Anti Viral IV for Chicken Pox exposure - Asthma Community ...

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Anti Viral IV for Chicken Pox exposure

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Hi, Can someone give me any info on this anti viral drug pls ?

My son Sean is in hospital on hourly nebs etc and now just to add to the fun and games he also been in very close contact with chicken pox. The hospital have orderd this drug which is on its way by taxi from another hospital as Sean on immune suppresants so chicken pox could cause problems. Ive been told its a one off IV infusion which will give him two weeks cover but I dont know anything else about it like possible side effects etc?

If anyone can shed any light i'd appreciate it

Thanks

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Hi Julie,

I'm so sorry to hear that Sean is poorly again, I know you must all be so worried and weary. Thinking of you and all the family.

In terms of the exposure to chicken pox, there are two main treatments that they might be giving him, and I'm not entirely sure which they will try first, so I'll tell you about both of them.

From what you have said about it being a one-off infusion, I think it's most likely to be IV immunoglobulin that they are planning on giving Sean. IV immunoglobulin is a blood product. It consists of antibodies which have been extracted from pooled plasma from the population of blood donors - one 'dose' contains extracts from the plasma of at least 1000 blood donors. Because most blood donors have been exposed to chicken pox and are immune, it contains antibodies to the chicken pox virus, along with antibodies to a lot of other common viruses like mumps, measles and hepatitis A. It's used in a lot of different ways in medicine - people who have a primary immune deficiency (ie they don't make their own antibodies) are often on it, and I know there are a few people on the boards who are on it for this reason. Using it to give antibodies in the case of someone who is high risk and has been exposed to chicken pox is called 'passive immunisation' - because it has the same effect as immunising Sean against chicken pox would, although with a more rapid onset and for a much shorter time period. It lasts a few weeks before the antibodies break down in the body. It's generally well tolerated without too much in the way of side effects - it can cause non-specific malaise and fever, and rarely, allergic reactions. Of course, because it is a blood product there is the theoretical risk that there is with all blood products, of it being contaminated with an as yet unknown transmissible disease - this is very unlikely, as all the known, common and dangerous blood borne viruses are tested for by the Transfusion Service, and high risk groups are not allowed to give blood.

The alternative treatment for chicken pox exposure would be an antiviral medication - this is a drug rather than a blood product. The most commonly used one for chicken pox is aciclovir, which most people probably know best as the drug that is in Zovirax, the cold sore remedy. For chicken pox exposure it's usually given orally or IV. It's usually given for seven days starting one week after exposure. The most common side effects are stomach ones like nausea, vomiting, abdominal pain and diarrhoea, as well as things like headache, fever, fatigue, itching and rashes. More serious side effects are rare. When it's given IV it can cause inflammation around the cannula site so this has to be watched carefully.

The protocol for treatment of exposure to chicken pox in patients who are on immunosuppression varies from place to place, but in many places it is common to give one or both of these treatments. Certainly, if Sean were to develop chicken pox symptoms, I am sure they would consider starting aciclovir as well as giving IV immunoglobulin - even if it doesn't prevent the development of chicken pox, it should make the infection a lot shorter and less severe.

Just to remind everyone - if you are on steroids or have been on them in the last three months, and are exposed to someone with chicken pox, or someone who goes on to develop chicken pox in the next few days, you should see your GP urgently to see if you need this sort of treatment. People who are immunosuppressed and get chicken pox are more vulnerable to develop complications, which can be serious.

I do hope this helps, Julie; if you have any other questions, please feel free to ask.

Take care

Em

Agree with Em's initial assumption - if it's a one-off and on special order it's likely to be the Immunoglobulin (we have to order ours from the infectious diseases unit at Heartlands in this area as no-where else close stocks it!).

Hope Sean gets better soon.

Sorry - only just seen this. As I think you know, I'm on IVIG regularly for a primary immune deficiency. I used to find that an infusion left me very, very tired and just feeling slightly flu-ey. If Sean hasn't had it yet, make sure he drinks lots and lots of water both during and after. It's so concentrated that I find it's inclined to give you a headache - I like to think that it's a little like a hangover headache! Anyway, such bad luck for poor Sean, but hopefully this will forestall any further problems. xx

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