[Adults with chickenpox in the tropics]
Jaap L J Hanssen1, G J Joris Schakel, Jeanette M Fontilus-Rohoman
1St. Elisabeth Hospitaal, Willemstad, Curaçao.
Nederlands Tijdschrift Voor Geneeskunde
|March 3, 2016
Summary
Adults in tropical regions may not have chickenpox immunity. This can lead to severe illness, highlighting the need for awareness and vaccination, especially for travelers.
Area of Science:
- Infectious Diseases
- Virology
- Public Health
Background:
- Chickenpox (varicella-zoster virus, VZV) is less common in adults in tropical climates compared to temperate regions.
- A significant percentage of young adults (40% aged 20-29) in the Dutch Caribbean lack VZV antibodies.
- This lack of childhood immunity poses a risk for adult VZV infection.
Observation:
- Three adult cases of chickenpox (ages 37, 51, 90) are presented.
- Adult chickenpox presents with a more severe clinical course than in children.
- High-risk groups include pregnant women and individuals with T-cell immunodeficiency, facing even greater risks.
Findings:
- Aciclovir and valaciclovir are effective treatments for adult chickenpox with minimal side effects.
- Passive immunization with VZV-immunoglobulin within 96 hours of exposure is recommended.
- Treatment is often followed by acyclovir or valaciclovir for confirmed VZV infection.
Implications:
- Increased global migration necessitates awareness of adult VZV infection risks in travelers.
- Healthcare providers should consider VZV immunity status in adults, particularly migrants.
- Proactive screening and vaccination strategies may be needed to prevent severe adult chickenpox cases.
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