PEPtalk: postexposure prophylaxis against varicella in children with cancer

• DOI: 10.1136/adc.2010.209650
• Publication Date: 2011-06-30T00:25:46Z
• Authors: J. Bate; J. Chisholm; P. T. Heath; J. Breuer; R. Skinner; S. Manley; S. Patel; K. Wheatley; M. Ramsay; P. R. Kearns; S. Hambleton
• Keywords: Serostatus; Varicella zoster virus; Pre-exposure prophylaxis

<h3>Objectives</h3> To describe postexposure prophylaxis (PEP) against varicella zoster virus (VZV) in children being treated for malignancy the UK and Ireland: population at risk, frequency of exposure, clinical practice attitudes among healthcare providers. <h3>Design</h3> An observational study three parts: (1) a retrospective survey serostatus diagnosis malignancy, (2) collation immune globulin (VZIG) dispensing data over 3-year period (3) an online paediatric oncologists9 beliefs relation to VZV disease its prevention. <h3>Setting</h3> Ireland. <h3>Participants</h3> Children diagnosed with 2009 (serostatus survey) or receiving VZIG between April 2006 March (VZIG study). Paediatric oncologists haematologists working tertiary oncology centres related shared care units Ireland (physician survey). <h3>Results</h3> Of 1500 each year, least 24% are seronegative. Few make efforts prevent household exposure by vaccinating VZV-susceptible family members. Exposures result administration PEP approximately 250 cancer annually: half receive intramuscular injection while remainder course oral aciclovir. The choice is made doctors. There no consensus as which better option, reflecting lack secure evidence base. <h3>Conclusions</h3> A randomised controlled trial compare effectiveness acceptability aciclovir both desirable feasible.