RT Journal
T1 Notes from the field: Severe varicella in an immunocompromised child exposed to an unvaccinated sibling with varicella—minnesota, 2011
JF JAMA
JO JAMA
YR 2012
FD September 12
VO 308
IS 10
SP 968
OP 968
DO 
UL http://dx.doi.org/
AB 
On December 13, 2011, the Minnesota Department of Health was notified of varicella in a girl, aged 3 years, admitted to a hospital after a 2-day history of fever of 102.7°F (39.3°C) and an extensive maculopapulovesicular rash (>500 skin lesions) with vesicles in the mouth and throat. The child received weekly immunosuppressive therapy with methotrexate (12.5 mg) for juvenile rheumatoid arthritis diagnosed at age 18 months. Neither she nor her younger sibling, aged 21 months, had received a first dose of varicella vaccine (routinely recommended at age 12–15 months). Their parents refused vaccination because of personal beliefs. The parents reported varicella in the younger sibling 2 weeks before her older sister was admitted. The older sister had not received prophylactic varicella zoster immune globulin (VariZIG); however, her parents monitored her for varicella symptoms.