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  #1  
Old 08-09-2013
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Virus Varicella prevention

A 4-year-old girl with a rash is brought by her mother to the pediatrician. She had a fever and headache yesterday, and this morning broke out in a rash on her torso. She is in day care and has been otherwise healthy. On examination her temperature is 38.9C (102F) and she appears tired but otherwise well. The lesions are erythematous macules and vesicles in different stages, distributed diffusely over her trunk but most prominent on her left upper chest and right flank. A diagnosis of chickenpox is made. Of note, there is a 16-year-old sibling in the household who has not been vaccinated and has never had chickenpox. Which of the following interventions will most successfully prevent infection of susceptible household contacts?
(A) Administration of intravenous acyclovir to the patient
(B) Administration of oral acyclovir to the patient and household contacts
(C) Administration of vaccine and intramuscular varicella zoster immunoglobulin to household contacts
(D) Administration of varicella vaccine to household contacts
(E) No prophylaxis is necessary for household contacts under age 25 years
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  #2  
Old 08-09-2013
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i would go for C.
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Old 08-09-2013
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c seems about right!!
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  #4  
Old 08-10-2013
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Alwz tricks me.. I ll go wid D ie VZ vaccine.. From wat I learnt if u hv immunity from prev infxn or vaccine --> observation
If no immunity
Immune competent --> VZ vaccine
Immune compromised/pregnancy --> VZIG
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  #5  
Old 08-10-2013
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The correct answer is D. Varicella develops in approximately 90% of susceptible household contacts with significant exposure. The vaccine, if given in the first 3 days postexposure, has been shown to prevent or modify the course of illness in susceptible individuals. Seventy-eight percent of adults seroconvert after the first dose; a cumulative 99% have converted after the second dose.
Answer C is incorrect. Administration of varicella zoster immunoglobulin to adults after exposure is indicated for pregnant women, health care professionals with significant exposure, and immunocompromised individuals.
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  #6  
Old 08-16-2013
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peds section in mtb 3....post exposure prophylaxis for varicella..
susceptible children and household contacts ...vzig and vaccine [pg 343]
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Old 10-04-2014
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according to Uptodate, it's only "patients with altered immunity, who cannot receive varicella vaccination", that are eligible for passive immunization

but I would've thought, since they're asking which one would be "more successful", that the answer would be C...
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Old 06-25-2015
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C as Kaplan said and MTB 3
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  #9  
Old 02-12-2016
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According to Nelson's Textbook of Pediatrics, it should be the varicella vaccine. Immunocompromised patients and pregnant patients (cannot receive the vaccine) should be given the Immunoglobulin.
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Old 02-12-2016
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i think it is D .

and they should receive the vaccine in 3-5 days post exposure .

only immunocompromised and preg should get the ig and within 10 days of exposure . and should be monitored cause it doesn't prevent the infection only reduce the course and it can even prolong incubation period
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