OUTBREAK OF VARICELLA IN A PEDIATRIC ONCOLOGY UNIT

Background. Varicella-zoster virus (VZV) infection is usually benign b ut immunocompromised patients are at great risk for visceral dissemina tion and fatal outcome. During a nationwide varicella outbreak, severa l of our patients contracted the disease. We undertook studies of the epidemiology and the efficacy of antiviral treatment and immunoprophyl axis. Procedure. During a 9-month period, 52 patients were exposed to cases of active varicella. Twenty-seven of these children were reexpos ed to active varicella >1 month after their initial exposure. The expo sure concerned 7 VN waves of varying intimacy. In all cases, prophylax is with intravenous immunoglobulin (VIG), varicella-zoster globulin (V ZIG), or both was given. The spread of the disease was limited and onl y 6 patients tall immunosuppressed) developed varicella (7.6%). Three of 6 had been given IVIG and 3 VZIG + IVIG. All patients with varicell a received acyclovir 30 mg/kg/day for 14 days. The disease was mild an d all patients were ultimately cured. Results. Our results show that p rophylaxis was not 100% effective, but appeared to reduce the rate of spread. The differences in incidence among the regimens used were not significant. Conclusions. For the moment, immunoprophylaxis and acyclo vir administration appear to be quite satisfactory in managing immunoc ompromised children exposed to VZV. This may change with the wider use of the varicella vaccine. Med. Pediatr. Oncol. 31:166-169, 1998. (C) 1998 Wiley-Liss, Inc.