Varicella Zoster

Varicella is reportable to Public Health.

Varicella zoster immune globulin (VZIG) provides passive immunization against Varicella Zoster virus.

Indication for VZIG:

In the following high risk non-immune individuals within 96 hours of significant exposure to an active case of chickenpox:

• immunocompromised individuals with congenital, acquired immunodeficiency disease, or immunosuppression due to disease or therapy, e.g. > 20mg/day prednisone or equivalent for > 2 weeks
• susceptible pregnant women who have never had chickenpox or shingles (Varicella IgG negative)
• newborns whose mothers develop chickenpox within 5 days before delivery or within 48 hours after delivery
• hospitalized premature infants exposed during the first 4 weeks of life (If < 28 weeks gestation or ≤ 1000 grams, give VZIG regardless of maternal status.)
• exposed infants 29-37 weeks gestation if mother not immune at the time of birth.

- If VZIG is indicated, it should be given ASAP (maximum 96 hours after exposure). Canadian Blood Services should be contacted to arrange for release and delivery of VZIG.

• Susceptible health care workers should contact Occupational Health if exposed to chickenpox.
• Healthy susceptible individuals should contact physician if exposed.
  • Acyclovir can reduce severity of symptoms if started promptly (within 24h of rash).
  • Varicella vaccine has been shown to be effective in preventing or reducing the severity of disease if given to susceptible individuals within 72 hours and no longer than 5 days after exposure. Consider for post-exposure management in:
    • Susceptible non-pregnant healthcare workers and hospitalized patients in consultation with Infectious Diseases physician
    • Susceptible household or close contacts of high risk individuals (immunocompromised, chronic health problem)
    • Unique cases in special circumstances on a case by case basis with Medical Officer of Health