Manouchehrinia A, et al. - This study was performed to assess the prevalence of a history of prior varicella/herpes zoster infection in multiple sclerosis (MS). Knowledge of varicella zoster virus (VZV) exposure seemed crucial, given the risk of serious complications of first exposure while undergoing immunosuppressive treatment, in particular with fingolimod. In this study, a high rate of MS patients reported prior chickenpox infection, that was comparable with previous reports. A substantial proportion of MS patients, estimated to be higher than an age-matched general population, report single or multiple episodes of zoster. The data seemed to have utility while considering immunosuppressive treatments and/or VZV and zoster vaccination.

Methods

• Questionnaires requesting information about history of chickenpox, sibling/household/occupational exposure, history of zoster (shingles), and disease-modifying treatment were distributed to MS clinic patients.
• Researchers selected a random, proportionally representative sample of 51 patients that included patients with positive, negative, and unknown chickenpox history for determination of VZV IgG by ELISA.

Results

• 1206 questionnaires were distributed, 605/1206 were returned (50% response rate).
• In this study, 86% of the returned questionnaires reported history of chickenpox, 5.6% gave negative history, and 8.5% did not know.
• 594 answered the zoster question; 78% gave a negative response, 4% did not know, and 104 (17%) answered yes.
• Of these, 1 episode was reported by 83 respondents; 2 episodes were reported by 12 respondents; 3 episodes were reported by 5 respondents; and 5, 6, and 15 episodes were reported by 1 each.
• Of 51 patients tested for VZV IgG (44 “yes,” 4 “no,” and 3 “I don’t know” answers to the question of whether they had chickenpox), 48 were seropositive; the 3 seronegative all had reported having had chickenpox