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March 25, 1998

Varicella Infection in Adults Reporting Prior Varicella—Reply

JAMA. 1998;279(12):911-912. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-12-jbk0325

In Reply.—We believe Dr Murray may have misunderstood the intent of our study. We did not address the positive predictive value of a history of varicella in a military population. As we stated in our article, published studies show that the accuracy of a history of varicella in adults is 96% to 98%. Rather, we investigated a group of young adults with acute varicella who claimed to have had prior varicella. We discovered that none had preexisting antibodies to VZV in serum samples predating their acute varicella episode and concluded that true second episodes of varicella in immunocompetent adults must be rare. As we stated in our conclusions, the 20 patients who believed that they were having a second episode of varicella must represent the 2% to 4% of adults who believe they have had varicella previously but are, in fact, seronegative.13

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