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Zoster immune globulin for appreciable exposure; acyclovir for progressive infection
Most people in developed countries are infected with varicella zoster virus and develop chickenpox during childhood with no more than minor inconvenience. The few who develop infection later in life have a disproportionate share of serious complications. Although only about 2% of reported cases of chickenpox occur in people over 20, these cases account for one quarter of all deaths from the disease and are usually due to varicella pneumonia. Severe primary varicella often occurs in immunocompromised patients, especially those with cell mediated immune deficiency, in whom there is also an increased risk of reactivation of latent infection, manifested by herpes zoster.
The coincidence of chickenpox with pregnancy is uncommon, occurring in an estimated one in 2000 pregnancies in the United States. Contact with an infected person, however, is not infrequent and causes concern for the welfare of the pregnant woman and her fetus. The common perception that chickenpox is generally more severe in pregnant women than in others of the same age may partly reflect a bias towards reporting of more severe cases during pregnancy. Thus in cases reported up to 1963 the …