Mehl. UW varicella 04-02 (2)

Question 1

UW. varicella postexposure Mx. algorithm.
Varicella exposure -> ?

Answer 1

varicella immune? (prior infection or 2 doses of vaccine)

Question 2

UW. varicella postexposure Mx. algorithm.
Varicella exposure -> varicella immune? (prior infection or 2 doses of vaccine) -> YES ->?

Answer 2

observation

Question 3

UW. varicella postexposure Mx. algorithm.
Varicella exposure -> varicella immune? (prior infection or 2 doses of vaccine) -> NO ->? 2 ways

Answer 3

Immunocompetent OR Immunocompromised, pregnant, newborn.

Question 4

UW. varicella postexposure Mx. algorithm.
Varicella exposure -> varicella immune? (prior infection or 2 doses of vaccine) -> NO -> Immunocompetent ->?

Answer 4

varicella vaccine within 5 days of exposure

Question 5

UW. varicella postexposure Mx. algorithm.
Varicella exposure -> varicella immune? (prior infection or 2 doses of vaccine) -> NO -> Immunocompromised, pregnant, newborn ->?

Answer 5

VariZIG (immunoglobulin) within 10 days of exposure

Question 6

UW. varicella postexposure. varicella-zoster virus (VZV) = disease?

Answer 6

Chickenpox

Question 7

UW. varicella postexposure. transmission?

Answer 7

contact with skin lesions or aerosolized respiratory secretions.

Question 8

Mehl. Pediatric shingles. You need to know that pediatric shingles “is a thing.”
- Classically seen in immunocompromised children (e.g., due to chemotherapy).

Answer 8

.

Question 9

Mehl. Pediatric shingles. Is ,,aka”? caused by what?

Answer 9

aka “herpes zoster” and is caused by varicella zoster virus (VZV);

Question 10

Mehl. Pediatric shingles.
herpes zoster is not a virus name.

Answer 10

herpes zoster literally is just another name for shingles, which is caused by VZV (human herpes virus 3; HHV3), not HSV1/2 (HHV1/2)

Question 11

UW. VZV. ≤5 days after exposure: Patients age ≥1?

Answer 11

should receive the VZV vaccine as PEP

Question 12

UW. VZV. ≤5 days after exposure: Children age <1?

Answer 12

Cannot receive the VZV vaccine and are low risk for severe infection, and therefore do not require PEP

Question 13

UW. VZV. >5 days after exposure?

Answer 13

Due to lack of effectiveness after this time interval, PEP is not indicated and management is observation for rash, which can occur up to 21 days after exposure. However, to prevent future infection unrelated to the recent exposure, the VZV vaccine is still universally recommended in nonimmune children age ≥1.

Question 14

UW. VZV postexposure algorithm. Prie immunocompeten - exclude children <1 yo.

Answer 14

If child younger - dont give; if >1 yo = give vaccine

Question 15

UW. VZV postexposure algorithm. for newborns not 10 days, bet 5days prior to 2 days dfter delivery

Answer 15

.

Question 16

UW. VZV. Varicella titers are not recommended prior to administration of PEP and would be negative in this child with no history of chickenpox or varicella vaccination. In addition, VariZIG is reserved for patients with contraindications to the VZV vaccine (eg, immunocompromised), not present in this case.

Answer 16

.

Question 17

UW. VZV. VACCINE contraindicated in what patients?

Answer 17

immunocompromised, pregnant, or in the immediate newborn period .

GIVE IMMUNOGLOBULIN + in some cases can additionally give prophylactic acyclovir (but alone not)