Primary infection with VZV results in chickenpox via
- Direct contact with varicella or zoster lesions
- Air-borne droplet infection
- Vertical transmission during pregnancy
- Incubation period: 14 - 16 days
- Contagious: 1 - 2 days before onset of rash until all lesions are crusted (5 days)
Indications for VZV-Immunoglobulin (Varitect®) post exposure
- Children receiving immunosuppressive therapy
- Normal susceptible adolescents (> 15 y) and adults
- Pregnant women
- Newborn infant of a mother who had onset of chickenpox within 5 days before delivery or within 48 hours after delivery
- Hospitalized premature infant (> 28 week gestation) whose mother has no history of chickenpox
- Hospitalized premature infant (< 28 week gestation or < 1000 g) regardless of maternal history
- Treatment of zoster in immunocompromised patients who will not respond to the treatment with acyclovir
VZV-Immunoglobulin (Varitect® i.v.) Dosage
- Prevention of VZV-Infection *) 1 ml/ kg b.w
- Treatment of Zoster-disease **) 2 ml/ kg b.w
*) For maximal effectiveness Varitect should be given within 48 hours of exposure. For newborns from acutely infected mothers Varitect should be given as soon as possible after delivery (approx. 50 % of these newborns are prone to infections which can occur as early as 1 day after delivery)
**) According to the clinical course of the disease a second dosage of 2 ml/kg b.w. should be administered on day 3.