Varicella-zoster virus seroprevalence in children and adolescents in the pre-varicella vaccine era, Germany

BMC Infectious Diseases

Research Article

Ole Wichmann¹  Miriam Wiese-Posselt¹  Anette Siedler¹  Christina Poethko-Müller²  Annette Mankertz³  Andreas Sauerbrei⁴  Hartmut Hengel⁵ 

[1] Department for Infectious Disease Epidemiology, Robert Koch Institute, Immunization Unit, Seestrasse 10, 13353, Berlin, Germany;Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany;Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany;Institute of Virology and Antiviral Therapy, German Consulting Laboratory for HSV and VZV, Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany;Institute of Virology, Medical Center, Albrecht-Ludwigs-University, Faculty of Medicine, Freiburg, Germany;

关键词: Varicella-zoster virus;    Seroprevalence;    Elisa;    FAMA;    Varicella vaccination;   

DOI  :  10.1186/s12879-017-2461-2

 received in 2017-01-10, accepted in 2017-05-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn 2004, universal childhood varicella vaccination was introduced in Germany. We aimed to determine the age-specific prevalence of anti-varicella zoster virus (VZV) IgG-antibodies among children in the pre-varicella vaccine era in Germany, to identify factors associated with VZV seropositivity, and to assess the suitability of a commercially available ELISA for VZV seroepidemiological studies by comparing it with an in-house fluorescent antibody to membrane antigen test (FAMA) as the gold standard.MethodsSerum samples of 13,433 children and adolescents aged 1–17 years included in the population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS; conducted 2003–2006) were tested for anti-VZV IgG by ELISA. All samples with equivocal ELISA results and a random selection of ELISA-negative and -positive samples were tested by FAMA. Statistical analyses were conducted using a weighting factor adjusting the study population to the total population in Germany. Seroprevalences were calculated as percentages (%) with a 95% confidence interval (CI). Odds ratios (OR) were computed by multivariate logistic regression to determine the association between socio-demographic factors and VZV seropositivity.ResultsThe VZV seropositivity rate was 80.3% (95% CI: 79.3–81.3) in varicella-unvaccinated children and adolescents. VZV seropositivity rates differed significantly between age groups up to age 6 years, but not by gender. Of 118 retested serum samples with an equivocal ELISA result, 45.8% were FAMA-positive. The proportion of samples tested as false-negative in by ELISA varied by age group: 2.6% in children aged 1–6 and 9% in children aged 7–17 years. Multivariate analyses showed that age, having older siblings, and early daycare start were associated with seropositivity in preschoolers; migration background reduced the chance of VZV seropositivity in schoolchildren (OR: 0.65; 0.43–0.99) and adolescents (OR: 0.62; 0.4–0.97).ConclusionIn the pre-varicella vaccine era, most children in Germany contracted varicella by age six. Schoolchildren with a migration background and children without siblings have an increased risk of being VZV seronegative and should be targeted for catch-up vaccination, if they have no history of chickenpox. ELISAs are suitable for use in population-level serosurveys on VZV, but samples with equivocal ELISA results should be retested by FAMA.

【 授权许可】

CC BY   
© The Author(s). 2017