Varicella zoster

VARICELLA - ZOSTER VIRUS INFECTION

Chickenpox in pregnancy can lead to serious disease in newborn.

CLINICAL FEATURES

With maternal viraemia, the risk of foetal infection is about 25% and highest in initial half of gestation.

Early (6-12 weeks) gestational involvement have limb anomalies and later (16-20 weeks) involvement can have brain and eye involvement.

Foetopathy due to VZV is manifested by cicatricial skin lesions, hypo-pigmentation, micro-ophthalmia, cataracts, optic atrophy, chorioretinitis, microcephaly / hydrocephaly, intracranial calcifications, hypoplastic extremity, focal neurological deficits, etc.

Neonatal chickenpox occurs if the mother is infected in the 9th month of gestation and can manifest postnatally with CNS and hepatic involvement.

MANAGEMENT -

Foetopathy is preventable by immunization of VZV-susceptible women in reproductive age group.

Varicella zoster immunoglobulin (VZIG) should be given to neonate born to mother who has chicken pox less than 1 week before delivery.

Oral acydovir 20 mg/ml dose 6 hourly needs to be given if an infant develops chickenpox. With pneumonia, encephalitis, or hepatitis developing, intravenous acyclovir should be administered.

Neonatal chicken pox if appropriately treated with acyclovir, has a good prognosis.