Varicella-zoster virus (VZV) is the human herpesvirus that causes primary varicella infection, known as chickenpox. Latent VZV infection can reactivate as herpes zoster, also called shingles. Before the availability of a highly effective vaccine, VZV was responsible for nearly universal infection in childhood, with very few adults remaining susceptible to primary disease.

The clinical manifestations of chickenpox include a widespread, intensely pruritic vesicular rash. Affected individuals typically have between 250 and 500 lesions in varying stages of evolution, often associated with fever or other systemic symptoms. Infection in immunocompetent hosts generally is self-limited, but may vary greatly in severity. Adolescents, adults, and people who are immunocompromised are at particularly high risk for significant complications from this disease.

Although the most common complication of chickenpox is bacterial superinfection of skin lesions, varicella pneumonia is the most common cause of mortality, and pregnant women appear to be at particularly high risk of...

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