Itching to get home but, is your concern spot on?

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Question 1 of 3

1. Question
Which of the situations below count as ‘significant exposure’ to the Varicella-zoster virus? (Select all that apply)
- Being in the same room with someone who has active chickenpox for 20minutes
- Living with a child who has crusted lesions of chickenpox
- Shaking hands with an individual with herpes zoster if the affected area is on their face or hands
- Working alongside an individual with herpes zoster if affected area is fully covered but more than 10% of body surface area (BSA)
- Working alongside an individual with herpes zoster who is immunocompromised
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Question 2 of 3

2. Question
Luckily, Mum has registered for antenatal care at your hospital and you are able to arrange for her booking bloods to be tested for Varicella-zoster virus Immunoglobulin G antibodies (VZV IgG). The results are likely to be back in 24 hours so you arrange follow up with maternity services tomorrow. She is anxious about the result and wants to know the next steps.

Which is the most likely?
- As you arrange follow up, the obstetric team ask that you discharge her a course of oral acyclovir 800mg 5x a day for 7 days to start ahead of her appointment tomorrow.
- If the result tomorrow shows no pre-existing immunity the pregnancy woman should be offered oral anti-viral therapy (aciclovir) from day 7 to 14 post exposure.
- Regardless of the results, the obstetric team would advise she receives Varicella-zoster Immunoglobulin (VZIG) as her exposure has been significant.
- If the result tomorrow shows no pre-existing immunity, the obstetric team will advise she receives Varicella-zoster Immunoglobulin (VZIG) as soon as possible.
- If the result tomorrow shows no pre-existing immunity, the obstetric team will administer the chickenpox vaccine as she is not yet in her 3rd trimester.
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Question 3 of 3

3. Question
Her results showed no pre-existing immunity, but she declined aciclovir treatment, and unfortunately, she turns up 2 weeks later feeling generally well but with a new-onset vesicular rash.

What should you do now?
- You discharge her home with a 7-day course of oral acyclovir to start immediately. Admission risks exposure to other pregnant women and immunocompromised children.
- You recommend Varicella-zoster Immunoglobulin (VZIG) administration as this will minimise transmission to her foetus and reduce her risk of foetal varicella syndrome (FVS).
- You explain admission for close observation is now advised due to the increased severity of chickenpox illness in pregnant women.
- You explain admission for IV aciclovir administration is now advised due to the increased severity of chicken-pox illness in pregnant women.
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Itching to get home but, is your concern spot on?

Itching to get home but, is your concern spot on?

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