C. Sana

Does Monastic Life Predispose to the Risk of Saint Anthony’s Fire (Herpes Zoster)?

BACKGROUND The consequences of the epidemiology of varicella for zoster epidemiology are still debated. We therefore compared the frequency of herpes zoster in an adult population with virtually no varicella zoster virus (VZV) exposure with that in the general population (GP). METHODS We performed a national, multicenter, observational, exposed versus nonexposed, comparative study. The nonexposed population consisted of members of contemplative monastic orders (CMO) of the Roman Catholic Church living in 40 isolated monasteries in France. The exposed population consisted of a sample of the GP representative of the French population in terms of age group, sex, socio-occupational categories, and regions. RESULTS The primary analysis population comprised 920 members of CMO (41.5% nuns; mean age, 64.2 years) and 1533 members of the GP (51.9% women; mean age, 64.6 years). The reported frequency of zoster was 16.2% among CMO and 15.1% in the GP (P = .27, adjusted for sex and age). The reported mean age of onset of zoster was 54.8 and 48.6 years, respectively (P = .06). CONCLUSIONS This study failed to demonstrate an increased risk or earlier onset of zoster in members of CMO not exposed to VZV, compared with that in the GP. Although adults highly exposed to VZV could have a reduced risk of zoster, compared with the GP, our results suggest that the opposite is not true: adults not exposed to VZV are not at increased risk of zoster when compared with the GP, challenging the relevance of the assumptions and forecasts of current epidemiological models.

Prevalence of Anti-Varicella-Zoster Virus Antibodies in French Infants under 15 Months of Age

ABSTRACT Varicella is a widespread disease of childhood resulting from primary infection with varicella-zoster virus (VZV). The objective of this study was to determine the kinetics of the decline of maternal anti-VZV antibodies in French infants between birth and the age of 15 months in order to estimate the duration of passively acquired maternal anti-VZV immunoglobulin G (IgG). This prospective multicenter study was conducted between October 2005 and January 2007 in the pediatric wards and/or pediatric emergency units of seven French hospitals scattered throughout the country. The level of anti-VZV IgG antibodies in serum was measured by a time-resolved fluorescence immunoassay (TRFIA) (the threshold considered positive is 150 mIU/ml). A total of 345 infants were included. Seventy-seven percent of mothers reported a history of varicella. A rapid decline in the prevalence of anti-VZV antibodies was observed during the first few months of life, with the mean antibody titer decreasing from 536 mIU/ml at birth and through 1 month to below the 150-mIU/ml threshold at 3 to 4 months. The half-life of passively acquired maternal immunoglobulins was around 6 weeks. Based on a large number of subjects, this study clearly demonstrated, for the first time in France, high levels of passively acquired maternal antibodies during the neonatal period, and it allowed us to estimate the duration of passively acquired maternal anti-VZV IgG in French infants. After 4 to 5 months, infants had very low levels of maternal anti-VZV IgG, below the 150-mIU/ml cutoff of the VZV IgG TRFIA.

Survey of vaccination policies in French healthcare institutions

OBJECTIVE The survey was implemented to describe vaccination policies for healthcare professionals in French healthcare institutions. METHODS A cross-sectional survey based on questionnaires was sent to occupational physicians and chairpersons of hospital infection prevention and control committees (HIPC) of 38 institutions between November 2010 and January 2011. RESULTS Twenty-nine occupational physicians and 26 hospital infection prevention and control committees chairpersons (HIPC), from 30 institutions answered (response rate: 79%), 70% of the institutions were university hospitals. Overall, 76% of occupational physicians and 85% of HIPC chairpersons reported that information and awareness campaigns about vaccination recommendations for healthcare professionals were usually conducted in their establishment. Fifty-nine percent of occupational physicians and 31% of HIPC chairpersons reported that they were aware of the vaccine coverage rates of professionals in their institution. The occupational physicians reported that they suggested diphtheria, tetanus, polio, influenza, and acellular pertussis vaccination to all staff at their annual visit in 100%, 97%, and 62% of cases, respectively. Varicella and measles vaccinations were never suggested in 31% and 17% of cases, respectively. Among respondents, 55% of physicians reported that they had already managed a pertussis epidemic, and 42% a measles epidemic, and in both of these cases an awareness campaigns were usually conducted (93% and 96%). CONCLUSIONS The vaccine coverage rates of healthcare professionals in French healthcare institutions remain insufficiently documented and could be improved.

CL021 - Existe-t-il une association entre l’exposition au virus de la varicelle et la survenue d’un zona ? : Étude exposé - non exposé

Contexte – objectifs Des contacts repetes avec des enfants atteints de varicelle pourraient entretenir l’immunite contre le VZV et reduire le risque de zona a l’âge adulte. L’etude a pour but de comparer la frequence et l’âge de survenue du zona dans des populations presentant des niveaux d’expositions differents au virus de la varicelle. Methode Etude epidemiologique nationale, de type «exposes-non exposes » realisee par auto-questionnaire. Population non exposee : 920 moines et moniales vivants au sein de 40 monasteres isoles. Population exposee : echantillon representatif de la population francaise (1533 personnes). Population surexposee : 788 pediatres. Resultats la prevalence du zona etait de 16,2 % chez les moines et moniales, 15,1 % dans la population generale et 12,3 % chez les pediatres (p ajuste sur l’âge et le sexe : 0,59) L’âge moyen declare de survenue du zona etait respectivement, de la population la moins a celle la plus exposee de 54,8, 48,6 et 35,1 ans (p Conclusion il n’a pas ete mis en evidence dans cette etude d’association entre le niveau d’exposition au virus de VZV et le risque de developper un zona. Ces resultats suggerent que si l’exposition au virus VZV a un effet protecteur vis-a-vis de la survenue d’un zona chez l’adulte, l’effet doit etre faible.