RT Book, Section A1 Gomella, Tricia Lacy A1 Eyal, Fabien G. A1 Bany-Mohammed, Fayez SR Print(0) ID 1168359153 T1 Varicella-Zoster Infections T2 Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e YR 2020 FD 2020 PB McGraw-Hill Education PP New York, NY SN 9781259644818 LK accesspediatrics.mhmedical.com/content.aspx?aid=1168359153 RD 2024/03/28 AB Varicella-zoster virus (VZV) is a member of the herpesvirus family. Primary maternal VZV infection (chickenpox) can result in fetal or neonatal infection. Other rare complications include spontaneous abortion, fetal demise, and premature delivery. Reactivation infection (zoster, shingles) does not result in fetal infection. Primary maternal VZV infection during the last trimester can cause maternal pneumonia with significant morbidity and mortality. The overall incidence of maternal and neonatal varicella has decreased over the past 15 to 20 years, presumably due to varicella vaccination. Active surveillance among adults has shown that the incidence of varicella declined 74% during 1995 to 2005, despite vaccination rates among adults of only 3%. Herd immunity is the likely explanation for this phenomenon. As of 2013, more than 78% of 13- to 17-year-old adolescents have received 2 doses of varicella vaccine. Varicella immunization is recommended for all nonimmune women as part of prepregnancy and postpartum care. Varicella vaccine should not be administered to pregnant women, because the possible effects on fetal development are unknown, although no cases of congenital varicella syndrome or patterns of malformation have been identified after inadvertent immunization of pregnant women. When postpubertal females are immunized, pregnancy should be avoided for at least 1 month after immunization. Reporting of instances of inadvertent immunization to the US Food and Drug Administration with a varicella-zoster–containing vaccine during pregnancy is encouraged (1-877-888-4231).