1. Meningitis Caused by the Live Varicella Vaccine Virus: Metagenomic Next Generation Sequencing, Immunology Exome Sequencing and Cytokine Multiplex Profiling
- Author
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Wallen Jackson, Sonia Burrel, Geraldine Blanchard-Rohner, Bradley Ford, Ethan H Heusel, John E. Carpenter, Prashanth S. Ramachandran, Michael R. Wilson, Anne E. Wapniarski, Gaud Catho, Charles Grose, Tetsushi Yoshikawa, David Boutolleau, Nicoline Schiess, Randall J. Cohrs, University of California [San Francisco] (UCSF), University of California, Geneva University Hospitals and Geneva University, Johns Hopkins University School of Medicine [Baltimore], University of Colorado Anschutz [Aurora], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Fujita Health University, University of Iowa [Iowa City], University of California [San Francisco] (UC San Francisco), University of California (UC), and Gestionnaire, HAL Sorbonne Université 5
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Male ,Varicella vaccine ,Human herpesvirus 7 ,Human herpesvirus 6 ,Herpes zoster ,Serious adverse event ,serious adverse event ,medicine.disease_cause ,corticosteroids ,0302 clinical medicine ,innate immunity ► Show Figures ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Medicine ,Child ,innate immunity ,Exome ,Exome sequencing ,Innate immunity ,0303 health sciences ,ddc:618 ,biology ,High-Throughput Nucleotide Sequencing ,Meningitis, Viral ,QR1-502 ,3. Good health ,Vaccination ,Infectious Diseases ,IL-10 ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Cytokines ,human herpesvirus 7 ,Female ,human herpesvirus 6 ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Immunocompetence ,Meningitis ,Adolescent ,herpes zoster ,Microbiology ,Article ,Virus ,Chickenpox Vaccine ,03 medical and health sciences ,Virology ,Exome Sequencing ,Humans ,Corticosteroids ,[SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,030304 developmental biology ,varicella-zoster virus ,IL-6 ,business.industry ,Varicella zoster virus ,biology.organism_classification ,medicine.disease ,Immunology ,Oka strain ,Varicella-zoster virus ,Metagenomics ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
International audience; Varicella vaccine meningitis is an uncommon delayed adverse event of vaccination. Varicella vaccine meningitis has been diagnosed in 12 children, of whom 3 were immunocompromised. We now report two additional cases of vaccine meningitis in twice-immunized immunocompetent children and we perform further testing on a prior third case. We used three methods to diagnose or investigate cases of varicella vaccine meningitis, none of which have been used previously on this disease. These include metagenomic next-generation sequencing and cytokine multiplex profiling of cerebrospinal fluid and immunology exome analysis of white blood cells. In one new case, the diagnosis was confirmed by metagenomic next-generation sequencing of cerebrospinal fluid. Both varicella vaccine virus and human herpesvirus 7 DNA were detected. We performed cytokine multiplex profiling on the cerebrospinal fluid of two cases and found ten elevated biomarkers: interferon gamma, interleukins IL-1RA, IL-6, IL-8, IL-10, IL-17F, chemokines CXCL-9, CXCL-10, CCL-2, and G-CSF. In a second new case, we performed immunology exome sequencing on a panel of 356 genes, but no errors were found. After a review of all 14 cases, we concluded that (i) there is no common explanation for this adverse event, but (ii) ingestion of an oral corticosteroid burst 3–4 weeks before onset of vaccine meningitis may be a risk factor in some cases.
- Published
- 2021
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