RT Journal Article
SR Electronic
T1 PEPtalk: postexposure prophylaxis against varicella in children with cancer
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 841
OP 845
DO 10.1136/adc.2010.209650
VO 96
IS 9
A1 Jessica Bate
A1 Julia Chisholm
A1 Paul T Heath
A1 Judith Breuer
A1 Rod Skinner
A1 Sue Manley
A1 Soonie Patel
A1 Keith Wheatley
A1 Mary Ramsay
A1 Pamela R Kearns
A1 Sophie Hambleton
YR 2011
UL http://adc.bmj.com/content/96/9/841.abstract
AB Objectives To describe postexposure prophylaxis (PEP) against varicella zoster virus (VZV) in children being treated for malignancy in the UK and Ireland: the population at risk, frequency of exposure, clinical practice and attitudes among healthcare providers. Design An observational study in three parts: (1) a retrospective survey of serostatus at diagnosis of malignancy, (2) collation of varicella zoster immune globulin (VZIG) dispensing data over a 3-year period and (3) an online survey of paediatric oncologists' clinical practice and beliefs in relation to VZV disease and its prevention. Setting UK and Ireland. Participants Children diagnosed with malignancy in 2009 (serostatus survey) or receiving VZIG between April 2006 and March 2009 (VZIG dispensing study). Paediatric oncologists and haematologists working in tertiary paediatric oncology centres and related shared care units in the UK and Ireland (physician survey). Results Of 1500 children diagnosed with malignancy each year, at least 24% are VZV seronegative. Few centres make efforts to prevent household exposure by vaccinating VZV-susceptible family members. Exposures to VZV result in the administration of PEP to approximately 250 children with cancer annually: half receive an intramuscular injection of VZIG while the remainder receive a course of oral aciclovir. The choice of PEP is made by doctors. There is no consensus among paediatric oncologists as to which is the better option, reflecting the lack of a secure evidence base. Conclusions A randomised controlled trial to compare the effectiveness and acceptability of VZIG and aciclovir as PEP against varicella is both desirable and feasible.