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To the Editor.—The article by Dr Wallace and colleagues¹ concludes that "[a] history of previous varicella infection in adults with varicella may not be reliable." Based on my previous work with medical students² and 2 previously published large surveys of armed forces recruits,^3-4 it is hard to accept this conclusion on the basis of the limited data presented.

When assessing the value of a history of varicella, the positive predictive value, or the proportion of history-positive subjects who are antibody positive, is most important. The positive predictive value for a history of disease caused by varicella zoster virus (VZV) has been previously shown to be high (97%) using large populations of subjects.^3-4 This value does not reach 100% because other infectious illnesses, such as those caused by enteroviruses, infrequently may mimic the appearance of VZV. In addition, if VZV infection occurs in infants aged 6 months or younger, some . . . [Full Text of this Article]

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RELATED ARTICLE

Reliability of a History of Previous Varicella Infection in Adults
Mark R. Wallace, Carolyn J. Chamberlin, Leigh Zerboni, Mark H. Sawyer, Edward C. Oldfield, Patrick E. Olson, and Ann M. Arvin
JAMA. 1997;278(18):1520-1522.
ABSTRACT