title: Transmission of a newly characterized strain of varicella-zoster virus from a patient with herpes zoster in a long-term-care facility, West Virginia, 2004.
abstract: We investigated a small outbreak of varicella in a long-term-care facility after a case of herpes zoster. Clinical specimens and environmental samples were collected from all case patients and from surfaces in the case patients' rooms and other common-use areas. Wild-type varicella-zoster virus (VZV) DNA was identified in all 3 varicella case patients, and high concentrations of VZV DNA were detected in environmental samples from the room of the herpes zoster case patient. Genotypic analysis showed that the identical VZV strain was present in all samples; moreover, the strain was a unique Mosaic genotype isolate that included a stable Oka vaccine marker that had hitherto never been observed in a wild-type strain of VZV. This study provides evidence for the value of including environmental sampling during the investigation of varicella outbreaks and illustrates the importance of evaluating multiple vaccine-associated markers for the discrimination of vaccine virus from wild-type VZV.
authors.affiliation: National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. alopez@cdc.gov
authors.forename: Adriana S
authors.initials: AS
authors.lastname: Lopez
authors.forename: Andrea
authors.initials: A
authors.lastname: Burnett-Hartman
authors.forename: Ram
authors.initials: R
authors.lastname: Nambiar
authors.forename: Linda
authors.initials: L
authors.lastname: Ritz
authors.forename: Patricia
authors.initials: P
authors.lastname: Owens
authors.forename: Vladimir N
authors.initials: VN
authors.lastname: Loparev
authors.forename: Dalya
authors.initials: D
authors.lastname: Guris
authors.forename: D Scott
authors.initials: DS
authors.lastname: Schmid
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D002644:Chickenpox / Q000276:immunology / Q000635:transmission*; D019433:Chickenpox Vaccine / Q000235:genetics; D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission*; D004279:DNA, Viral / Q000145:classification; D004196:Disease Outbreaks; D005260:Female; D050456:Fomites / Q000821:virology; D005838:Genotype; D006562:Herpes Zoster / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics* / Q000635:transmission*; D014645:Herpesvirus 3, Human / Q000145:classification / Q000235:genetics*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D014903:West Virginia / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D019433:Chickenpox Vaccine; D004279:DNA, Viral