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Tuesday, May 21, 2013
Cancer patien exposed to chicken pox
My niece came down with chicken pox this morning after being with my sister-in-law all day yesterday. My sister-in-law has cancer and has been getting chemotherepy, although she hasn`t had it for 3 weeks. What kind of danger is she in? She already had chicken pox.
It sounds highly likely that your sister-in-law has been exposed to the Varicella-Zoster virus, which causes chicken pox, as person-to-person spread has been well described in the 48 hours before onset of the typical rash. If your sister-in-law has had chicken pox previously, she may still have some protective immunity, but you are correct to be concerned about the fact that she has cancer and has been receiving chemotherapy. Your sister-in-law should call her oncologist immediately for further advice, because if her oncologist recommends that she be given a dose of Varicella-Zoster Immune Globulin (VZIG), this should be given as soon as possible after the exposure (within 96 hours for best protection). In addition, if she develops a chicken pox rash later, her oncologist may want to treat her with acyclovir or a similar drug as soon as possible after the rash appears. Disease will appear within 20 days if it`s going to (28 days if she has received VZIG). Your niece will no longer be infectious when all her blisters are crusted over, and should not visit your sister-in-law again until then (usually 4-5 days). There is a vaccine to prevent chicken pox, but it is not given to people who have already had chicken pox.
Lisa A Haglund, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati