Management of vesicular rash (varicella/herpes-zoster) exposure in pregnancy

Women who are exposed to varicella or herpes-zoster in pregnancy should seek medical attention as soon as possible.

A significant contact is defined as being in the same room (eg house or classroom or 2-4 bed hospital bay) for a significant period of time (15 minutes or more) or face-to-face contact.

If the woman has a past history of varicella or zoster, protection can be assumed and reassurance given.

If there is no history of past varicella or zoster, the woman's susceptibility should be determined urgently and if they are varicella-zoster IgG negative then they may be offered VZIG if they are within 10 days of the exposure (21). For continuous household exposure (for example when a child in the household is infected), VZIG should be offered within 10 days of the onset of rash in the index case.

Aciclovir and valaciclovir are not licensed to be used prophylactically and so cannot yet be recommended for this purpose.