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Chickenpox - Management
How should I manage a neonate with chickenpox?

  • Seek urgent specialist advice regarding further management.
  • Give advice about contact with other people.
  • 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 more information on managing neonates who have been in contact with but not yet developed chickenpox, see Neonate.
Basis for recommendation
  • CKS recommends seeking specialist advice on the management of neonates 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].
  • Neonates with chickenpox should be treated with aciclovir [HPA, 2007a; RCOG, 2007], but this should only be initiated by a specialist.
    • The Royal College of Obstetricians and Gynaecologists guidelines on chickenpox in pregnancy state that varicella-zoster immunoglobulin is not beneficial if neonatal chickenpox has already developed [RCOG, 2007].
    • The Health Protection Agency advises that if severe varicella develops in a neonate who has been given varicella-zoster immunoglobulin following exposure to chickenpox, treatment with high-dose intravenous aciclovir should be started as soon as possible [HPA, 2007a].

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