Varicella virus antenatal infection


The infection of a mother with the varicella virus whilst she is pregnant.


* Mental deficiency * Seizures * Cortical atrophy * Prenatal growth deficiency * Small head * Chorioretinitis * Hypoplasia of limb * Rudimentary fingers * Rudimentary toes * Atrophy of limb * Limb paralysis * Clubfoot * Cutaneous scars * Vesicular eruptions * Rash * Malaise * Anorexia * Headache * Pruritic * Fever * Crop lesions


Chickenpox can occur at any age, but it's most common in children ages 2 to 8. Congenital varicella may affect infants whose mothers had acute infections in their first or early second trimester. Neonatal infection is rare, probably because of transient maternal immunity. However, neonates born to mothers who develop varicella 5 days before delivery or up to 2 days after delivery are at risk for developing severe generalized varicella. Second attacks are also rare. This infection is transmitted by direct contact (primarily with respiratory secretions; less commonly, with skin lesions) and indirect contact (airborne). The incubation period usually lasts 14 to 17 days but can be as short as 10 days and as long as 20 days. (See Incubation and duration of common rash-producing infections, page 232.) Chickenpox is probably communicable from 1 day before lesions erupt to 6 days after vesicles form (it's most contagious in the early stages of eruption of skin lesions).


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Chickenpox calls for droplet and contact isolation until all vesicles and most of the scabs are dry (no new lesions; usually 1 week after the onset of the rash). Children with only a few remaining scabs are no longer contagious and can return to school. Congenital chickenpox requires no isolation. In most cases, treatment consists of local or systemic antipruritics: lukewarm oatmeal baths, calamine lotion, or diphenhydramine (or another antihistamine). Antibiotics are unnecessary unless bacterial infection develops. Salicylates are contraindicated because of their link with Reye's syndrome. Susceptible patients may need special treatment. When given up to 72 hours after exposure to varicella, varicella-zoster immunoglobulin may provide passive immunity. Acyclovir and famciclovir, antiviral agents, may slow vesicle formation, speed skin healing, and control the systemic spread of infection.