Akiko Tomitaka

Detection of Aerosolized Varicella-Zoster Virus DNA in Patients with Localized Herpes Zoster

We examined the excretion of varicella zoster virus (VZV) in hospitalized patients with herpes zoster localized to the thoracic region whose skin lesions were covered with either hydrocolloid dressing agents (hydrocolloid group) or conventional gauze bandages (gauze group). The presence of VZV DNA in swab samples from lesion coverings, the throat, and filters of air purifiers was examined by use of a sensitive polymerase chain reaction assay. For the hydrocolloid group, VZV was detected in none of the samples from lesion coverings or air purifier filters; for the gauze group, VZV DNA was detected in samples from gauze coverings and air purifier filters for all 6 patients. VZV DNA was detected less frequently in throat samples from patients in the hydrocolloid group than in those from patients in the gauze group. The results of the present study suggest that hydrocolloid dressing agents prevent excretion of aerosolized VZV DNA from skin lesions of patients with localized herpes zoster.

Rapid contamination of the environments with varicella‐zoster virus DNA from a patient with herpes zoster

Patients with zoster are considered to be less contagious than varicella patients because their infection is localised. It is not known, however, when and for how long a spread of varicella‐zoster virus (VZV) from a zoster patient begins and continues and the extent of virus spread from the patient. The polymerase chain reaction (PCR) was used to detect VZV DNA in samples obtained from the hands and throat of a patient with zoster and from her room environments including surfaces of the back of a chair, the door handle, the table and the air conditioner filter. VZV DNA was detected on the surfaces of the back of the seat and the table and in peripheral blood mononuclear cells (PBMCs) and serum on Day 4 of the illness. VZV DNAemia persisted for 4 days until Day 7 of the illness. It was also detected in samples collected from throat and the air conditioner filter on Days 6 and 7 of the illness respectively. All of the surfaces, that were examined in her home environment, were contaminated with VZV DNA by Day 7 of the illness. The present study showed rapid and wide spread of VZV DNA in the environment even from a patient with zoster. J. Med. Virol. 63:64–66, 2001.

Anaphylaxis after hamster bites: a rare case?

Hamsters are increasingly raised as pets in Japan. We found only 5 case reports of anaphylaxis after hamster bites (1–4), 3 of which, surprisingly, were from Japan (1–3). A 36-year-old woman was admitted with symptoms of anaphylaxis. She had a past history of atopic dermatitis and bronchial asthma in childhood. For the last 2⁄2 years she had been raising 3 hamsters and, though bitten on the hands several times, had developed no symptoms. On the day of admission, one of the hamsters had bitten her left hand. Within a few minutes she felt a warm flush in her left hand, which gradually spread and caused a generalized urticaria accompanied by pruritus of her eyes. She began to sneeze and feel itchy 20 min later, and breathing became difficult. On admission, she was pale, and her blood pressure was low (95/36 mmHg). After a few minutes she fainted and required emergency treatment with i.v. hydrocortisone sodium succinate (500 mg) and antihistamines. Specific IgE antibodies (CAP RAST FEIA) against Dermatophagoides pteronyssinus and house dust were class 5 but specific IgE antibodies (AlaSTAT) against mouse epithelium, mouse urine, rat epithelium, rat urine, rat serum proteins and hamster epithelium were all negative. Prick tests using prick lancets (EWO CARE AB, Sweden) with the three hamsters’ saliva as is and urine, diluted to 20% in physiological saline (Otsuka Pharmaceutical Co, Ltd, Tokyo, Japan), were performed with the patient’s informed consent. We filtered the solutions to sterilize them through a 0.22 mm Millex-GV membrane (Millipore, Japan). Readings were done 15 min later. We used physiological saline as a negative control and histamine chloride (Wako Pure Chemical Industries, Ltd, Osaka, Japan) 10 mg in 1 mL of physiological saline as a positive control. The diameters of wheals were 0 mm and 3 mm, respectively. On prick testing, the patient showed positive reactions to their saliva with 4 mm, 5 mm and 4 mm diameters of wheals, but negative results with their urine. Also with the patient’s informed consent, we performed prick tests on her child, who had been bitten several times by the same hamsters. These tests were negative. We concluded that our patient’s positive prick test reaction to the hamsters’ saliva was allergic.