UBC Faculty Research and Publications

Fifteen-minute consultation : prevention and treatment of chickenpox in newborns Holland, Charlotte; Sadarangani, Manish


There are inconsistencies in how newborns are managed following exposure to varicella, ranging from reassurance and observation to administration of varicella zoster immunoglobulin (VZIG) and admission to hospital for varying length courses of IV aciclovir. In this article, we review the evidence for risk to non-immune mothers, the fetus and newborns who had different types of exposure to varicella, with recommendations for management and treatment of confirmed neonatal chickenpox. Hospitalised preterm babies exposed to varicella should receive VZIG. Administration can otherwise be limited to pregnant non-immune women, or to newborns if there is development of maternal chickenpox from 5 days prior to delivery up to 48 hours post-delivery. Intravenous aciclovir is only recommended in cases of newborn disease despite VZIG, or in severe disease. The use of VZIG may not prevent varicella, but may reduce severity of disease.

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