- conventional wisdom stated by eminent textbooks is that it is not possible
to get chickenpox twice - the argument claims that a single chickenpox infection
provides subsequent lifelong immunity
- however it is argued (1) that if immunity was lifelong then shingles would
not occur since this represents a localised reactivation of the virus (indicating
a failure of immunological control of latency)
- there is evidence that true re-infection with chickenpox can occur (2)
- twenty-three healthy and apparently immunocompetent children with a
history of 2-5 episodes of chickenpox were studied after repeat disease
- serial sera were tested for VZV-IgG subclass patterns and VZV IgG and
G-subclass antibody avidity by urea elution enzyme linked immunoassay
- of 11 patients studied within 8 weeks of repeat chickenpox (Early Group),
mean antibody avidity was significantly lower (31.3 +/- 26.81) than control
(65.1 +/- 12.38) (P < .001). Seven had low avidity antibody (< 30 percent)
and an abundance of IgG3 which was a pattern like primary chickenpox,
and 2/11 had high avidity antibody characteristic of anamnestic responses.
Early Group patients and 12 others studied over 8 weeks after repeat disease
(Late Group) showed avidity maturation and attrition of IgG subclass antibodies
other than IgG1
- at least nine children failed to show VZV-specific secondary (memory)
immune responses early in the course of repeat disease. It is possible
that failure to maintain or evoke a secondary immune response could explain
their susceptibility to repeat chickenpox.
- there is also evidence that chickenpox infection has occurred in patients
who have been vaccinated and been demonstrated to have antibody and cellular
immunity against varicella-zoster virus - in these cases virus typing has
demonstrated wild-type virus and not vaccine strain, therefore confirming
- Pulse (2003), 63 (26), 88.
virus antibody avidity and IgG-subclass patterns in children with recurrent
chickenpox. J Med Virol. 1994 Jun;43(2):119-24.