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Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students

  • Original Paper
  • Published:
International Journal of Occupational Medicine and Environmental Health

Abstract

Objectives

We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity.

Material and Methods

255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen’s kappa and positive and negative likelihood ratios of recalled history were determined. p < 0.05 was considered statistically significant.

Results

The mean age of participants was 21.3±4.3 years. Seropositivity rate was 74.5%. The relationships between marital status, number of family members, and acquired VZV history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively.

Conclusions

Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection.

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References

  1. Heininger U, Seward JF. Varicella. Lancet. 2006;368(9544):1365–1376, http://dx.doi.org/10.1016/S0140-6736(06)69561-5.

    Article  PubMed  Google Scholar 

  2. Whitley RJ. Varicella-Zoster virus. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s, Principles and practice of infectious diseases. 7nd ed. Philadelphia: Elsevier Churchill Livingstone Press; 2010. p. 1963–199.

    Chapter  Google Scholar 

  3. Liese JG, Grote V, Rosenfeld E, Fischer R, Belohradsky BH, von Kries R, et al. The burden of Varicella complications before the introduction of routine Varicella vaccination in Germany. Pediatr Infect Dis J. 2008;27(2):119–124, http://dx.doi.org/10.1097/INF.0b013e3181586665.

    Article  PubMed  Google Scholar 

  4. Persson A, Bergström T, Lindh M, Namvar L, Studahl M. Varicella-zoster virus CNS disease-Viral load, clinical manifestations and sequels. J Clin Virol. 2009;46(3):249–253, http://dx.doi.org/10.1016/j.jcv.2009.07.014.

    Article  CAS  PubMed  Google Scholar 

  5. Deborah E. McCarter-Spaulding. Varicella infection in pregnancy. JOGNN. 2001;30:667–673, http://dx.doi.org/10.1111/j.1552-6909.2001.tb00014.x.

    Article  Google Scholar 

  6. Almuneef M, Dillon J, Abbas MF, Memish Z. Varicella zoster virus immunity in multinational health care workers of a Saudi Arabian hospital. Am J Infect Control. 2003;31(6):375–381, http://dx.doi.org/10.1016/S0196-6553(02)48204-1.

    Article  PubMed  Google Scholar 

  7. Apisarnthanarak A, Kitphati R, Tawatsupha P, Thongphubeth K, Apisarnthanarak P, Mundy LM, et al. Outbreak of Varicella-zoster virus infection among Thai healthcare workers. Infect Control Hosp Epidemiol. 2007;28(4):430–434, http://dx.doi.org/10.1086/512639.

    Article  PubMed  Google Scholar 

  8. Wu MF, Yang YW, Lin WY, Chang CY, Soon MS, Liu CE. Varicella zoster virus infection among healthcare workers in Taiwan: Seroprevalence and predictive value of history of Varicella infection. J Hosp Infect. 2012;80(2):162–167, http://dx.doi.org/10.1016/S0196-6553(02)48204-1.

    Article  PubMed  Google Scholar 

  9. Sam IC, Tariman H, Chan YF, Bador MK, Yusof MY, Hassan H. Varicella-zoster virus seroprevalence in healthcare workers in Kuala Lumpur, Malaysia. Med J Malaysia. 2008;63(5):429–430.

    CAS  PubMed  Google Scholar 

  10. Holmes CN. Review Predictive value of a history of Varicella infection. Can Fam Physician. 2005;51(1):60–65.

    PubMed Central  PubMed  Google Scholar 

  11. Talebi Taher M, Rezaie O. Seroepidemiology of VZV in the young adults referring to Rasoul-Akram Hospital in Tehran. Sci J Kurdistan Univ Med Sci. 2012;17(1):36–42.

    Google Scholar 

  12. Ziyaeyan M, Alborzi A, Jamalidoust M, Moieni M, Pourabbas B. Seroepidemiology of Varicella zoster virus infection among 1–70 year individuals in Iran. Iran Red Crescent Med J. 2012;12(2):176–180.

    Google Scholar 

  13. SharifiZ, Emadi Ghanjin S. The seroepidemiology of Varicella zoster (VZV) in different age groups in Tehran, Iran. Iran J Allergy Asthma Immunol. 2005;4(2):95–98.

    Google Scholar 

  14. Mamani M, Zamani M, Hashemi SH, Akhtari M, Niayesh A. Seroepidemiology of Varicella zoster virus among pregnant women in Hamedan, Iran. Afr J Microbiol Res. 2012;6(8):1829–1832.

    Google Scholar 

  15. Bayani M, Siadati S, Esmaeilzadeh S, Asgari S, Salmani S. Seroprevalence of Varicella zoster antibodies among pregnant women in Babol, Northern Iran. Iran J Pathol. 2013;8(3):171–177.

    Google Scholar 

  16. Pourahmad M, Davami MH, Sotoodeh-Jahromi AR. Evaluation of anti-Varicella antibody in young women before their marriage: A sero-epidemiologic study in Iran. J Clin Virol. 2010;48(4):260–263, http://dx.doi.org/10.1016/j.jcv.2010.04.015.

    Article  CAS  PubMed  Google Scholar 

  17. Hosseininasab A, Arabzadeh A, Haghdoost AA, Helmi Z. Immunity against Varicella zoster virus based on history of previous chickenpox: A study in premarital Iranian women. Int J Infect Dis. 2013;17(7):e568–e569, http://dx.doi.org/10.1016/j.ijid.2013.01.033.

    Article  PubMed  Google Scholar 

  18. Farshchi A, Niayesh A. Seroprevalence of Varicella antibodies in healthcare workers in Imam Reza Hospital of Kermanshah-Iran. J Pharma & Health Sci. 2012;1(1):37–40.

    Google Scholar 

  19. Pourakbari B, Shahbaznezhad L, Parvaneh N, Nikkhah S, Mahmoudi S, Teymuri M, et al. Seroepidemiology of Varicella zoster virus among children, adolescents and medical students in a referral children medical center, Tehran, Iran. Iran J Microbiol. 2012;4(3):136–138.

    CAS  PubMed Central  PubMed  Google Scholar 

  20. Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health [Internet]. Version 3.1. Atlanta: Rollins School of Public Health, Emory University; 2013 [updated 2013 Apr 6; cited 2013 Aug 2]. Available from: http://www.openepi.com.

    Google Scholar 

  21. Centre for Evidence-based Medicine at the University of Oxford (CEBM) Likelihood Ratios [cited 2013 Aug 1]. Available from: http://www.cebm.net/?o=1158.

  22. Talebi-Taher M, Noori M, Shamshiri AR, Barati M. Varicella zoster antibodies among health care workers in a university hospital, Teheran, Iran. Int J Occup Med Environ Health. 2010;23(1):27–32, http://dx.doi.org/10.2478/v10001-010-0011-x.

    Article  PubMed  Google Scholar 

  23. Motamedifar M, Handjani F, Hadi N, Shahkarami MK, Mehrabani D. Seroprevalence of Varicella-zoster virus in children from Shiraz-Iran. Iran J Immunol. 2006;3(1):43–46.

    Google Scholar 

  24. Ehsanipour F, Shayanfar N, Salariyan K. Surveying of protective antibody against Varicella zoster virus (VZV) infection in children referring to Hazrat-e-Rasool Akram Hospital 2005. Iran Uni Med Sci J. 2009;16(64):38–44.

    Google Scholar 

  25. Hambleton S, Gershon AA. Preventing Varicella-zoster disease. Clin Microbiol Rev. 2005;18:70–80, http://dx.doi.org/10.1128/CMR.18.1.70-80.2005.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Richard VS, John TJ, Kenneth J, Richard VS, John TJ, Kenneth J, et al. Should health care workers in the tropics be immunized against Varicella? J Hosp Infect. 2001;47(3):243–245, http://dx.doi.org/10.1053/jhin.2000.0855.

    Article  CAS  PubMed  Google Scholar 

  27. Baer G, Bonhoeffer J, Schaad UB, Heininger U. Seroprevalence and immunization history of selected vaccine preventable diseases in medical students. Vaccine. 2005;23(16):2016–2020, http://dx.doi.org/10.1016/j.vaccine.2004.03.073.

    Article  PubMed  Google Scholar 

  28. Wicker S, Rabenau HF, Gottschalk R, Doerr HW, Allwinn R. Seroprevalence of vaccine preventable and bloodtransmissible viral infections (measles, mumps, rubella, polio, HBV, HCV and HIV) in medical students. Med Microbiol Immunol. 2007;196(3):145–150, http://dx.doi.org/10.1007/s00430-007-0036-3.

    Article  PubMed  Google Scholar 

  29. Uduman SA, Tahira AM, Al-Wash R, Usmani MA, Bener A. Varicella susceptibility among children and healthy adults in the United Arab Emirates. East Mediterr Health J. 2001;7(4–5):604–608.

    CAS  PubMed  Google Scholar 

  30. Nichols RA, Averbeck KT, Poulsen AG, Al Bassam MM, Cabral F, Aaby P, et al. Household size is critical to Varicella-zoster virus transmission in the tropics despite lower viral infectivity. Epidemics. 2011;3(1):12–18, http://dx.doi.org/10.1016/j.epidem.2010.11.003.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Allami A, Mohammadi N, Afaghi A, Lashgari A. BCG Scar formation and test results in two generations. Shiraz E Med J. 2011 [cited 2014 Feb 24];12(1): [about 8 p.]. Available from: http://semj.sums.ac.ir/vol12/jan2011/89036.pdf.

    Google Scholar 

  32. Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35(10):S65–S164, http://dx.doi.org/10.1016/j.ajic.2007.10.007.

    Article  PubMed  Google Scholar 

  33. Banz K, Wagenpfeil S, Neiss A, Goertz A, Staginnus U, Vollmar J, et al. The cost-effectiveness of routine childhood Varicella vaccination in Germany. Vaccine. 2003;21(11):1256–1267, http://dx.doi.org/10.1016/S0264-410X(02)00431-0.

    Article  CAS  PubMed  Google Scholar 

  34. Alagappan K, Fu L, Strater S, Atreidis V, Auerbach C. Seroprevalence of Varicella antibodies among new house officers. Ann Emerg Med. 1999;33(5):516–519.

    Article  CAS  PubMed  Google Scholar 

  35. Coyle PV, McCaughey C, Wyatt DE, O’Neill HJ. Varicella vaccine in pregnancy. Testing should be offered to women without a history of chickenpox. Br Med J. 1997;314(7075):226, http://dx.doi.org/10.1136/bmj.314.7075.226.

    Article  CAS  Google Scholar 

  36. Burnham BR, Wells TS, Riddle JR. A cost-benefit analysis of a routine Varicella vaccination program for United States Air Force Academy cadets. Mil Med. 1998;163(9):631–634.

    CAS  PubMed  Google Scholar 

  37. Dashraath P, Ong E-S, Lee VJ. Seroepidemiology of Varicella and the reliability of a self-reported history of Varicella infection in Singapore military recruits. Ann Acad Med Singapore. 2007;36(8):636–641.

    CAS  PubMed  Google Scholar 

  38. Almuneef M, Memish ZA, Abbas MF, Balkhy HH. Screening healthcare workers for Varicella zoster virus: Can we trust the history? Infect Control Hosp Epidemiol. 2004;25(7):595–598, http://dx.doi.org/10.1086/502445.

    Article  PubMed  Google Scholar 

  39. Baer G, Bonhoeffer J, Schaad UB, Heininger U. Seroprevalence and immunization history of selected vaccine preventable diseases in medical students. Vaccine. 2005;23(16):2016–2020, http://dx.doi.org/10.1016/j.vaccine.2004.03.073.

    Article  PubMed  Google Scholar 

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Correspondence to Navid Mohammadi.

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Allami, A., Mohammadi, N. & Najar, A. Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students. IJOMEH 27, 304–313 (2014). https://doi.org/10.2478/s13382-014-0265-9

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  • DOI: https://doi.org/10.2478/s13382-014-0265-9

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