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Varicella exposure in immunocompromise — RACP Paediatrics MCQ

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HardInfectious diseases and immunisationVaricella exposure in immunocompromiseRACP Paediatrics

A 6-year-old receiving chemotherapy for leukaemia has household exposure to chickenpox. He has no history of varicella infection and serology confirms he is non-immune. He is currently afebrile. What is the most appropriate management?

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Correct answer: D — Give varicella-zoster immunoglobulin and arrange oncology follow-up

An immunocompromised non-immune child with significant varicella exposure should receive varicella-zoster immunoglobulin where indicated and urgent specialist follow-up. Live varicella vaccine is contraindicated during intensive immunosuppression. Post-exposure management is time-critical because severe varicella can be life-threatening.

Reference: Australian Immunisation Handbook; Therapeutic Guidelines (eTG)