using modeling techniques, thereby deducing the identity of the source. Methods: We conducted an individual contact survey within the class affected by the epidemic and utilized an agent-based model (ABM) to estimate the key parameters related to the timing of the infectious source's emergence and the duration of its infectiousness. The point estimates derived from the ABM served as prior information for a subsequent Bayesian analysis, which in turn provided the posterior distribution for these parameters. Results: Our models suggested the infection source entered the classroom around April 24th (95% credible interval: April 22nd to April 26th), with an infectious period of approximately two days. Based on these findings, we should aim to detect students who may have been absent due to atypical chickenpox symptoms during this period and closely examine teachers who were present for two consecutive days for any indication of potential infection. Conclusion: This study demonstrates the efficacy of combining contact surveys with mathematical modeling for outbreak source tracing, offering a novel approach to supplement field epidemiological surveys. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

The World Health Organization declared a state of emergency in 2022 because of monkeypox. This disease has raised international concern as it has spread beyond Africa, where it is endemic. The global community has shown attention and solidarity in combating this disease as its daily increase becomes evident. Various skin symptoms appear in people infected with this disease, which can spread easily, especially in a polluted environment. It is difficult to diagnose monkeypox in its early stages because of its similarity with the symptoms of other diseases such as chicken pox and measles. Recently, computer-aided classification methods such as deep learning and machine learning within artificial intelligence have been employed to detect various diseases, including COVID-19, tumor cells, and Monkeypox, in a short period and with high accuracy. In this study, we propose the CanDark model, an end-to-end deep-learning model that incorporates cancelable biometrics for diagnosing Monkeypox. CanDark stands for cancelable DarkNet-53, which means that DarkNet-53 CNN is utilized for extracting deep features from Monkeypox skin images. Then a cancelable method is applied to these features to protect patient information. Various cancelable techniques have been evaluated, such as bio-hashing, multilayer perceptron (MLP) hashing, index-of-maximum Gaussian random projection-based hashing (IoM-GRP), and index-of-maximum uniformly random permutation-based hashing (IoM-URP). The proposed approach's performance is evaluated using various assessment issues such as accuracy, specificity, precision, recall, and fscore. Using the IoM-URP, the CanDark model is superior to other state-of-the-art Monkeypox diagnostic techniques. The proposed framework achieved an accuracy of 98.81%, a specificity of 98.73%, a precision of 98.9%, a recall of 97.02%, and fscore of 97.95%. [ABSTRACT FROM AUTHOR]

Objective To understand the epidemiological characteristics of chickenpox -related absenteeism among primary and secondary school students in HuaiJ an city, providing reference for further improving chickenpox prevention and control in schools. Methods Descriptive epidemiological methods were employed to analyze data on chickenpox-related absenteeism collected from the Jiangsu Provincial Student Health Monitoring System for the 2018 to 2022 academic years. The circular distribution method was used to analyze the seasonal characteristics of absenteeism due to chickenpox. Results The average annual rate of chickenpox-related absenteeism among primary and secondary school students in HuaiJ an city from 2018 to 2022 was 26.23 per 100 000, The absenteeism rates varied between 11.96 (2021 academic year) and 70.84 (2020 academic year) (101 240.39; P < 0.01), with an average of 3.98 days absent per student The absenteeism rate for boys was higher than that for girls (27.06 vs. 25.26, 护=166.19, P < 0.01). Among different school types, the average absenteeism rate ranged from 430 (vocational high schools) to 39.97 (primary schools), with urban students exhibiting a higher average absenteeism rate compared to those in suburban areas (30,84 vs. 17.10, 於二9 519.78, P < 0,01). A primary peak in absenteeism occurred from October to December in the first semester, while a secondary peak was observed from April to June in the second semester. Circular distribution method analysis revealed a significant seasonal concentration trend, with peak days occurring on November 26 and May 1& and peak periods spanning from October 29 to December 25 and from April 9 to June 26, re spectively (Z values of 48 673.79 and 3 217.29, with P values < 0.01). Conclusion The rate of chickenpox-related absenteeism among primary and secondary school students in HuaiJ an city is relatively high. Monitoring should focus on boys, primary schools, urban areas, and the two peak periods (October-December and April-June). The circular distribution method for analyzing seasonal characteristics of absenteeism due to chickenpox demonstrates good practicality and can provide data support for chickenpox prevention and control in schools. [ABSTRACT FROM AUTHOR]

Background/Objectives: The increasing global prevalence of inflammatory bowel disease (IBD) presents significant challenges to healthcare systems. Our objective was to identify the sociodemographic and clinical characteristics of IBD patients in Catalonia. Methods: A cross-sectional analytical study was carried out on patients diagnosed with IBD in Catalonia (2021). The database of the Information System for the Development of Research in Primary Care of Catalonia was used. Results: In Catalonia, the prevalence of IBD was 474 cases per 100,000 people (pcm), with an average diagnosis age of 42.9 years. Crohn's disease (CD) represented 34.34% of cases, and 21.2% were smokers and 1% were alcoholics. Nutritional status showed 3% underweight, 36.2% overweight, and 20% obese, with only 0.27% diagnosed as malnutrition. Mental health issues are notable; 36,531 pcm patients were diagnosed with anxiety and 14,656 pcm with depression, and 8.24% had a high risk of mortality measured by the Charlson index. The most prevalent vaccine-preventable infections were influenza (19,356 pcm), herpes zoster (8099 pcm), and varicella zoster (6946 pcm), with 4.56% of patients requiring hospitalisation for one of these reasons and 32.8% of patients for IBD complications, with higher rates observed in cases of CD. Conclusions: The prevalence of IBD was high, especially in urban areas, and patients showed a relevant number of comorbidities. IBD requires a comprehensive evaluation and interdisciplinary management to improve disease control. [ABSTRACT FROM AUTHOR]

The article discusses a case study of a 26-year-old female patient with anetoderma, initially presenting as leprosy due to prolonged steroid use. The patient had asymptomatic oval and saccular papules and plaques on her upper limbs, with histopathological evidence confirming indeterminate leprosy. The study highlights the challenges of diagnosing leprosy in patients with prolonged steroid use and emphasizes the importance of a comprehensive diagnostic approach and pharmacovigilance in endemic areas. [Extracted from the article]

This study aimed to identify the specific vaccine strain associated with herpes zoster (HZ) in children following a series of diagnosed cases and to explore whether differences in single nucleotide polymorphisms (SNPs) among various vaccine strains are linked to an increased incidence of herpes zoster after vaccination. From February 2021 to March 2024, children <12 years old suspected of vaccine-related varicella-like rash or HZ were included. Varicella zoster virus DNA isolated from the patients were sequenced to differentiate vaccine type versus wild-type. 3D protein structures of pORF62 were simulated using open reading frame 62 sequences extracted from whole genome sequencing of vOka, MAV/06, Oka/SK vaccines, and pOka reference. A total of 27 children with a median age of 2.1 (interquartile range, 1.5–3.4) years old presented with vaccine-related varicella-like rash (n = 4/27, 14.8%) or HZ (n = 23/27, 85.2%). One patient with varicella-like rash and 34.8% (n = 8/23) with HZ had disseminated skin involvement. All were immunized with the Oka/SK strain varicella vaccine. Genotyping showed 88.2% (n = 15/17) had SNPs specific to the Oka/SK strain, and two had SNPs considered pOka type contained within the Oka/SK vaccine. Despite accumulations of SNPs in ORF 62 of Oka/SK, the translated amino acid sequence and 3D protein structure were identical to wild-type pOka's pORF62. In vOKA and MAV/06, changes in amino acids occurred at two positions, S628G and R958G, within pORF62. The predicted 3D protein structure of vOka and MAV/06's pORF62 showed that the α helical structure within region I undergoes conformational change, potentially increasing difficulties in interactions with infection-related proteins and thereby decreasing virulence. pORF62 in pOka and Oka/SK exhibited more stable structure complex of the α helical structure. Lack of structural alternations in region I of pORF62 due to the absence of critical genetic polymorphisms in open reading frame 62 could be associated with the heightened incidence of adverse events. [ABSTRACT FROM AUTHOR]

The article discusses the preservation of vaccine-associated antibodies against vaccine-preventable infections (VPIs) in patients undergoing chimeric antigen receptor T-cell (CAR-T) therapy for lymphoma. The study evaluated seropositivity against VPIs between 0 and 6 months post-infusion and found that a high proportion of patients maintained antibodies against viral VPIs and tetanus. The results suggest the need for individualized vaccine schedules post-CAR-T to ensure optimal immune response. The study had strengths in complete longitudinal follow-up but was limited by a small sample size. Further research is needed to determine the best approach for preventing infections in CAR-T patients. [Extracted from the article]

Lumpy skin disease virus (LSDV) is an extremely infectious, viral, and chronic skin disease that is caused by the Capripox virus. This viral disease is predominantly found in cows. Mosquitoes and ticks are the primary transmitters for the spread of this virus. Recently, LSDV has been rapidly spreading all over the world, especially in several areas of Pakistan, India, and Iran. Thousands of cows have died due to this infectious virus in Pakistan and early detection of LSDV is needed to avoid further loss. The prediction and classification of LSDV are hindered by the lack of publicly available datasets. Despite a few studies using LSDV datasets, such datasets are often small, which may lead to model overfitting. In this regard, we collect the dataset from several online sources, as well as, collecting images from veterinary farms in different areas of Pakistan. Deep learning has been widely used in the medical field for disease detection and classification. Therefore, this study leverages DenseNet deep learning models for LSDV detection and classification. Experiments are performed using VGG-16, ResNet-50, MobileNet-V2, custom-designed convolutional neural network, and Inception-V3. The DenseNet architecture presents a Convolutional Block Attention Module (CBAM) and Spatial Attention (SA) for the prediction and classification of LSD. Results demonstrate that a 99.11% accuracy can be obtained on the augmented dataset while a 94.23% accuracy can be achieved with the original dataset for chicken pox, monkey pox, and LSDV. Comparison with state-of-the-art studies corroborates the superior performance of the proposed model. [ABSTRACT FROM AUTHOR]

Objective To analyze the epidemic characteristics of breakthrough cases of varicella in Shapingba District, Chongqing, and provide reference for the prevention and control of the varicella epidemic in the area.[WTHZ]Methods [WTBZ]Collect information on varicella cases and their vaccination in Shapingba District from 2019 to 2023, Use descriptive epidemiological methods to analyze the epidemiological characteristics of varicella breakthrough cases, and use linear regression to analyze the relationship between breakthrough cases and age at the time of vaccination and the time interval between vaccination and onset of disease.[WTHZ]Results [WTBZ]From 2019 to 2023, there were a total of 802 breakthrough cases of varicella in Shapingba District, Chongqing, accounting for 14.87% of the total number of varicella cases. The majority of cases were vaccinated with one dose of varicella (648 cases, accounting for 80.80%), and the differences in composition among different years were statistically significant (χ²=16.400, P<0.005); The epidemic has a bimodal distribution, from October to December and May to July each year. The least cases are in winter (142 cases, accounting for 11.68%), and the most cases are in spring (198 cases, accounting for 17.32%). The composition differences between different seasons are statistically significant (χ2=16.348, P<0.001); The breakthrough cases of chickenpox are mainly male, with the highest incidence among primary school students aged 6～10, and the differences in composition are statistically significant (χ²=877.420, P<0.001); The time interval from the first dose of chickenpox vaccine to the onset of breakthrough cases was 46 days to 17 years, with a median\[M(P25, P75)\] of 7 years (4 years, 10 years). The median time interval between scattered children, primary school students, and middle school students was 3 years (2 years, 4 years), 8 years (6 years, 9 years), and 12 years (11 years, 14 years), respectively, with statistical significance (H=497.280, P<0.001); There is a negative correlation between age at the time of first dose vaccination and the interval between onset of the disease in breakthrough cases, with a correlation coefficient of r=-0.230 (t=-6.693, P<0.001).[WTHZ]Conclusion [WTBZ]Breakthrough cases of varicella in Shapingba, Chongqing are mainly concentrated in primary school students during the start of the school season, with an interval of 7 years between onset. It is necessary to further strengthen the prevention and control of the varicella epidemic in primary schools, further improve the vaccination rate of children with varicella vaccines, and recommend receiving two doses of vaccines before starting primary school to reduce the risk of breakthrough cases. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Herpes zoster is rarely seen in children, but is more common and more severe in those with underlying medical conditions. The purpose of this study was to comprehensively evaluate cases of herpes zoster in all paediatric patients and to detail the clinical course and complications of this disease in children with and without underlying health problems in terms of similarities and differences.The course of paediatric patients diagnosed with herpes zoster in a tertiary university hospital over a 19‐year period was evaluated from the time of diagnosis, divided into groups with and without underlying disease.In our study, where we evaluated 150 herpes zoster attacks in 143 children, 79.3% of the patients (n = 119) had underlying diseases, while 20.7% (n = 31) were healthy children. The age at the time of primary varicella‐zoster virus and herpes zoster was significantly younger in the group without an underlying disease compared to the group with an underlying disease. Pain was reported more in the healthy group, and the duration of symptoms was longer. Ophthalmic nerve involvement was significantly higher in the group without a known disease. Treatment was administered in 90% of all attacks. In the group with underlying diseases, the duration of intravenous treatment and hospital stay were significantly higher as expected.This study shows that herpes zoster attacks in healthy children can also progress with severe symptoms and complications. Approaches to reduce the burden of herpes zoster should be adopted and developed for all paediatric patients. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Herpes zoster is an acute cutaneous viral disease resulting from reactivation of dormant varicella‐zoster virus. The maxillary nerve is the least frequently affected branch of the trigeminal nerve. Rarely, cutaneous lesions can be secondarily infected with Klebsiella species. This report discusses a case of maxillary zoster with nasociliary nerve involvement and Klebsiella superinfection. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a demyelinating disease affecting millions of people worldwide. Hereditary susceptibility and environmental factors contribute to disease risk. Infection with Epstein–Barr virus (EBV) and human herpesvirus 6A (HHV‐6A) have previously been associated with MS risk. Other neurotropic viruses, such as rubella virus (RV), are possible candidates in MS aetiopathogenesis, but previous results are limited and conflicting. Methods: In this nested case–control study of biobank samples in a Swedish cohort, we analysed the serological response towards RV before the clinical onset of MS with a bead‐based multiplex assay in subjects vaccinated and unvaccinated towards RV. The association between RV seropositivity and MS risk was analysed with conditional logistic regression. Results: Seropositivity towards RV was associated with an increased risk of MS for unvaccinated subjects, even when adjusting for plausible confounders including EBV, HHV‐6A, cytomegalovirus and vitamin D (adjusted odds ratio [AOR] = 4.0, 95% confidence interval [CI] 1.8–8.8). Cases also had stronger antibody reactivity towards rubella than controls, which was not seen for other neurotropic viruses such as herpes simplex or varicella zoster. Furthermore, we observed an association between RV seropositivity and MS in vaccinated subjects. However, this association was not significant when adjusting for the aforementioned confounders (AOR = 1.7, 95% CI 1.0–2.9). Conclusions: To our knowledge, these are the first reported associations between early RV seropositivity and later MS development. This suggests a broadening of the virus hypothesis in MS aetiology, where molecular mimicry between rubella epitopes and human central nervous system molecules could be an attractive possible mechanism. [ABSTRACT FROM AUTHOR]

Background: Levamisole is less expensive and has a better toxicity profile compared to other steroid sparing agents used in nephrotic syndrome. It has a plasma half-life of 2.0 to 5.6 hours, but is conventionally administered on alternate days. We aimed to assess whether daily levamisole is safe and more effective than standard alternate-day therapy in maintaining remission in children with frequently relapsing or steroid-dependent nephrotic syndrome (FR/SDNS). Methods: An open-label randomized controlled trial was conducted in children with FR/SDNS. Group A received daily while Group B received alternate-day levamisole (2–3 mg/kg/dose) for 12 months. Prednisolone was tapered off by 3 months. Patients were monitored for relapses, further steroid requirement, and adverse effects. Results: A total of 190 children with FR/SDNS (94 in Group A and 96 in Group B) were analyzed. Sustained remission for 12 months was observed in 36% of Group A and 27% of Group B patients (p = 0.18). Numbers completing 12 months in the study were 67% in Group A and 56% in Group B (p = 0.13). Time to first relapse, persistent FR/SDNS, and withdrawal due to poor compliance were statistically similar in both groups, while relapse rate and cumulative steroid dosage were significantly lower in Group A compared to Group B (p = 0.03 and p = 0.02, respectively). The incidence of adverse effects was comparable in both groups, with reversible leucopenia and hepatic transaminitis being the commonest. Conclusions: Daily levamisole therapy was not superior to alternate-day therapy in maintaining sustained remission over 12 months. Nevertheless, relapse rate and cumulative steroid dosage were significantly lower without increased adverse effects. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]

Background: Varicella zoster virus (VZV) is the causative agent for chickenpox and herpes zoster (HZ, shingles). HZ is a debilitating disease affecting elderly and immunocompromised populations. Glycoprotein E (gE) is indispensable for viral replication and cell-to-cell spread and is the primary target for anti-VZV antibodies. Importantly, gE is the sole antigen in Shingrix, a highly efficacious, AS01B-adjuvanted vaccine approved in multiple countries for the prevention of HZ, yet the three-dimensional (3D) structure of gE remains elusive. Objectives: We sought to determine the structure of VZV gE and to understand in detail its interactions with neutralizing antibodies. Methods: We used X-ray crystallography and cryo-electron microscopy to elucidate structures of gE bound by recombinant Fabs of antibodies previously elicited through vaccination with Zostavax, a live, attenuated vaccine. Results: The 3D structures resolve distinct central and C-terminal antigenic domains, presenting an array of diverse conformational epitopes. The central domain has two beta-sheets and two alpha helices, including an IgG-like fold. The C-terminal domain exhibits 3 beta-sheets and an Ig-like fold and high structural similarity to HSV1 gE. Conclusions: gE from VZV-infected cells elicits a human antibody response with a preference for the gI binding domain of gE. These results yield insights to VZV gE structure and immunogenicity, provide a framework for future studies, and may guide the design of additional herpesvirus vaccine antigens. Teaser: Structures of varicella zoster virus glycoprotein E reveal distinct antigenic domains and define epitopes for vaccine-elicited human antibodies. [ABSTRACT FROM AUTHOR]

Background: Monkeypox is a viral disease caused by the monkeypox virus (MPV). A surge in monkeypox infection has been reported since early May 2022, and the outbreak has been classified as a global health emergency as the situation continues to worsen. Early and accurate detection of the disease is required to control its spread. Machine learning methods offer fast and accurate detection of COVID-19 from chest X-rays, and chest computed tomography (CT) images. Likewise, computer vision techniques can automatically detect monkeypoxes from digital images, videos, and other inputs. Objectives: In this paper, we propose an automated monkeypox detection model as the first step toward controlling its global spread. Materials and method: A new dataset comprising 910 open-source images classified into five categories (healthy, monkeypox, chickenpox, smallpox, and zoster zona) was created. A new deep feature engineering architecture was proposed, which contained the following components: (i) multiple nested patch division, (ii) deep feature extraction, (iii) multiple feature selection by deploying neighborhood component analysis (NCA), Chi2, and ReliefF selectors, (iv) classification using SVM with 10-fold cross-validation, (v) voted results generation by deploying iterative hard majority voting (IHMV) and (vi) selection of the best vector by a greedy algorithm. Results: Our proposal attained a 91.87% classification accuracy on the collected dataset. This is the best result of our presented framework, which was automatically selected from 70 generated results. Conclusions: The computed classification results and findings demonstrated that monkeypox could be successfully detected using our proposed automated model. [ABSTRACT FROM AUTHOR]

Objective To analyze the epidemiological characteristics of varicella and effectiveness of varicella vaccine in Jinan. Methods We collected data of varicella surveillance in Jinan from 2006 to 2022 from the Chinese Information System for Disease Control and Prevention and vaccination data for children born during 2010-2021 form the Jinan Immunization Planning Information System. All reported varicella cases from 2006 to 2022 in Jinan were analyzed with descriptive epidemiological methods; Coverage and effectiveness of varicella vaccine for children born during 2010 to 2021 were conducted with the screening method. Results 61 145 cases of varicella were reported in Jinan during 2006-2022, yielding an annual average incidence of 51.82 per 100 000 population; the incidence ranged from 74.48 per 100 000 in 2008 to 28.47 per 100 000 in 2022. Peak varicella incidences occurred between April and June and between November and the following January. The highest incidence rate was 5-9 years old group from 2006-2016 and was 15-19 years old group from 2017 to 2022. Coverage levels for one doses was 77.32% in the 2010-2021 births; the overall effectiveness of varicella vaccine was 91.83% (95%CI: 91.43%-92.30%). Coverage levels for two doses was 45.86% in the 2010-2018 births; the overall effectiveness of varicella vaccine was 95.14%(95%CI: 94.56%-95.66%). Conclusion The high incidence age group shifted from 5-9 years old to 15-19 years old. It was suggested that the vaccine administration should be used to targeted age groups. Levels of vaccine effectiveness for 2 doses of varicella vaccine were greater than levels of Vaccine effectiveness for one-doses. We suggest to introduce 2 dose of varicella vaccine into the national immunization program for children. [ABSTRACT FROM AUTHOR]

Objective To analyze the epidemiological distribution characteristics of chickenpox in Urumqi City from 2015 to 2023, to construct a prediction model by combining Baidu search keywords, and to explore the complementary application of Baidu index in chickenpox prevention and monitoring. Methods Descriptive epidemiological methods were used to analyze the characteristics of varicella case triple distribution in Urumqi City from 2015 to 2023. Chickenpox keywords were identified and a comprehensive Baidu search index was constructed. The models ARIMA and ARIMAX were constructed, the prediction effectiveness of the two models was evaluated by mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean square error (RMSE). Results The average annual reported incidence rate of varicella in Urumqi was 80.85/100 000, with a higher incidence in men than in women (χ² = 1.136, P = 0.287), there were statistically significant differences in incidence rates by age group (χ² = 7 582.372, P < 0.001), seven districts and one county had different average annual incidence rates (χ² = 21.496, P < 0.001), with the highest in the Toutunhe district (100.54/100 000). ARIMAX(1,1,0)(1,0,0)52 was selected as the best prediction model (prediction set MAE 12.04%, RMSE 13.80%, MASE 1.18%) with a good fitting effect. Conclusion The ARIMAX prediction model established based on the search term Baidu index has a certain degree of predictability and sensitivity, and can predict the epidemic trend of chickenpox in Urumqi in time, which can be used as a technical support and further expansion of the traditional monitoring and early warning system. [ABSTRACT FROM AUTHOR]

The Varicella zoster virus (VZV), responsible for both varicella (chickenpox) and herpes zoster (shingles), presents significant global health challenges. While primary VZV infection primarily affects children, leading to chickenpox, reactivation in later life can result in herpes zoster and associated post-herpetic neuralgia, among other complications. Vaccination remains the most effective strategy for VZV prevention, with current vaccines largely based on the attenuated vOka strains. Although these vaccines are generally effective, they can induce varicella-like rashes and have sparked concerns regarding cell virulence. As a safer alternative, subunit vaccines circumvent these issues. In this study, we developed a nanoparticle-based vaccine displaying the glycoprotein E (gE) on ferritin particles using the SpyCatcher/SpyTag system, termed FR-gE. This FR-gE nanoparticle antigen elicited substantial gE-specific binding and VZV-neutralizing antibody responses in BALB/c and C57BL/6 mice—responses that were up to 3.2-fold greater than those elicited by the subunit gE while formulated with FH002C, aluminum hydroxide, or a liposome-based XUA01 adjuvant. Antibody subclass analysis revealed that FR-gE produced comparable levels of IgG1 and significantly higher levels of IgG2a compared to subunit gE, indicating a Th1-biased immune response. Notably, XUA01-adjuvanted FR-gE induced a significant increase in neutralizing antibody response compared to the live attenuated varicella vaccine and recombinant vaccine, Shingrix. Furthermore, ELISPOT assays demonstrated that immunization with FR-gE/XUA01 generated IFN-γ and IL-2 levels comparable to those induced by Shingrix. These findings underscore the potential of FR-gE as a promising immunogen for the development of varicella and herpes zoster vaccines. [ABSTRACT FROM AUTHOR]

To assess the safety of varicella vaccine (VarV) by conducting post-marketing surveillance on adverse events following immunization (AEFI) in Jiangsu Province, China. Methods: We utilized the AEFI Information System of mainland China to monitor and categorize adverse reactions associated with VarV. Results: The incidence rate of AEFI was significantly higher after the first dose (48.79/100,000 doses) compared to the second dose (45.18/100,000 doses) (χ2 = 4.63, P = 0.031). Regional variations in AEFI incidence were observed within Jiangsu Province. Common reactions comprised 90.96% of AEFIs, while rare reactions and coincidental events accounted for 6.59% and 0.51%, respectively. Notably, there were no adverse events linked to vaccine quality, program errors, psychogenic reactions, or fatalities. Over 96% of AEFIs occurred within three days of VarV administration, with redness at the injection site (2.6 cm to 5 cm in diameter) being the most frequently observed symptom. Conclusion: VarV demonstrates a commendable safety profile. Although there was a slight increase in AEFI incidence between 2022 and 2023, common vaccine reactions were predominantly observed, and the rates of rare reactions remained very low. [ABSTRACT FROM AUTHOR]

In the present study, fowl pox was diagnosed in 129 backyard chicken based on gross and histopathological lesions. Fowl pox is manifested by pock nodular lesions on featherless parts of body (cutaneous form) and purulent, cheesy patches in upper respiratory tract (diphtheritic form). Tissue samples revealed Bollinger bodies in epithelial cells on histopathology. Among these, extraction of DNA was carried out from cutaneous and diphtheretic lesions from 29 fowl pox affected chicken. Molecular diagnosis of fowl pox was performed by amplification of P4b gene of fowl pox virus using specific primers and obtained a desired amplicon of 578 bp. Nucleotide sequencing and phylogenetic analysis of four cutaneous fowl pox samples revealed close relation with the FPV isolates from Singapore, North America and USA (KY464130, MH175285 and KC017961 with an identity of 97.28%, 97.21% and 97.16% respectively) when compared to FPVs isolated from Portugal, Brazil, Jammu and India (KM974727, KX863706, MF496042 and HM481406 respectively with an identity of 96.66% to 96.86%). [ABSTRACT FROM AUTHOR]

La varicelle est une maladie infantile fréquente due au virus VZV responsable d'épidémies touchant principalement les enfants de moins de 10 ans. Bien qu'elle soit bénigne dans la plupart des cas, elle peut entraîner des complications sévères dont les plus fréquentes sont les surinfections cutanées bactériennes. Du fait de la mise en place de la vaccination systématique dans de nombreux pays, l'épidémiologie de la varicelle a beaucoup évolué ces dernières années avec une nette diminution de l'incidence de la varicelle et de ses complications dans les pays ou la vaccination a été mise en place. Afin d'étudier les caractéristiques épidémiologiques, cliniques et thérapeutiques des enfants hospitalisés pour varicelle, nous avons réalisé une étude rétrospective dans les différents services de pédiatrie de l'hôpital Armand Trousseau à Paris incluant tous les enfants de moins de 18 ans, avec ou sans antécédents, hospitalisés pour une varicelle entre le 1er janvier 2021 et le 1er juin 2023. Cent cinq patients ont été inclus dans l'étude. L'âge médian était de 2,1 ans [1–4,2]. On retrouvait des complications chez 75 % (n = 79) des enfants hospitalisés avec une prédominance de surinfections cutanées bactériennes (n = 53, 67 %), suivies des complications neurologiques (n = 11, 14 %), respiratoires (n = 7, 9 %) et ostéoarticulaires (n = 5, 6 %). Staphylococcus aureus était la bactérie la plus fréquemment retrouvée (11 prélèvements positifs soit 26 % des prélèvements). En moyenne, la durée de traitement par antibiotique était de 7,5 j [écart-type : 7,2] avec une médiane à 7 j [1–10]. La durée moyenne de traitement antiviral était de 4,2 j. Notre étude confirme la gravité potentielle de la varicelle qui n'est pas toujours une maladie bénigne. La mise en place d'une vaccination systématique chez tous les enfants, en place dans de nombreux pays déjà depuis plusieurs années, pourrait permettre de diminuer l'incidence du nombre de cas de varicelle annuel, ainsi que le nombre de complication, encore responsables de 20 décès par an en France pouvant être évités. Varicella is a common childhood disease due to the varicella-zoster virus, which is responsible for epidemics mainly affecting children under the age of 10. Although benign in most cases, it can lead to severe complications, the most frequent of which are bacterial skin infections. With the introduction of systematic vaccination in many countries, the epidemiology of varicella has evolved considerably in recent years, with a clear reduction in the incidence of varicella and its complications in countries where vaccination has been introduced. In order to study the epidemiological, clinical and therapeutic characteristics of children hospitalized for varicella, we carried out a retrospective study in the various pediatric wards of the Armand Trousseau Hospital in Paris, including all children under 18 years of age, with or without previous history, hospitalized for varicella between January 1, 2021 and June 1, 2023. One hundred and five patients were included in the study. The median age was 2.1 years [1–4.2]. Complications occurred in 75 % (n = 79) of hospitalized children, with a predominance of bacterial skin infections (n = 53, 67 %), followed by neurological (n = 11, 14 %), respiratory (n = 7, 9 %) and osteoarticular (n = 5, 6 %) complications. Staphylococcus aureus was the most frequently found bacterium (11 positive samples, i.e. 26 % of all samples). On average, the duration of antibiotic treatment was 7.5 days [standard deviation: 7.2], with a median of 7 days [1–10]. The mean duration of antiviral treatment was 4.2 days. Our study confirms the potential seriousness of varicella, which is not always a benign disease. The introduction of systematic vaccination of all children, which has already been in place in many countries for several years, could help to reduce the incidence of annual cases of varicella, as well as the number of complications, which are still responsible for 20 preventable deaths per year in France. [ABSTRACT FROM AUTHOR]

Objective: The survival rates of children with acute lymphoblastic leukemia (ALL) have improved over the years, but infections remain a significant cause of morbidity and mortality. Chemotherapy has a range of harmful side effects including the loss of protective antibodies against vaccine-preventable diseases. The objective of this study was to evaluate the serological status of pediatric ALL cases before and after intensive chemotherapy. Materials and Methods: Children treated and followed for ALL at Dokuz Eylül University were included in this retrospective crosssectional study. Antibody levels against hepatitis A, hepatitis B, and rubella were routinely assessed at both the time of diagnosis and 6 months after completion of chemotherapy. Measles, mumps, and varicella antibody levels were evaluated at only 6 months after treatment. Results: Seventy-eight children who completed chemotherapy for ALL were enrolled in the study. All participants had non-protective antibody levels for at least one of the diseases. The highest seropositivity rate was found for hepatitis A (55.1%) and the lowest for measles (17.9%) after chemotherapy. Overall, 50.7%, 30.6%, and 45.7% of the patients significantly lost their humoral immunity against hepatitis B, hepatitis A, and rubella, respectively. Patients in the higher-risk group for ALL had lower seropositivity rates than patients of the other risk groups. There were statistically significant relationships between the protective antibody rates for hepatitis A and varicella and the ages of the patients. Except for hepatitis A vaccination, pre-chemotherapy vaccination did not affect post-chemotherapy serology. On the other hand, all children with a history of varicella before diagnosis showed immunity after chemotherapy. Conclusion: Patients with ALL, including those previously fully vaccinated, are at great risk of infection due to the decrease in protective antibody levels after chemotherapy. There is a need for routine post-chemotherapy serological testing and re-vaccination based on the results obtained. [ABSTRACT FROM AUTHOR]

Background: Varicella infections follow a benign course in around 90% of cases, with more severe forms occurring in adults. To identify potential pockets of susceptibility and to improve targeted immunization strategies, this study aims to critically assess immunological status by evaluating varicella seroprevalence among adults (18–99 years) in the province of Florence (Italy), nearly a decade after Tuscany introduced the vaccination program. Methods: A convenience sample of 430 subjects aged 18 to 94 years (mean age 51.8 ± 18.8 years), stratified by age and sex (53.7% of subjects were female; N = 231), was collected between 2018 and 2019. Sero-analytical analyses were conducted utilizing EUROIMMUN Anti-VZV ELISA (IgG) kits. Results: Most of them were of Italian nationality (87.4%; N = 376). Among the 430 tested samples, 385 (89.5%) were positive and 39 (9.1%) were negative. The remaining six sera (1.4%), confirmed as equivocal, were excluded from further analysis. No significant differences were found based on sex (p-value = 0.706) or nationality (p-value = 0.112). The application of trend tests (Mantel–Haenszel; Kendall Tau-b) showed a significant trend (p < 0.024 and p < 0.032, respectively), with an increasing probability of finding a positive anti-varicella serological status passing from a lower age group (84.2%) to a higher one (93.0%). By considering the female population aged 18–49 years, the seroprevalence of anti-varicella antibodies was found to be 88.4%, with a susceptibility of 11.6%, highlighting the risk of acquiring infection during pregnancy. Conclusions: The introduction of varicella vaccination has had a significant impact on public health in Tuscany and in Italy more generally. However, further efforts should be made to reduce the number of individuals still susceptible in adulthood, with particular attention given to women of childbearing age and the promotion of vaccination through mass and social media and institutional websites. [ABSTRACT FROM AUTHOR]

Healthcare workers (HCWs) are occupationally exposed to varicella zoster virus (VZV), and their inappropriate vaccination status could contribute to an outbreak involving both professionals and the patients they care for, with a potential impact on the general population. Therefore, since 2007, the Advisory Committee on Immunization Practices (ACIP) recommends that all HCWs have evidence of immunity against varicella. The present meta-analysis was therefore designed to collect the available evidence on the seronegative status of VZV among HCWs. PubMed, Scopus, and Embase databases were searched without backward limit for articles reporting on the seroprevalence of VZV among HCWs, and all articles meeting the inclusion criteria were included in a random-effect meta-analysis model. From 1744 initial entries, a total of 58 articles were included in the quantitative analysis (publication range: 1988 to 2024), for a pooled sample of 71,720 HCWs. Moreover, the included studies reported on seroprevalence data on measles (N = 36,043 HCWs) and rubella (N = 22,086 HCWs). Eventually, the pooled seronegative status for VZV was estimated to be 5.72% (95% confidence interval [95% CI] 4.59 to 7.10) compared to 6.91% (95% CI 4.79 to 9.87) for measles and 7.21% (5.36 to 9.64) for rubella, with a greater risk among subjects younger than 30 years at the time of the survey (risk ratio [RR] 1.434, 95% CI 1.172 to 1.756). Interestingly, medical history of either VZV infection/vaccination had low diagnostic performances (sensitivity 76.00%; specificity 60.12%; PPV of 96.12% but PNV of 18.64%). In summary, the available data suggest that newly hired HCWs are increasingly affected by low immunization rates for VZV but also for measles and rubella, stressing the importance of systematically testing test newly hired workers for all components of the measles–pertussis–rubella–varicella vaccine. [ABSTRACT FROM AUTHOR]

To estimate the economic burden of varicella among children in France from family and societal perspectives. We conducted an online cross-sectional survey of caregivers of 185 French children (≤ 17 years) diagnosed with varicella in the previous six weeks. Data collected included varicella-related healthcare resource use, out-of-pocket costs, missed school days, and workdays missed by either parents or other caregivers. Mean and median direct and indirect costs (2022 Euros) were calculated using survey data and published literature. The annual societal burden of pediatric varicella in France was estimated. Of the 185 children, 95.1% had ≥ 1 outpatient visit, 10.3% had ≥ 1 emergency room visit, and 2.2% were hospitalized. The median [interquartile range, IQR] number of outpatient visits/child was 1.0 [1.0 – 2.0]. The median length of hospital stay among those hospitalized (n = 4) was 5.0 [3.5 – 6.5] days. Caregivers of 185 children missed a median of 2.0 [0 – 5.0] workdays; 113 families (61.1%) had ≥ 1 parent miss work. A median of 5.0 [3.0 – 7.0] school days were missed by 170 children who attended preschool or school. The median direct out-of-pocket cost to the family was €30.0 [€17.0 – €60.0]. The median [IQR] societal costs per varicella case were €455.2 [€70.5 – €1013.5]; the median [IQR] direct and indirect costs per child were €60.8 [€39.0 – €102.7] and €364.7 [€0.0 – €911.7] respectively. The annual societal burden of varicella among children in France was estimated to be €450,427,578 (95% CI: €357,144,618 – €543,710,538), with indirect costs accounting for 85%. Conclusions: A substantial economic burden is associated with pediatric varicella in France, primarily due to the productivity loss among caregivers. What is Known: • Although varicella is considered a mild disease, it poses a significant burden on caregivers and society. Our study aimed to estimate the economic burden of varicella among children in France from family and societal perspectives to support policymakers in understanding the value of UVV in France. What is New: • We conducted an online survey of caregivers of 185 French children (≤17 years) diagnosed with varicella and collected data on varicella-related healthcare resource use, missed school days and workdays. Our study estimated annual societal burden of pediatric varicella in France. Out of 185 children with varicella, most (95.1%) had at least one outpatient visit, 10.3% had at least one emergency room visit, and 2.2% were hospitalized. 61.1% of parents with sick child, missed work and median productivity loss was 2.0 workdays. Additionally, 170 children who attended school or preschool missed a median of 5.0 school days. • The societal burden of pediatric varicella in France was estimated to be €450,427,578 (95% CI, €357,144,618 - €543,710,538), with indirect costs accounting for 85%. Pediatric varicella is associated with a substantial economic burden in France, primarily due to high productivity losses among parents and caregivers. [ABSTRACT FROM AUTHOR]

In this study, we aimed to characterize a cohort of children hospitalized due to varicella before and after the outbreak of the COVID-19 pandemic. Medical charts of all children hospitalized in the Regional Hospital of Infectious Diseases in Warsaw due to varicella in the years 2019 and 2022 were retrospectively analyzed and compared. In total, 221 children were included in the analysis; 59 of them were hospitalized in 2019, whereas 162 were hospitalized in 2022. Children hospitalized in 2022 were older than those reported in 2019 (median 4.0 vs. 3.0 years, p = 0.02). None of the hospitalized children received complete varicella vaccination. The most common complication in both years was bacterial superinfection of skin lesions, found in 156/221 (70.6%) of patients. This complication rate was higher in 2022 (50.8% in 2019 vs. 77.8% in 2022, p = 0.0001), OR = 3.38, 95% CI: 1.80–6.35. Moreover, skin infections in 2022 more often manifested with cellulitis (in 2022 13.6% vs. 3.4% in 2019, p = 0.03), OR = 4.40, 95% CI: 1.00–19.33. Sepsis as a complication of varicella was almost five-fold more prevalent in 2022 than in 2019 (p = 0.009), OR = 5.70, 95% CI: 1.31–24.77. Antibiotic use increased between 2019 and 2022 (71.2% vs. 85.2%, p = 0.01). Furthermore, patients were treated more frequently with the combination of two different antibiotics simultaneously (only 3.4% of patients in 2019 compared to 15.4% in 2022, p = 0.01). Primary infections with varicella zoster virus in 2022 led to a more severe course of the disease.

Introduction: The incidence of varicella in Canada has decreased by almost 99% since vaccination was introduced. However, variation in the timing and eligibility of vaccination programs across the country has resulted in some cohorts being under-vaccinated and therefore potentially susceptible to infection. Methods: We used nationally representative specimens from the Biobank of Statistics Canada's Canadian Health Measures Survey (CHMS) as well as residual specimens from Ontario collected between 2009–2014 to estimate population immunity across age-groups and geography, and identify any groups at increased risk of varicella infection. Results: The weighted proportion of specimens with antibody levels above the threshold of protection was 93.6% (95% CI: 92.4, 95.0). Protection was lowest among those aged 3–5 years (54.3%; 95% CI: 47.3, 61.4), but increased with age. Individuals born outside Canada had more than twice the odds of varicella susceptibility than those born in Canada (aOR: 2.7; 95% CI: 1.4, 5.0; p = 0.004). There were no differences by sex or geography within Canada, and there were no statistically significant differences when Ontario CHMS sera were compared to Ontario residual sera, apart from in participants aged 12–19 year age-group, for whom the CHMS estimate (91.2%; 95% CI: 86.7, 95.7) was significantly higher (p = 0.03) than that from residual specimens (85.9%, 95% CI: 81.1, 90.8). Discussion: Varicella immunity in Canada is changing. Children appear to have low population immunity, placing them at greater risk of infection and at increased risk of severe disease as they age. Our results underscore the importance of performing periodic serosurveys to monitor further population immunity changes as the proportion of vaccine-eligible birth-cohorts increases, and to continually assess the risk of outbreaks. [ABSTRACT FROM AUTHOR]

Mucosal-associated invariant T (MAIT) cells are unconventional T cells that respond to riboflavin biosynthesis and cytokines through TCR-dependent and -independent pathways, respectively. MAIT cell activation plays an immunoprotective role against several pathogens, however the functional capacity of MAIT cells following direct infection or exposure to infectious agents remains poorly defined. We investigated the impact of Varicella Zoster Virus (VZV) on blood-derived MAIT cells and report virus-mediated impairment of activation, cytokine production, and altered transcription factor expression by VZV infected (antigen+) and VZV exposed (antigen-) MAIT cells in response to TCR-dependent and -independent stimulation. Furthermore, we reveal that suppression of VZV exposed (antigen-) MAIT cells is not mediated by a soluble factor from neighbouring VZV infected (antigen+) MAIT cells. Finally, we demonstrate that VZV impairs the cytolytic potential of MAIT cells in response to riboflavin synthesising bacteria. In summary, we report a virus-mediated immune-evasion strategy that disarms MAIT cell responses. Author summary: Mucosal-associated invariant T (MAIT) cells are a uniquely specialised and substantial innate-T cell population that can rapidly respond to diverse bacterial and fungal pathogens through T cell receptor dependent recognition of riboflavin synthesis derived metabolite antigens. Additionally, MAIT cells can be triggered by local pro-inflammatory cues such as cytokines; therefore extending their functionality to non-riboflavin pathogens such as viral infections. Despite the capacity of MAIT cells to play a protective role against several classes of pathogens, there remains a dearth of studies investigating direct pathogenic suppression of MAIT cell functionality. Here, we investigate a previously uncharacterised interplay between MAIT cells and the causative agent of varicella (chickenpox) and shingles (zoster): Varicella Zoster Virus (VZV). VZV successfully infects and establishes lifelong latency within the host; in part to their ability to effectively manipulate several innate and adaptive axes of the host immune response. In this study, we report that VZV profoundly impairs MAIT cell activation in response to both riboflavin synthesis and cytokine stimulation, therefore resulting in a downstream paralysis of several effector functions such as cytokine production and cytotoxic potential. This work highlights a previously uncharacterised strategy of viral pathogens to effectively target and restrict the MAIT cell effector response. [ABSTRACT FROM AUTHOR]

Background: During surgical procedures, heat-generating devices are widely used producing surgical smoke (SS). Since the SS can transmit infectious viruses, this systematic review was designed to investigate the potential viruses transmitted through SS. Methods: PubMed, Scopus, Web of Science, ProQuest, and Embase databases, along with Cochran Library, and Google Scholar search engine were searched systematically (by April 21, 2024). No language, place, and time restrictions were considered. All studies evaluating the SS and virus transmission, and whole investigations regarding the viral infections transmitted through SS were totally considered inclusion criteria. Besides, non-original, qualitative, case reports, case series, letters to the editor, editorial, and review studies were excluded from the analysis. This study was conducted in accordance with the PRISMA 2020 statement. Results: Twenty-six eligible studies were selected and reviewed for data extraction. The results showed that the SS contains virus and associated components. Six types of viruses or viral components were identified in SS including papillomavirus (HPV, BPV), Human Immunodeficiency Virus (HIV), varicella zoster, Hepatitis B (HBV), SARS-CoV-2, and Oral poliovirus (OPV), which are spread to surgical team through smoke-producing devices. Conclusions: Since the studies confirm the presence of viruses, and viral components in SS, the potential risk to the healthcare workers, especially in operating room (OR), seems possible. Thus, the adoption of protective strategies against SS is critical. Despite the use of personal protective equipment (PPE), these viruses could affect OR personnel in surgical procedures. [ABSTRACT FROM AUTHOR]

Background: Varicella‐zoster virus (VZV) pretransplant immunization rates, exposures, and posttransplant disease are poorly characterized among pediatric solid organ transplant (SOT) recipients in the two‐dose varicella vaccine era. Methods: A retrospective analysis of the electronic health records among children <18 years old who received SOT from January 1, 2011 through December 31, 2021, was performed at a single center to assess for missed pretransplant varicella vaccination opportunities, characterize VZV exposures, and describe posttransplant disease. Results: Among 525 children, 444 were ≥6 months old (m.o.) at SOT with a documented VZV vaccine status. Eighty‐five (19%) did not receive VZV Dose One; 30 out of 85 (35%) could have been immunized. Infants 6–11 m.o. accounted for 14 out of 30 (47%) missed opportunities. Among children ≥12 m.o. with documented Dose Two status (n = 383), 72 had missed vaccination opportunities; 57 out of 72 (79%) were children 1–4 years old. Most children had unclassifiable pre‐SOT serostatus as varicella serology was either not obtained/documented (n = 171) or the possibility of passive antibodies was not excluded (n = 137). Of those with classified serology (n = 188), 69 were seroimmune. Forty‐seven of 525 (9%) children had recorded VZV exposures; two developed varicella—neither had documented pre‐SOT seroimmunity nor had received post‐exposure prophylaxis. Nine additional children had medically attended disease: four primary varicella and five zoster. Of the 11 cases, 10 had cutaneous lesions without invasive disease; one had multi‐dermatomal zoster with transaminitis. Seven (64%) received treatment exclusively outpatient. Conclusions: VZV exposure and disease still occur. Optimizing immunization among eligible candidates and ensuring patients have a defined VZV serostatus pretransplantation remain goals of care. [ABSTRACT FROM AUTHOR]

Background: Varicella‐zoster virus (VZV) reactivation is the most common infectious complication in the late posthematopoietic stem cell transplantation (HSCT) period and is reported as 16%–41%. Acyclovir prophylaxis is recommended for at least 1 year after HSCT to prevent VZV infections. However, studies on the most appropriate prophylaxis are ongoing in pediatric patients. Methods: Patients who underwent allogeneic HSCT between January 1, 1996 and January 1, 2020 were retrospectively analyzed to outline the characteristics of VZV reactivation after allogeneic HSCT in pediatric patients using 6 months acyclovir prophylaxis. Results: There were 260 patients and 273 HSCTs. Median age was 10.43 (0.47–18.38), and 56% was male. Median follow‐up was 2325 days (18–7579 days). VZV reactivation occurred in 21.2% (n = 58) at a median of 354 (55–3433) days post‐HSCT. The peak incidence was 6–12 months post‐HSCT (43.1%). Older age at HSCT, female gender, history of varicella infection, lack of varicella vaccination, low lymphocyte, CD4 count, and CD4/CD8 ratio at 9 and 12 months post‐HSCT was found as a significant risk for herpes zoster (HZ) in univariate analysis, whereas history of varicella infection and low CD4/CD8 ratio at 12 months post‐HSCT was an independent risk factor in multivariate analysis. Conclusions: Tailoring acyclovir prophylaxis according to pre‐HCT varicella history, posttransplant CD4 T lymphocyte counts and functions, and ongoing immunosuppression may help to reduce HZ‐related morbidity and mortality. [ABSTRACT FROM AUTHOR]