Therapeutic targets
- Improvement of the symptomatology
- Avoidance of complications
Therapy recommendations
- Symptomatic therapy (antipyretic/antipyretic drugs if necessary).
- Virostasis (antivirals/drugs that inhibit viral replication; indications: Adolescents, adults, 3rd trimester of pregnancy (with confirmed exposure/exposure), immunosuppression).
- In pregnant women with confirmed exposure additional administration of varicella-zoster immunoglobulin required.
- If necessary, antibiotics to prevent bacterial superinfection (secondary infection by bacteria).
- Post-exposure prophylaxis (PEP) [see below].
- See also under “Further therapy“.
Antiviral therapyAntiviral drugs are preparations that act against viruses. Among them are the preparations aciclovir and famciclovir. However, this therapy is used only in immunocompromised individuals or in courses with complications.
Postexposure prophylaxis (PEP)
Postexposure prophylaxis is the provision of medication to prevent disease in persons who are not protected against a particular disease by vaccination but 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.
- Immunodeficient/suppressed (immunocompromised) patients with unknown or absent varicella immunity.
- Premature infants with pathogen contact.
- Newborns whose mother contracted varicella 5 days before to 2 days after delivery
Implementation
- In unvaccinated persons with a negative history of varicella and contact with persons at risk:
- Postexposure vaccination within 5 days of exposure (“exposure”) or within 3 days of onset of exanthema (rash) in the index case (first documented case of disease). Regardless, contact with at-risk individuals (see above) should be avoided at all costs.
- Pregnancy: all unvaccinated pregnant women without a history of varicella within 3 days and a maximum of up to 10 days after exposure administration of varicella zoster immunoglobulin (VZIG) in the case of negative or borderline anti-VZV IgG.Alternatively to VZIG: Aciclovir in terms of exposure prophylaxis after the end of the 14th SSW.
- In individuals at increased risk for varicella complications:
- Postexposure administration of varicella-zoster immunoglobulin (VZIG/antibody) within 96 hours of exposure. It can prevent or significantly attenuate the onset of disease.
- In premature infants: Postexposure administration of varicella-zoster immunoglobulin (VZIG/antibody) within 96 hours of exposure; use until 10 days after pathogen contact.
If the contact was more than four days ago and the person can not be vaccinated, there is still the option of therapy with antivirals (drugs that stop the reproduction of viruses) such as aciclovir for seven days.
Exposure means:
- 1 hour or longer with infectious person in a room.
- Face-to-face contact
- Household contacts
