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Varicella exposure in immunocompromised child — RACP Paediatrics MCQ

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HardInfectious diseases and immunisationVaricella exposure in immunocompromised childRACP Paediatrics

A 6-year-old receiving chemotherapy is exposed to chickenpox at school. He has no history of varicella infection or vaccination and serology confirms no immunity. He is currently well. What is the most appropriate management?

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Correct answer: B — Varicella-zoster immunoglobulin with oncology and public health advice

A significantly immunocompromised varicella-susceptible child needs post-exposure prophylaxis with VZIG according to timing and specialist advice. Live varicella vaccine is contraindicated during significant immunosuppression. The pearl is that preventing severe varicella after exposure is more urgent than waiting for symptoms.

Reference: Australian Immunisation Handbook; Therapeutic Guidelines (eTG): Antibiotic