Presentation:
1. The disease is caused by the Varicella Zoster Virus (VZV).
2. Typical symptoms include a sudden rash that can progress to vesicles filled with fluid.
Risk Factors:
. Risk of neonatal chickenpox is elevated if the mother develops the rash within a week of delivery or within 7 days after delivery.
. Transplacental transmission of the virus is possible, but the antibody IgG does not have enough time to develop, leaving the baby vulnerable.
Investigation:
i. Diagnostic tests usually include PCR tests or skin scrapings to confirm VZV infection.
ii. Maternal history of chickenpox or exposure is crucial for diagnosis.
Management:
1. High Risk (Mother’s rash appears within a 7 days before delivery or within 7 days after delivery):
Administer Varicella Zoster Immunoglobulin (VZIG) to the neonate as soon as possible.
Start Acyclovir treatment for the neonate.
The baby is at a 30% risk of severe complications like pneumonia or fulminant hepatitis, hence prompt treatment is essential.
2. Low Risk (Mother’s rash appears >7 days before or >7 days post-delivery):
Observation is the key, and no immediate pharmacological intervention is generally required.