noelle
Forum Elite
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A 6 YR OLD CHILD EXPOSED TO HIS COUSIN WITH CHICKEN POX 1 WEEK AGO. PARENTS COME TO U ... WHAT TO DO NEXT???
VACCINATE... OR BLAH BLAH??
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| ELM
Forum Guru
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Check the vaccination record ----> if not relaible--->check serum Ab titer-----> nothing good looking proceed with Ig against varicella....I think.
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ELM
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| lucky
Forum Guru
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blah blah i think !
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| ELM
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Yeah right! :lol:
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ELM
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| noelle
Forum Elite
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LUCKY IS RIGHT ITS BLAH BLAH ACC. TO UW! THEY SAY WAIT FOR RASH TO APPEAR N INFORM PARENTS ABT THAT ... WAHT BULLSHIT!! THERES NO LOGIC OF COMIN TO DOCTOR THEN!!
WHAT DOES MIKY SAY???
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| SA
Forum Elite
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I will also go for BLAH BLAH :lol:
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| Drmos
Forum Junior
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1st step: Check vaccination record, 2nd: look for antibodies 3rd if negative, not vaccine, too late, complications are not coomon in these age group.
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| lucky
Forum Guru
Topics: 23
Posts: 505
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noelle i faintly remeber this q from uw because i had it wrong. the reason they gave was pretty strange although i don't remeber it exatly.
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| drvic
Forum Elite
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Posts: 181
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vaccine is only effective as postexposure prophylaxis if given within 72 hours of documented exposure. subsequently (as in this case, its been 1 week already), even vaccine won't help.
it might be useful to assess the primary case also (i.e. the cousin) and take a proper history regarding the timing of exposure - coz if his lesions had already crusted by the time this kid in question was exposed to him, the likelihood of transmission will be almost nil. remember the old adage - patient can transmit varicella 24-48 hrs before the onset of rash upto the time the lesion is crusted, which is usually 3-7 days after the onse of the rash.
post exposure prophylaxis with Varicella Zoster Immunoglobulin (VZIG) is recommended for:
a) immunocompromised children
b) pregnant women
c) neonates exposed to maternal varicella (i.e. mother developed it within 5 days before and 2 days after delivery)
oral acyclovir has no role either...
so the only option is - BLAH, BLAH! :wink:
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| mikyro
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A 6 YR OLD CHILD EXPOSED TO HIS COUSIN WITH CHICKEN POX 1 WEEK AGO. PARENTS COME TO U ... WHAT TO DO NEXT???
Here's what ECFMG wants from you:
Recent exposure:
No Sx
Check vaccination status ----> not vaccinated--> give the vaccine immediately; if vaccinated---->check Ab levels --->if protective (frankly I don't remember exactly the protective levels; I think it's about 1?), don't do anything & reassure the child's parents; if not protective, give the booster.
Sx present--->don't vaccinate - it's useless; however, check the immune status--->if immunocompetent, do nothing; if immunoincompetent---->give antivirals to prevent complications / a serious and protacted course to develop.
Hope it helped.
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the same miky - always ready to help my patients and friends as well
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