Serological and molecular investigation of suspected chickenpox cases from India, 2016–2025

IF 4.8 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2026-03-01 Epub Date: 2026-01-12 DOI:10.1016/j.jiph.2026.103147

Sunil R. Vaidya, Sarang S. Kamble, Madhukar B. Kamble, Roben P. George, Pankaj G. Pandey, Atul M. Walimbe

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Abstract

Background

Varicella, commonly known as chickenpox is a neglected disease in India with numerous outbreaks reported in the last decade. Unfortunately, varicella vaccine is not included in India’s Universal Immunization Program (UIP), and active surveillance is not in place. Investigation of suspected varicella cases from various Indian regions was done to understand disease burden and molecular epidemiology.

Methods

Between 2016 and 2025, 195 clinical cases from suspected chickenpox cases were referred for virological investigation from five States and one Union Territory of India. Samples were analyzed for Varicella-Zoster Virus (VZV) using IgM-EIA and/or conventional PCR. Virus isolation was attempted on Vero, MRC-5, and WI-38 cell lines. PCR-positive products were sequenced for phylogenetic analysis to identify circulating VZV clades.

Results

Of the 195 suspected cases, 159 (81.53 %) were confirmed by serological or molecular methods. Majority of the cases (n = 152, 77.94 %) occurred in individuals under 18 years of age, with higher incidence among males (n = 119) than females (n = 76). Of 58 diverse clinical specimens, 43 showed VZV DNA. Sequencing of representative PCR products showed circulation of VZV clade-5 in 29 cases and clade-9 in a single case. Unfortunately, attempts at VZV isolation were not successful.

Conclusion

The study confirms a high laboratory-confirmed rate of varicella among suspected cases in India, with children being the most affected. Molecular data identified VZV clade-5 as primary circulating genotype. These findings highlight a significant burden of chickenpox and provide molecular evidence to support inclusion of the varicella vaccine in India’s Universal Immunization Program.

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2016-2025年印度水痘疑似病例血清学和分子调查

水痘，俗称水痘，在印度是一种被忽视的疾病，在过去十年中报道了多次暴发。不幸的是，水痘疫苗不包括在印度的普遍免疫规划（UIP）中，也没有开展主动监测。对来自印度不同地区的水痘疑似病例进行调查，以了解疾病负担和分子流行病学。方法对2016 - 2025年来自印度5个邦和1个联邦直辖区的195例疑似水痘临床病例进行病毒学调查。采用IgM-EIA和/或常规PCR对样品进行水痘-带状疱疹病毒（VZV）检测。在Vero、MRC-5和WI-38细胞系上尝试分离病毒。pcr阳性产物测序用于系统发育分析，以确定循环VZV支系。结果195例疑似病例中，经血清学或分子检测确诊159例（81.53 %）。大多数病例（n = 152,77.94 %）发生在18岁以下的个体，男性发病率（n = 119）高于女性（n = 76）。在58份不同的临床标本中，43份显示VZV DNA。代表性PCR产物测序结果显示，29例病例中存在VZV分支枝-5,1例病例中存在分支枝-9。不幸的是，隔离VZV的尝试没有成功。结论：该研究证实，印度水痘疑似病例的实验室确诊率很高，儿童受影响最大。分子数据鉴定VZV clade-5为主要的循环基因型。这些发现突出了水痘的重大负担，并提供了分子证据，支持将水痘疫苗纳入印度的普遍免疫规划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.