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.

Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 7/01/23.