title: Latency of varicella zoster virus in dorsal root, cranial, and enteric ganglia in vaccinated children.
abstract: Despite vaccination, varicella-zoster virus (VZV) remains an important pathogen. We investigated VZV latency in autopsy specimens from vaccinees, in gastrointestinal tissue removed surgically, and in a guinea pig model. We propose that retrograde transport from infected skin and viremia deliver VZV to neurons in which it becomes latent. Wild type (WT) VZV was found to be latent in many ganglia of vaccinated children with no history of varicella, suggesting that subclinical infection with WT-VZV occurs with subsequent viremic dissemination. The 30% to 40% rate of WT-VZV zoster reported in vaccinees and occasional trigeminal zoster due to vaccine type VZV (vOka) are consistent with viremic delivery of VZV to multiple ganglia. Most human intestinal specimens contained latent VZV within neurons of the enteric nervous system (ENS). Induction of viremia in guinea pigs led to VZV latency throughout the ENS. The possibility VZV reactivation in the ENS is an unsuspected cause of gastrointestinal disease requires future investigation.
authors.affiliation: Department of Pediatrics, Columbia University Medical Center, 650 West 168th St, New York, NY, 10032, USA. aag1@columbia.edu
authors.forename: Anne A
authors.initials: AA
authors.lastname: Gershon
authors.forename: Jason
authors.initials: J
authors.lastname: Chen
authors.forename: Larry
authors.initials: L
authors.lastname: Davis
authors.forename: Clarissa
authors.initials: C
authors.lastname: Krinsky
authors.forename: Robert
authors.initials: R
authors.lastname: Cowles
authors.forename: Ross
authors.initials: R
authors.lastname: Reichard
authors.forename: Michael
authors.initials: M
authors.lastname: Gershon
mesh_terms: D000293:Adolescent; D000818:Animals; D001344:Autopsy; D002644:Chickenpox / Q000097:blood / Q000517:prevention & control* / Q000821:virology; D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003391:Cranial Nerves / Q000473:pathology / Q000821:virology*; D004195:Disease Models, Animal; D017615:Enteric Nervous System / Q000473:pathology / Q000821:virology*; D005260:Female; D005727:Ganglia, Spinal / Q000473:pathology / Q000821:virology*; D005767:Gastrointestinal Diseases / Q000503:physiopathology / Q000821:virology; D006168:Guinea Pigs; D014645:Herpesvirus 3, Human / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D014766:Viremia / Q000097:blood / Q000821:virology; D017735:Virus Latency / Q000502:physiology*
chemical_list: D019433:Chickenpox Vaccine; D012367:RNA, Viral