Chicken pox in a newborn is a life-threatening disease usually acquired from an infected mother, according to Stanford University obstetricians Candace K. Smith and Ann M. Arvin in a 2009 article in "Seminars in Fetal and Neonatal Medicine." Typically, according to Smith and Arvin, the newborn initially appears well; however, the disease quickly spreads to the lung, liver, brain and bone marrow, producing severe symptoms. Even with aggressive treatment, some newborns die or suffer permanent disability.
Intravenous Immunoglobulin
Intravenous immunoglobulin IgG, or I.V.I.G., treatment involves the infusion of antibodies that adults and older children make on their own. According to Smith and Arvin, I.V.I.G. contains a large proportion of antibodies that specifically target the varicella-zoster virus that causes chicken pox. Although a chicken pox-specific product, varicella-zoster immunoglobulin, or V.Z.I.G., is available, there's little evidence to suggest a benefit over standard I.V.I.G. Since the addition of I.V.I.G. to standard treatment for chicken pox in newborns, explain Smith and Arvin, mortality has decreased from 31 percent to about 7 percent.
Acyclovir
Acyclovir prevents the virus that causes chicken pox, varicella-zoster, from replicating within the body. In the 2004 edition of "Pediatric Clinics of North America," Stanford pediatricians Andrea M. Enright and Charles G. Prober explain that doctors often use intravenous acyclovir, along with I.V.I.G. Although the U.S. Food and Drug Administration has not specifically approved the use of acyclovir in newborns with chicken pox, doctors believe it is safe because the drug has been approved to treat severe infections caused by a related virus, herpes simplex. Although there are no large studies, Enright and Prober note that a few small ones suggest that using I.V.I.G. with acyclovir improves outcomes compared to I.V.I.G. alone; however, they also caution that combination treatment provides no guarantees. Some newborns die despite treatment with I.V.I.G. and acyclovir.
Symptom-Based Care
Symptom-based treatment does not cure chicken pox or any other disease; however, it does improve patient comfort and often reduces the risk of complications. In the 2008 edition of "Harrison's Principles of Internal Medicine," University of Alabama Medical School Professor of Pediatrics Richards J. Whitely explains that good skin hygiene prevents most of the avoidable complications of chicken pox, such as secondary bacterial infections. Parents or caregivers should bathe the newborn daily, using mild soap and warm water. Fingernails represent a recognized reservoir for bacteria, so clipping the newborn's nails or applying protective mittens reduces the risk of bacterial infections, as well as skin trauma. Many newborns with chicken pox also require more aggressive symptom-based care, such as supplemental oxygen, mechanical ventilation and intravenous fluids.
References
- "Seminars in Fetal and Neonatal Medicine;" Varicella in the Fetus and Newborn; C.K. Smith and A.M. Arvin; 2009
- "Pediatric Clinics of North America;" Herpesviridae Infections in Newborns; A.M. Enright and C.G. Prober; 2004
- "Harrison's Principles of Internal Medicine, 23rd Edition;" A.S. Fauci et al. (Eds.); 2008
