TRANSMISSION OF VACCINE STRAIN VARICELLA-ZOSTER VIRUS FROM A HEALTHY ADULT WITH VACCINE-ASSOCIATED RASH TO SUSCEPTIBLE HOUSEHOLD CONTACTS

Twelve days after receiving an investigational Oka strain live attenua ted varicella vaccine, a 38-year-old healthy white woman developed a r ash consisting of 30 scattered lesions. Sixteen days later, her 2 chil dren also developed rash. Swabs obtained from the skin lesions of the vaccinee and her children demonstrated the presence of varicella-zoste r virus (VZV) DNA by a polymerase chain reaction (PCR) assay. Restrict ion endonuclease polymorphisms present in wild and vaccine type VZV we re examined, and the amplified VZV DNA was determined to be vaccine ty pe. This case documents transmission of varicella vaccine type virus f rom a healthy vaccinee to susceptible household contacts. Since vaccin e-associated rashes are uncommon and mild, it is likely that transmiss ion of vaccine virus will also be uncommon. With widespread immunizati on beginning in the United States, ongoing studies will define the fre quency of this transmission.