Age: 76.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Herpes zoster, Myalgia, Pain, Varicella zoster virus serology positive
Clinical narrative: Information has been received from a healthcare worker concerning a 78 year old female who was vaccinated with a dose of ZOSTAVAX (Merck).  Four days ago the patient developed a shingles outbreak.  The reporter stated that the office would be interested in the VZV analysis by PCR.  The patient sought medical attention through an office contact.  At the time of this report the patient was recovering.  Follow up information received on 05-FEB-2009 from a herpes zoster questionnaire stated that the patient had chickenpox on 1935.  It was also stated that the patient was vaccinated with a dose of ZOSTAVAX (Merck) on 30-AUG-2006, the rash did not occur within 42 days of the vaccination.  The patient developed herpes zoster on 26-JAN-2009, other symptoms experienced by the patient includes fatigue, and ache in muscles, the maximum temperature experienced by the patient was 98.1.  The pain was quantified as 5.  It was unknown if the patient was recently exposed to chickenpox.  At the time of this report the patient had recovered.  The patient was enrolled in the Varicella Zoster Virus Identification Program to identify if VZV is present and if it is present to identify if it is associated with the wild-type (WT) VZV strain or with the Merck vaccine VZV strain.  It was also stated that the patient had PENICILLIN allergy;  the patient received the dose of ZOSTAVAX in left arm.  The specimen was obtained on 02-FEB-2009 and sent to the laboratory on 03-FEB-2009, it was collected from a patient vesicle.  The lesions were treated but not cured and were distributed in back, chest and in the left axilla.  The sample of collection was collected on 02-FEB-2009.  The sample was taken from a patient's vesicle.  The PCR results for the specimen from the patient's vesicle identified the presence of Wild Type VZV.  No further information is available. This is in follow-up to report (s) previously submitted on 3/27/2009.  Follow up information received on 03-FEB-2009 from a herpes zoster questionaire stated that the patient had chickenpox on 1935.  It was also stated that the patient was vaccinated with a dose of ZOSTAVAX on 30-AUG-2006, the rash did not occure within 42 days of the vaccination.  The patient developed herpes zoster on 26-JAN-2009, other symptoms experienced by the patient includes fatigue, and ache in muscles, the maximum temperature experienced by the patient was 98.1.  The pain was quantified as 5.  It was unknown if the patient was recently exposed to chickenpox.  At the time of this report the patient had recovered.  The patient was enrolled in the Varicella Zoster Virus Idenification Program to identify VZV is present and if it is present to identify if it is associated with the wild-type (WT) VZV strain or with the OKA/Merck vaccine VZV strain.  It was also stated that the patient had penicillin allergy; the patient received the dose of zoster vaccine live (oka/Merck) in left arm.  The specimen was obtained on 02-FEB-2009 and sent to the laboratory on 03-FEB-2009.  It was collected from a patient vesicle.  The lesions were treated but not cured and were distributed in back, chest and in the left axilla.  The specimen arrived in the laboratory on 05-FEB-2009.  The sample of collection was collected on 02-FEB-2009.  The sample was taken from a patient's scab lesion (previously reported from a patient's vesicle).  The PCR results for the specimen from the patient's scab lesion identified the presence of Wild Type VZV.  The interpretation was: an adequate specimen, wild type strain.  No further information is available.