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Chickenpox - Management
How should I manage an immunocompromised person with chickenpox?

  • Seek immediate specialist advice regarding confirming the diagnosis of chickenpox and whether urgent antiviral treatment is required.
  • Offer symptomatic treatment.
  • Give advice about contact with other people and when to seek medical advice.
  • Admit to hospital if serious complications (e.g. pneumonia, encephalitis) are suspected.
  • Notify the relevant authorities if in Scotland or Northern Ireland (chickenpox is not a notifiable disease in England or Wales).
  • For advice on how to manage an immunocompromised person who has been exposed to but not yet developed chickenpox, see Immunocompromised person.
Clarification / Additional information
  • Confirm that the person fulfils the criteria for immunosuppression (if in doubt, seek specialist advice).
Basis for recommendation
  • CKS recommends seeking specialist advice on the management of immunocompromised people with chickenpox because of the increased risk of severe disease and complications in this group.
  • The recommendation on reporting cases of chickenpox is from the Department of Health and the Health Protection Agency [DH, 2006; HPA, 2006].
  • People at higher risk of serious complications from chickenpox may be given antiviral drugs, such as aciclovir, to try to prevent severe illness [HPA, 2006].
    • Even immunocompromised people who have received varicella-zoster immunoglobulin prophylaxis may develop severe or fatal varicella. These people should be carefully monitored and given aciclovir at the first sign of illness [DH, 2006].

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