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The usefulness of skin test in evaluation of immunity to varicella

Korean Journal of Pediatrics 2008;51(4):377-382.
Published online April 15, 2008.
The usefulness of skin test in evaluation of immunity to varicella
Ji-Young Kim, Hye Jeen Lee, Me Jin Kim, Young Ho Kim, Ji A Jung, Seung Yang, Il Tae Hwang, Hae Ran Lee
Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
수두에 대한 면역력 평가에 있어서 피부 시험의 유용성
김지영, 이혜진, 김미진, 김영호, 정지아, 양승, 황일태, 이혜란
한림대학교 의과대학 소아과학교실
Correspondence: 
Hae Ran Lee, Email: drran@hallym.or.kr
Abstract
Purpose
: The aim of this study is to assess the usefulness of skin test by an inactivated, 1/50 diluted solution of attenuated varicella vaccine in evaluating the immune status to varicella.
Methods
: Total 41 subjects (22 males, 19 females, aged 1-32 years) were enrolled from July to August, 2005. Past medical history including varicella infection, varicella vaccination were investigated through questionnaires. The skin test solution was prepared from solution of attenuated varicella vaccine(Oka strain) which was inactivated by exposure to room temperature for 10 days and diluted at 1/50 with normal saline. Skin test was done by injecting 0.1 mL of the solution intradermally into the volar surface of the right forearm and sterile normal saline was used as a control on the left forearm. Positive reaction was defined when the transverse diameter of the induration was 5 mm or more. Serum varicella zoster virus specific IgG antibody test by ELISA (enzyme-linked immunosorbent assay) was done.
Results
: In adults, the sensitivity of the varicella zoster virus skin test compared to ELISA was 94.7% and the positive predictive value was 100%. In children, both the positive predictive value and specificity were 100% but the sensitivity and the negative predictive value were 50% and 30.7% respectively. Children showed smaller skin test reactivity compared to adults.
Conclusion
: The varicella zoster virus skin test using inactivated, 1/50 diluted solution of attenuated varicella vaccine was proved as one of the useful tools for evaluating the immunity and susceptibility of the varicella zoster virus.
Key Words: Skin tests, Chickenpox, Immunity


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