Hello Dear

i have one baby delievered to a mother with active chickenbox lesion which was appeared 4 days before delievery.

baby asymptomatic and we dont have VZIG ( not in libya, not in tunisea).

what can i do ? oral acyclovir ? iv acyclovir  or just observation?

 

 

Our guidelines in Sweden (infpreg.se) is to give oral acyklovir, 10 mg/kg x 4 over 14 days when VZIG is delayed.

I guess the same would apply if VZIG is not available at all.

A very practical advice of much use in developing countries.

It’s good protocol if IVIG ( zoster) not available 

How long we can wait?

We give acyclovir 

we don’t have VZ Ig 

By the way I want to ask about time  limits for this recommandation

We recently had a mother who had chickenpox but was totally healed 12 days before labor ! The newborn case was debated ! And baby had chickenpox at J5 

Our national guidelines for VZIG is to give that to infants   

• of mothers that debuted with varicella during the seven days before or after the delivery
• of seronegative mothers who were exposed to varicella during the last three weeks before delivery
• who are preterm (< 36 weeks) that has been exposed to varicella during fetal life (maternal infection during pregnancy) or postnatally IF the mother is seronegative

With regard to giving oral acyklovir in contexts without VZIG - I don't really know personally what is good to advice but using the same time frames would make some sense I guess. 

Unfortunately We never have it in our hospital