varicella Flashcards
Breastfeeding mum with 6 month old gets chickenpox. How to manage?
treat mum with PO aciclovir if presents within 24hours of rash.
if severe, give mum iv aciclovir 10mg/kg tds min 7days.
If lesion on nipple, express the milk. the expressed milk can be given to baby if baby covered by VZIG/aciclovir.
Baby: if baby >7days old, then no need for anything for baby . “VZIG is not usually required for infants born more than seven days after the onset of maternal chickenpox or whose mothers develop zoster before or after delivery, as these infants will have maternal antibody”
Healthcare worker, non-immune, significantly exposed to chickenpox.
How to manage?
tell occupational health. they will risk assess and consider exclusion from high-risk pt work day 8 -21.
if develops symptoms sooner, to treat.
vaccinate (some evidence vaccine effective within 3 days of giving). will need one dose vaccine then another at 4-8weeks (live vaccine - so no pregnancy for one month after vaccine, and avoid salicylates for 6weeks post vaccine).
if can’t take vaccine (pregnant/immunocompromised), consider VZIG/prophylactic aciclovir as per guidelines.
if gets post vaccine localised rash - if can cover, continue working. if generalised post-vaccine rash, then exclude from work till all lesions crusted.
Immunosuppressed patient exposed to healthy brother who has shingles on trunk (shingles were covered). Need to act?
No, coz not significant exposure.
