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Varicella Information for Ob-Gyns

UPDATED: The FDA approved an extended period for administering the varicella zoster immune globulin preparation (VariZIG), increasing the time frame from 4 days to 10 days post-exposure.

Varicella (chickenpox) is highly infectious (up to a 90% secondary attack rate of susceptible family members), and it spreads through inhalation of respiratory droplets. It has an incubation period of 14–16 days.

The typical varicella rash is first macular, becomes papular, and finally forms 200–500 blister-like vesicles that crust over. The rash or lesions begin on the scalp or face and spread downward, with a concentration of lesions on the trunk. Lesions appear in stages. Complications include infection of skin lesions; scarring; pneumonia; and, rarely, cerebral edema and death. Most varicella infections today are atypical, with fewer than 50–100 lesions, making clinical diagnosis more difficult and laboratory confirmation essential.

The risk of serious consequences of varicella increases with age; adolescents, adults, and immunocompromised persons typically have more severe cases of disease and are at higher risk for complications.

The varicella (chickenpox) vaccine is recommended for adults and adolescents aged 13 years and older, who do not have evidence of varicella immunity. Two doses, 4–8 weeks apart, are recommended in order to achieve a complete immune response.

Varivax (Merck & Co., Inc.) is the only varicella vaccine approved by the U.S. Food and Drug Administration for individuals over the age of 12 years. This vaccine is a live-attenuated viral vaccine. It should not be administered to pregnant women or women who desire to become pregnant within 1 month. Although the package insert states “within 3 months,” ACIP reviewed data and determined that one month is a safe interval to wait.

The varicella vaccine should not be given to individuals who have had a life-threatening allergic reaction to a previous dose of chickenpox vaccine, to gelatin, or to the antibiotic neomycin; individuals who are moderately or severely ill at the time the shot is scheduled; and pregnant women or women planning on becoming pregnant within a month.

People should check with their doctor about whether they should get the varicella vaccine, including individuals who have HIV/AIDS or another disease that affects the immune system; who are being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer; who have any kind of cancer; or who are receiving cancer treatment with radiation or drugs.

People who recently had a transfusion or were given other blood products should ask their doctor when they should receive the varicella vaccine.

Visit CDC's Varicella information page for more information.

Last Updated: 8/2/2013

 

Varicella Information for Patients

UPDATED!

Varicella (chickenpox) is a virus that spreads easily among people by coughing or sneezing. It incubates in the body for 14–16 days, then causes a very itchy rash. Blisters usually begin on the scalp or face and spread down to the trunk. Besides causing discomfort, the blisters can become infected and cause scarring. Sometimes varicella infection can be serious or life threatening. Although serious infection is rare, it can cause pneumonia, brain swelling, and death.

The risk of serious infection increases with age. Adolescents, adults, and people with certain high-risk conditions typically have more severe cases of disease. Getting a vaccine is the best way to prevent varicella.

People ages 13 years and older who do not have varicella immunity should get the vaccine. Two doses, given 4–8 weeks apart, are recommended.

Varivax is the only varicella vaccine available for individuals over age 12 years. This vaccine contains a live virus. The varicella vaccine should not be given to pregnant women or women who are trying to become pregnant within 1 month.

Groups who should not get the varicella vaccine include:

• Those who have had a severe allergic reaction to a previous dose of chickenpox vaccine, to gelatin, or to the antibiotic neomycin

• Those who have more than a minor illness at the time the shot is scheduled

• Pregnant women or women planning on becoming pregnant within 1 month.

In addition, you should check with your health care provider about whether you should get the vaccine if:

• You have human immunodeficiency virus or another disease that affects the immune system

• You are taking long-term steroids

• You have any kind of cancer

• You or are being treated for cancer with radiation or drugs

• You recently had a blood transfusion or were given other blood products.

Visit the Centers for Disease Control and Prevention's Varicella information page for more information.

Last Updated 8/2/2013

 




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