Chickenpox in the Neonatal Period


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.


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.


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):

    • VZIG and isolation for the neonate are usually not necessary.

Observation is the key, and no immediate pharmacological intervention is generally required.

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