The majority of Hospital Infection Control Varicella Prevention policies are based on the 2007 MMWR ACIP’s Recommendations for the Prevention of Varicella (MMWR Vol 56, 6-22-07, RR04, 1-40).   Most OB-Gyne will serosurvey their pregnant patient for evidence of immunity to Varicella in the peri-natal period.  Most hospitals will require a Varicella titer on their new hire HCWs as a means to document their immunity prior to working with patients.  In my hospital, it is their policy that any HCW (including pregnant HCW) without documented immunity be reassigned away from Varicella patients and active Shingles patients.  If a pregnant HCW with no documentation of immunity has already been exposed, they are referred to their OB-Gyne for counselling, to validate their susceptibility to varicella, and for consideration for the administration of VariZIG or VZIG.   Information on VariZIG (which is replacing VZIG) can be found in MMWR 3-3-2006 and MMWR 7-19-13.   Since varicella vaccine is not 100% protective, the ACIP (2007) also recommends that the exposed HCW’s with documented immunity monitor themselves for any evidence of varicella infection for 21 weeks (28 days if they received VariZIG or VZIG) following an exposure and report this to Infection Control in their Healthcare facility (ACIP 2007).   I hope this is helpful.

Best wishes,

Michael

Michael  A. Sauri, MD, MPH&TM, FACP,

FACPM, FACOEM, FRSTM&H, CTropMed

Medical Director

Occupational Health Consultants

15005 Shady Grove Road, Suite 450

Rockville, MD 20850

301-738-6420

Fax 301-738-2215

msauri@ohcmd.com

www.ohcmd.com