Biologic and geographic differences between vaccine and clinical varicella-zoster virus isolates

  • P. S. LaRussa
  • A. A. Gershon


Vaccine and wild-type strains of varicella-zoster virus differ both in their biologic characteristics and in the clinical manifestations of infection caused by each strain. The biologic differences described for the vaccine strain (temper­ature sensitivity and host cell preference) probably reflect the methods used to adapt the wild-type strain to the in vitro growth conditions imposed during the at­tenuation process in cell culture. In addition, restriction fragment polymorphisms have been described that reflect geographic strain variations between the parental virus used to develop the vaccine strain and other wild-type strains. These poly­morphisms have been exploited as tools for the identification and differentiation of vaccine and wild-type strains in clinical studies. Infection with the wild-type strain results in the typical extensive rash of varicella, frequent transmission to other susceptible contacts, establishment of latency, and in some individuals, re­activation with the clinical picture of zoster. Infection with the vaccine strain results in the development of a protective immune response, minimal rash in a minority of individuals, rare transmission to other susceptible contacts, and a greatly reduced risk of zoster.


Herpes Zoster Vaccine Virus Vaccine Strain Varicella Vaccine Restriction Fragment Polymorphism 
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  1. 1.
    Asano Y, Nakayama H, Yazaki T, Ito S, Isomura S (1977) Protective efficacy of vacci­nation in children in four episodes of natural varicella and zoster in the ward. Pediatrics 59: 8–12PubMedGoogle Scholar
  2. 2.
    Asano Y, Nakayama H, Yazaki T, Kato R, Hirose S, Tsuzuki K, Ito S, Isomura S, Taka­hashi M (1977) Protection against varicella in family contacts by immediate inoculation with live varicella vaccine. Pediatrics 59: 3–7PubMedGoogle Scholar
  3. 3.
    Asano Y, Yazaki T, Miyata T, Nakayama H, Hirose S (1975) Application of a live attenuated varicella vaccine to hospitalized children and its protective effect on spread of varicella infection. Biken J 18: 35–40PubMedGoogle Scholar
  4. 4.
    Baba K, Yabuuchi H, Okuni H, Takahashi M (1978) Studies with live varicella vaccine and inactivated skin test antigen: protective effect of the vaccine and clinical application of the skin test. Pediatrics 61: 550PubMedGoogle Scholar
  5. 5.
    Bogger-Goren S, Baba K, Hurley P, Yabuuchi H, Takahashi M, Ogra PL (1982) Antibody response to varicella-zoster virus after natural or vaccine-induced infection. J Infect Dis 146: 260–265PubMedCrossRefGoogle Scholar
  6. 6.
    Brunell PA, Geiser CF, Novelli V, Lipton S, Narkewicz S (1987) Varicella-like illness caused by live varicella vaccine in children with acute lymphocytic leukemia. Pediatrics 79: 922–927PubMedGoogle Scholar
  7. 7.
    Bruusgaard E (1932) The mutual relation between zoster and varicella. Br J Dermatol Syph 44: 1–24CrossRefGoogle Scholar
  8. 8.
    Feder HM, Jr LaRussa P, Steinberg S, Gershon AA (1997) Clinical varicella following varicella vaccination: don’t be fooled. Pediatrics 99: 897–899PubMedCrossRefGoogle Scholar
  9. 9.
    Gomi Y, Mori T, Imagawa T, Takahashi M, Yamanishi K (1999) Virus and other clinical isolates of varicella-zoster virus. In: The International Conference on Immunity and Prevention of Herpes Zoster, Osaka, Japan, p 12Google Scholar
  10. 10.
    Hardy IB, Gershon A, Steinberg S, LaRussa P (1991) The incidence of zoster after immunization with live attenuated varicella vaccine. A study in children with leukemia. N Engl J Med 325: 1545–1550PubMedCrossRefGoogle Scholar
  11. 11.
    Hayakawa Y, Torigoe S, Shiraki K, Yamanishi K, Takahashi M (1984) Biologic and biophysical markers of a live varicella vaccine strain (Oka): identification of clinical isolates from vaccine recipients. J Infect Dis 149: 956–963PubMedCrossRefGoogle Scholar
  12. 12.
    Hayakawa Y, Yamamoto T, Yamanishi K, Takahashi M (1986) Analysis of varicella­zoster virus DNAs of clinical isolates by endonuclease HpaI. J Gen Virol 67: 1817­-1829PubMedCrossRefGoogle Scholar
  13. 13.
    Just M, Berger R, Luescher D (1985) Live varicella vaccine in healthy individuals. Postgrad Med J 61: 129–132PubMedGoogle Scholar
  14. 14.
    Kamiya H, Kato T, Isaji M, Torigoe S, Oitani K, Ito M, Ihara T, Sakurai M, Takahashi M (1984) Immunization of acute leukemic children with a live varicella vaccine (Oka strain). Biken J 27: 99–102PubMedGoogle Scholar
  15. 15.
    Kinchington PR, Ling P, Pensiero M, Ruyechan WT, Hay J (1990) The glycoprotein products of varicella-zoster virus gene 14 and their defective accumulation in a vaccine strain (Oka). J Virol 64: 540–548Google Scholar
  16. 16.
    Kohl S, Rapp J, LaRussa P, Gershon A, Steinberg S (1999) Natural varicella zoster virus reactivation shortly after varicella immunization in a child. Pediatr Infect Dis J 18: 1112–1113PubMedCrossRefGoogle Scholar
  17. 17.
    Kundratitz K (1925) Experimentelle Ubertragung von Herpes Zoster auf den Mensschen and die Beziehungen von Herpes Zoster zu Varicellen. Monatssbl Kinderheilkd 29: 516–523Google Scholar
  18. 18.
    LaRussa P, Lungu O, Hardy I, Gershon A, Steinberg SP, Silverstein S (1992) Restriction fragment length polymorphism of polymerase chain reaction products from vaccine and wild-type varicella-zoster virus isolates. J Virol 66: 1016–1020PubMedGoogle Scholar
  19. 19.
    LaRussa P, Steinberg S, Arvin A, Dwyer D, Burgess M, Menegus M, Rekrut K, Ya­manishi K, Gershon A (1998) Polymerase chain reaction and restriction fragment length polymorphism analysis of varicella-zoster virus isolates from the United States and other parts of the world. J Infect Dis 178 [Suppl 1]: S64—S66Google Scholar
  20. 20.
    LaRussa P, Steinberg S, Gershon A (1994) Diagnosis and typing of varicella-zoster virus (VZV) in clinical specimens by polymerase chain reaction (PCR). In: 34th ICAAC, Orlando, Abstract #1486Google Scholar
  21. 21.
    LaRussa P, Steinberg S, Meurice F, Gershon A (1997) Transmission of vaccine strain varicella-zoster virus from a healthy adult with vaccine-associated rash to susceptible household contacts. J Infect Dis 176: 1072–1075PubMedCrossRefGoogle Scholar
  22. 22.
    LaRussa P, Steinberg S, Sharrar R, Galea S, Gershon A (1997) Identification and differ­entiation of wild (WT)- and vaccine (OKA)-strain VZV isolates by PCR from recipients of live attenuated varicella vaccine (LAVV). In: 3rd International Conference on the Varicella-Zoster Virus, Palm Beach, Florida, Abstract #P-49Google Scholar
  23. 23.
    Lawrence R, Gershon A, Holzman R, Steinberg S, NIAID Varicella Vaccine Collabora­tive Study Group (1988) The risk of zoster after varicella vaccination in children with leukemia. N Engl J Med 318: 543–548CrossRefGoogle Scholar
  24. 24.
    Martin JH, Dohner DE, Wellinghoff WJ, Gelb LD (1982) Restriction endonuclease analysis of varicella-zoster vaccine virus and wild-type DNAs. J Med Virol 9: 69–76PubMedCrossRefGoogle Scholar
  25. 25.
    Moffat JF, Zerboni L, Kinchington PR, Grose C, Kaneshima H, Arvin AM (1998) At­tenuation of the vaccine Oka strain of varicella-zoster virus and role of glycoprotein C in alphaherpesvirus virulence demonstrated in the SCID-hu mouse. J Virol 72: 965–974PubMedGoogle Scholar
  26. 26.
    Ndumbe PM, Cradock-Watson JE, MacQueen S, Dunn H, Andre F, Davies EG, Dudgeon JA, Levinsky RJ (1985) Immunisation of nurses with a live varicella vaccine. Lancet 1: 1144–1147PubMedCrossRefGoogle Scholar
  27. 27.
    Plotkin SA, Starr S, Connor K, Morton D (1989) Zoster in normal children after varicella vaccine. J Infect Dis 159: 1000–1001PubMedCrossRefGoogle Scholar
  28. 28.
    Ross A, Lencher E, Reitman G (1962) Modification of chickenpox in family contacts by administration of gamma globulin. N Engl J Med 267: 369–376PubMedCrossRefGoogle Scholar
  29. 29.
    Salzman MB, Sharrar RG, Steinberg S, LaRussa P (1997) Transmission of varicella­vaccine virus from a healthy 12-month-old child to his pregnant mother. J Pediatr 131: 151–154PubMedCrossRefGoogle Scholar
  30. 30.
    Shapiro E, LaRussa P, Steinberg S, Gershon A (1998) Protective efficacy of varicella vaccine. In: 34th Annual Meeting of The Infectious Diseases Society of America, Denver, Abstract #78Google Scholar
  31. 31.
    Shapiro E, Vazquez M, LaRussa P, Steinberg S, Gershon A (1999) Protective efficacy of varicella vaccine. In: 24th International Herpes Virus Workshop, Boston, Abstract 13.030Google Scholar
  32. 32.
    Sharrar R, LaRussa P, Galea S, Steinberg S, Keatley R, Wells M, Stephenson W, Gershon A (2000) The postmarketing safety profile of varicella vaccine. Vaccine (in press)Google Scholar
  33. 33.
    Takahashi M (1996) The varicella vaccine. Vaccine development. Infect Dis Clin North Am 10: 469–488PubMedCrossRefGoogle Scholar
  34. 34.
    Takahashi M, Gershon A (1994) Varicella vaccine. In: Mortimer E, Plotkin S (eds) Vaccines. WB Saunders, Philadelphia, pp 387–417Google Scholar
  35. 35.
    Takahashi M, Kamiya H, Baba K, Asano Y, Ozaki T, Horiuchi K (1985) Clinical expe­rience with Oka live varicella vaccine in Japan. Postgrad Med 61: 61–67CrossRefGoogle Scholar
  36. 36.
    Takahashi M, Otsuka T, Okuno Y, Asano Y, Yazaki T, Isomura S (1974) Live vaccine used to prevent the spread of varicella in children in hospital. Lancet 2: 1288–1290PubMedCrossRefGoogle Scholar
  37. 37.
    Tsolia M, Gershon AA, Steinberg SP, Gelb L (1990) Live attenuated varicella vaccine: evidence that the virus is attenuated and the importance of skin lesions in transmission of varicella-zoster virus. National Institute of Allergy and Infectious Diseases Varicella Vaccine Collaborative Study Group. J Pediatr 116: 184–189PubMedCrossRefGoogle Scholar
  38. 38.
    White C (1992) Varicella vaccine reflux, reply to letter. Pediatrics 89: 354Google Scholar
  39. 39.
    White CJ (1996) Clinical trials of varicella vaccine in healthy children. Infect Dis Clin North Am 10: 595–608PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2001

Authors and Affiliations

  • P. S. LaRussa
    • 1
    • 2
  • A. A. Gershon
    • 1
  1. 1.Columbia UniversityNew YorkUSA
  2. 2.Division of Pediatric Infectious DiseasesCollege of Physicians & SurgeonsNew YorkUSA

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