Chickenpox screening: Difference between revisions

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Latest revision as of 20:54, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S [2]

Overview

According to Center for Disease Control and Prevention (CDC), there is insufficient evidence to recommend routine screening among general population. Children are vaccinated against chickenpox and most adults generally may have been infected with VZV in their early years. Screening is recommended for specific populations which include, healthcare workers, pregnant women, newborns, HIV/AIDS patients and for people prior to organ transplantation.

Screening

According to Center for Disease Control and Prevention (CDC), there is insufficient evidence to recommend routine screening among general population.
Children are vaccinated and most adults generally may have been infected with VZV in their early years. Hence, screening for general population is not recommended. Testing for VZV or for the antibodies produced in response to VZV infection may be performed when required.

Screening Varicella in specific populations

Screening tests are recommended for people without symptoms, who are at higher risk of acquiring chickenpox. The specific groups in which screening for chickenpox is recommended include:^[1]
- Healthcare workers
- Pregnant women
- Newborns
- HIV/AIDS patients
- Potential organ transplant recepients

Blood tests are done to measure the levels of antibodies in the blood, which indicates whether the individual has developed an immunity to chickenpox from previous infection or a missed immunization.
Testing for VZV or for the antibodies produced in response to VZV infection may be performed for screening purposes. Also, screening may be advised for newborns, pregnant women, prior to organ transplantation, and in those with HIV/AIDS.

Antenatal screening

Routine antenatal screening for evidence of immunity is recommended for pregnant women.^[2]

Routine antenatal varicella screening of all pregnant women with negative or indeterminate varicella histories is not cost-effective. It could be cost-effective in groups of women with increased exposure risk.^[3]

Screening in Healthcare Workers

A study shows that 26% to 55% of healthcare workers with no history of chickenpox and who test negative for antibody against varicella require vaccination. Hence, in healthcare facilities, varicella screening and vaccination should be offered to all healthcare workers.^[4]

References

↑ "Chickenpox and Shingles Tests: The Test".
↑ "Prevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP)".
↑ Glantz JC, Mushlin AI (1998). "Cost-effectiveness of routine antenatal varicella screening". Obstet Gynecol. 91 (4): 519–28. PMID 9540934.
↑ Chong CY, Lim SH, Ng WY, Tee N, Lin RV (2004). "Varicella screening and vaccination for healthcare workers at KK Women's and Children's Hospital". Ann. Acad. Med. Singap. 33 (2): 243–7. PMID 15098642.

Template:WikiDoc Sources

[urlChickenpox_and_Shingles_Tests:_The_Test-1] "Chickenpox and Shingles Tests: The Test".

[urlPrevention_of_Varicella:_Recommendations_of_the_Advisory_Committee_on_Immunization_Practices_(ACIP)-2] "Prevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP)".

[pmid9540934-3] Glantz JC, Mushlin AI (1998). "Cost-effectiveness of routine antenatal varicella screening". Obstet Gynecol. 91 (4): 519–28. PMID 9540934.

[pmid15098642-4] Chong CY, Lim SH, Ng WY, Tee N, Lin RV (2004). "Varicella screening and vaccination for healthcare workers at KK Women's and Children's Hospital". Ann. Acad. Med. Singap. 33 (2): 243–7. PMID 15098642.

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Chickenpox}}
-{{CMG}}
+{{CMG}} {{AE}} {{ARK}}
-{{MJM}}
 ==Overview==
-* Screening aids in early diagnosis and treatment. Screening tests are recommended for people without current symptoms, but for those at high risk for certain diseases or conditions.
+According to [[Centers for Disease Control and Prevention|Center for Disease Control and Prevention]] ([[Centers for Disease Control and Prevention|CDC]]), there is insufficient evidence to recommend routine [[Screening (medicine)|screening]] among general population. Children are [[Vaccination|vaccinated]] against [[chickenpox]] and most [[Adult|adults]] generally may have been [[Infection (disambiguation)|infected]] with [[Varicella zoster virus|VZV]] in their early years. [[Screening (medicine)|Screening]] is recommended for specific populations which include, healthcare workers, [[pregnant]] women, [[newborns]], [[Human Immunodeficiency Virus (HIV)|HIV]]/[[HIV AIDS|AIDS]] patients and for people prior to [[organ transplantation]].
-* Here, screening is done to determine whether if the person has acquired an immunity to the disease.
-* Blood tests are done to measure the levels of antibodies in the blood which indicates  whether the individual has developed an immunity to chickenpox from previous infection or a missed immunisation.
 ==Screening==
-* Laboratory tests can help confirm the diagnosis, if needed.
+* According to [[Centers for Disease Control and Prevention|Center for Disease Control and Prevention]] ([[Centers for Disease Control and Prevention|CDC]]), there is insufficient evidence to recommend routine [[Screening (medicine)|screening]] among general population.
+* Children are [[Vaccination|vaccinated]] and most adults generally may have been [[Infection (disambiguation)|infected]] with [[Varicella zoster virus|VZV]] in their early years. Hence, [[Screening (medicine)|screening]] for general population is not recommended. Testing for [[Varicella zoster virus|VZV]] or for the [[antibodies]] produced in response to [[Varicella-Zoster Virus (VZV) Infections|VZV infection]] may be performed when required.
-===Antibody Testing===
+=== Screening Varicella in specific populations ===
-* When an individual is exposed to VZV, their immune system responds by producing antibodies to the virus. Laboratory tests detect and measure the level of two classes of VZV antibodies in the blood namely IgM and IgG.
+* [[Screening (medicine)|Screening]] tests are recommended for people without [[symptoms]], who are at higher risk of acquiring [[chickenpox]]. The specific groups in which screening for chickenpox is recommended include:<ref name="urlChickenpox and Shingles Tests: The Test">{{cite web |url=https://labtestsonline.org/understanding/analytes/chickenpox/tab/test/ |title=Chickenpox and Shingles Tests: The Test |format= |work= |accessdate=}}</ref>
+** Healthcare workers
+** Pregnant women
+** Newborns
+** HIV/AIDS patients
+** Potential organ transplant recepients
-====IgM====
+* [[Blood]] tests are done to measure the levels of [[antibodies]] in the [[blood]], which indicates whether the individual has developed an [[Immunity (medical)|immunity]] to [[chickenpox]] from previous [[infection]] or a missed [[immunization]].
-*First antibodies to be produced in response to the infection.
+* Testing for [[Varicella zoster virus|VZV]] or for the [[antibodies]] produced in response to [[Varicella-Zoster Virus (VZV) Infections|VZV infection]] may be performed for [[Screening (medicine)|screening]] purposes. Also, [[Screening (medicine)|screening]] may be advised for [[newborns]], [[pregnant]] women, prior to [[organ transplantation]], and in those with [[HIV AIDS|HIV/AIDS]].
-*Can be detected within a week or two post exposure.
-*The levels of IgM antibodies rises for a short period of time and then falls below detectable levels.
-*Post-Infection, in the future, the IgM levels rise only when the latent VZV is reactivated.
-====IgG====
-*Produced several weeks after the initial exposure.
-*IgG levels rise during active infection and then the levels become stable as the VZV infection gets resolves and as the virus gets inactivated.
-*Provides Long-Term protection
-===Viral detection===
+===Antenatal screening===
-* Viral detection is done by finding VZV in a blood, vesicle fluid, or tissue sample. Detection done by culturing the virus or by detecting it's genetic material (VZV DNA).
+* Routine [[antenatal]] screening for evidence of [[immunity]] is recommended for [[Pregnancy|pregnant]] women.<ref name="urlPrevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP)">{{cite web |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5604a1.htm |title=Prevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP) |format= |work= |accessdate=}}</ref>
-===VZV DNA testing===
+*Routine [[antenatal]] [[Chickenpox|varicella]] [[Screening (medicine)|screening]] of all [[Pregnancy|pregnant]] women with negative or indeterminate [[varicella]] histories is not cost-effective. It could be cost-effective in groups of women with increased exposure risk.<ref name="pmid9540934">{{cite journal |vauthors=Glantz JC, Mushlin AI |title=Cost-effectiveness of routine antenatal varicella screening |journal=Obstet Gynecol |volume=91 |issue=4 |pages=519–28 |year=1998 |pmid=9540934 |doi= |url=}}</ref>
-* Performed to detect VZV genetic material in a person's sample. This method is sensitive. It can identify and measure the amount of the virus.
+===Screening in Healthcare Workers===
+*A study shows that 26% to 55% of healthcare workers with no history of [[chickenpox]] and who test negative for [[antibody]] against [[Chickenpox|varicella]] require [[vaccination]]. Hence, in healthcare facilities, [[varicella]] [[Screening (medicine)|screening]] and [[vaccination]] should be offered to all healthcare workers.<ref name="pmid15098642">{{cite journal |vauthors=Chong CY, Lim SH, Ng WY, Tee N, Lin RV |title=Varicella screening and vaccination for healthcare workers at KK Women's and Children's Hospital |journal=Ann. Acad. Med. Singap. |volume=33 |issue=2 |pages=243–7 |year=2004 |pmid=15098642 |doi= |url=}}</ref>
-===Direct Fluorescent Antibody (DFA)===
-* DFA test visualizes the presence of VZV in the cells taken from an individuals's skin lesion using a special microscope and labeled antibody. Advantages of DFA test are that it is rapid, but less specific and sensitive than DNA testing.
-===VZV culture===
-* Culture is not very reliable for VZV and can lead to false-negative results.
-The choice of tests and samples collected depends on the person, their symptoms, and on the healthcare practitioner's clinical findings.
 ==References==
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