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Varicella Zoster Virus Infections

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Viral Infections of the Human Nervous System

Part of the book series: Birkhäuser Advances in Infectious Diseases ((BAID))

Abstract

Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which the virus becomes latent in ganglionic neurons along the entire neuraxis. With advancing age or immunosuppression, cell-mediated immunity to VZV declines and virus reactivates to cause zoster (shingles), dermatomal-distribution pain and rash on an erythematous base in 1–3 dermatomes. Zoster may develop anywhere on the body. Skin lesions resolve within 1–2 weeks, while complete cessation of pain usually takes 4–6 weeks. Unfortunately, zoster can be followed by chronic pain (post-herpetic neuralgia), cranial nerve palsies, zoster paresis, vasculopathy, meningoencephalitis, cerebellitis, myelopathy, and multiple ocular disorders. VZV reactivation also produces chronic radicular pain without rash (zoster sine herpete). In fact, all of the neurological and ocular disorders listed above may also develop without rash. This review covers clinical, laboratory and pathological features of neurological complications of VZV reactivation, including diagnostic testing to verify active VZV infection in the nervous system and the potential value of examining saliva for VZV DNA in patients with neurological disease without rash. Additional perspectives are provided by discussions of the VZV genome, VZV latency, viral pathology, pathogenesis and immunity, and of the value of vaccination of elderly individuals to boost cell-mediated immunity to VZV and prevent VZV reactivation.

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Acknowledgments

This work was supported in part by NIH grants AG006127 to DG, AG032958 to DG and RJC, and NS067070 to MAN. We thank Marina Hoffman for editorial assistance and Lori DePriest for manuscript preparation.

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  1. Departments of Neurology and Microbiology, University of Colorado School of Medicine, 12700 E. 19th Avenue, B182, Aurora, CO, 80045, USA

    Maria A. Nagel, Randall J. Cohrs & Don Gilden

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  1. Maria A. Nagel
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  2. Randall J. Cohrs
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  3. Don Gilden
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Correspondence to Maria A. Nagel .

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  1. , Health Sciences Centre, University of Manitoba, Sherbrook Street 820, Winnipeg, R3A 1R9, Manitoba, Canada

    Alan C. Jackson

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Nagel, M.A., Cohrs, R.J., Gilden, D. (2013). Varicella Zoster Virus Infections. In: Jackson, A. (eds) Viral Infections of the Human Nervous System. Birkhäuser Advances in Infectious Diseases. Springer, Basel. https://doi.org/10.1007/978-3-0348-0425-7_5

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