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Stephen T. Green, MD, MRCP; Dilip Nathwani, MRCP; David J. Goldberg, MRCP
Ruchill Hospital Glasgow, Scotland

John C. P. Kingdom, MRCP, DCH
University of Glasgow Queen Mother's Hospital, Yorkhill Glasgow, Scotland

JAMA. 1990;263(11):1495.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Dr Johnson¹ suggested that early return of varicella-infected children to school would increase herd immunity and decrease the eventual incidence of varicella in adults. However, while Dr Bass'¹ reply stressed the potential risk to community-based immunosuppressed individuals of contracting chickenpox by secondary exposure, the failure to mention nonimmune pregnant women was a significant omission, as both mother and fetus are at risk of serious morbidity and mortality.² A maternal mortality rate of 40% has been reported,³ and varicella, like any febrile condition, may lead to spontaneous abortion,⁴ while a fetal varicella-related syndrome is recognized.⁵

Pneumonitis is the main danger, especially among tobacco smokers,⁶ and can progress to respiratory failure over a matter of hours.² Should pulmonary involvement be suspected, early recourse to high-dose intravenous acyclovir therapy (15 to 20 mg/kg of body weight three times daily)⁷ and high-flow . . . [Full Text PDF of this Article]

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