Postexposure prophylaxis is the provision of medication to prevent disease in persons who are not protected against a particular disease by vaccination but who have been exposed to it.
Indications (areas of application)
- Unvaccinated persons with a negative history of varicella and contact with persons at risk.
- Persons at increased risk for varicella complications, ie:
- Unvaccinated pregnant women without a history of varicella.
- Immunocompromised patients with uncertain or absent varicella immunity
- Newborns whose mother had varicella 5 days before to 2 days after delivery
- Premature infants from 28 weeks of gestation whose mothers lack immunity, after exposure in the neonatal period (first 28 days after the birth of a child)
- Preterm infants born before 28 weeks of gestation, after exposure in the neonatal period, regardless of maternal immunity status
Implementation
- In unvaccinated persons with a negative history of varicella and contact with persons at risk:
- Postexposure vaccination within 5 days of exposure or within 3 days of onset of exanthema in the index case. Regardless, contact with high-risk persons (persons at increased risk for varicella complications) should be avoided at all costs.
- In persons at increased risk for varicella complications:
- Post-exposure administration of varicella-zoster immunoglobulin (VZIG/antibody; = passive immunization) as early as possible within 3 days and up to a maximum of 10 days after exposure* . It can prevent or significantly attenuate the onset of disease. For application and dosage of VZIG, the information in the technical information must be observed!
- The postexposure administration of VZIG can be carried out in conjunction with antiviral chemoprophylaxis, if necessary.
If the contact is more than four days ago and the person can not be vaccinated, there is still the possibility of therapy with antivirals such as aciclovir for seven days.
Exposure means:
- 1 hour or longer with infectious person in a room.
- Face-to-face contact
- Household contacts
