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Article
March 16, 1990

Public Health Policy on Varicella Infection

Author Affiliations

Ruchill Hospital Glasgow, Scotland
University of Glasgow Queen Mother's Hospital, Yorkhill Glasgow, Scotland

Ruchill Hospital Glasgow, Scotland
University of Glasgow Queen Mother's Hospital, Yorkhill Glasgow, Scotland

JAMA. 1990;263(11):1495. doi:10.1001/jama.1990.03440110057023
Abstract

To the Editor.—  Dr Johnson1 suggested that early return of varicella-infected children to school would increase herd immunity and decrease the eventual incidence of varicella in adults. However, while Dr Bass'1 reply stressed the potential risk to community-based immunosuppressed individuals of contracting chickenpox by secondary exposure, the failure to mention nonimmune pregnant women was a significant omission, as both mother and fetus are at risk of serious morbidity and mortality.2 A maternal mortality rate of 40% has been reported,3 and varicella, like any febrile condition, may lead to spontaneous abortion,4 while a fetal varicella-related syndrome is recognized.5Pneumonitis is the main danger, especially among tobacco smokers,6 and can progress to respiratory failure over a matter of hours.2 Should pulmonary involvement be suspected, early recourse to high-dose intravenous acyclovir therapy (15 to 20 mg/kg of body weight three times daily)7 and high-flow

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