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Prevention

Preventive measures should be considered for individuals at risk of contracting severe varicella infection e.g. leukaemic children, neonates, and pregnant women

Where urgent protection is needed, passive immunization should be given. Zoster immunoglobulin (ZIG) is the preparation of choice but it is very expensive. Where ZIG is not available, HNIG should be given instead.

A live attenuated vaccine is available. There had been great reluctance to use it in the past, especially in immunocompromised individuals since the vaccine virus can become latent and reactivate later on.

However, recent data suggests that the vaccine is safe, even in children with leukaemia provided that they are in remission.

It is highly debatable whether universal vaccination should be offered since chickenpox and shingles are normally mild diseases.

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