title: Varicella zoster virus infection.
abstract: Infection with varicella zoster virus (VZV) causes varicella (chickenpox), which can be severe in immunocompromised individuals, infants and adults. Primary infection is followed by latency in ganglionic neurons. During this period, no virus particles are produced and no obvious neuronal damage occurs. Reactivation of the virus leads to virus replication, which causes zoster (shingles) in tissues innervated by the involved neurons, inflammation and cell death - a process that can lead to persistent radicular pain (postherpetic neuralgia). The pathogenesis of postherpetic neuralgia is unknown and it is difficult to treat. Furthermore, other zoster complications can develop, including myelitis, cranial nerve palsies, meningitis, stroke (vasculopathy), retinitis, and gastroenterological infections such as ulcers, pancreatitis and hepatitis. VZV is the only human herpesvirus for which highly effective vaccines are available. After varicella or vaccination, both wild-type and vaccine-type VZV establish latency, and long-term immunity to varicella develops. However, immunity does not protect against reactivation. Thus, two vaccines are used: one to prevent varicella and one to prevent zoster. In this Primer we discuss the pathogenesis, diagnosis, treatment, and prevention of VZV infections, with an emphasis on the molecular events that regulate these diseases. For an illustrated summary of this Primer, visit: http://go.nature.com/14xVI1.
authors.affiliation: Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, New York 10032, USA.
authors.forename: Anne A
authors.initials: AA
authors.lastname: Gershon
authors.affiliation: Department of Infection and Immunity, University College London, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Breuer
authors.affiliation: Medical Virology Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Massachusetts, USA.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Cohen
authors.affiliation: Departments of Neurology and Microbiology and Immunology, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Cohrs
authors.affiliation: Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Gershon
authors.affiliation: Departments of Neurology and Microbiology and Immunology, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Gilden
authors.affiliation: Division of Infectious Diseases/Virology, Children's Hospital, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Grose
authors.affiliation: Primary Immunodeficiency Group, Institute of Cellular Medicine, Newcastle University Medical School, Newcastle upon Tyne, UK.
authors.forename: Sophie
authors.initials: S
authors.lastname: Hambleton
authors.affiliation: Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow University, Glasgow, Scotland, UK.
authors.forename: Peter G E
authors.initials: PG
authors.lastname: Kennedy
authors.affiliation: Infectious Diseases Section, Medicine Service, Veterans Affairs San Diego Healthcare System, Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, San Diego, California, USA.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Oxman
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Jane F
authors.initials: JF
authors.lastname: Seward
authors.affiliation: Research Foundation for Microbial Diseases, Osaka University, Suita, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamanishi
mesh_terms: D000328:Adult; D002644:Chickenpox / Q000821:virology; D019433:Chickenpox Vaccine / Q000627:therapeutic use; D006562:Herpes Zoster / Q000821:virology; D014645:Herpesvirus 3, Human; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D051474:Neuralgia, Postherpetic / Q000821:virology; D000073618:Varicella Zoster Virus Infection / Q000150:complications / Q000517:prevention & control / Q000821:virology*; D017735:Virus Latency
chemical_list: D019433:Chickenpox Vaccine