A 17 yo female calls the office reporting that 2 days ago, she babysat a 4 year old with a fever. He developed a pruritic rash that progressed to vesicles. The patient has no record of her immunizations. She’s never had a similar rash. She is asymptomatic. What is the best next step?
Primary infection with varicella zoster virus (VZV) causes chickenpox and reactivation causes shingles
Varicella spread by direct contact, air, droplets
Incubation period 14-16 days
Varicella vaccination is live attenuated
Vaccination is recommended in those who are exposed but have no evidence of immunity (lab results, documented history of the disease or documented vaccine)
Should be given within 3-5 days of exposure
Varicella immune globulin can be given if vaccination is contraindicated (pregnant women, immunocompromised patients, neonates). Should be given asap but no later than 10 days post-exposures.
Serious complications of VZV include encephalitis and sepsis