Yes. Chickenpox, or varicella zoster infection, may be acquired via exposure to cases in the hospital or in the home. The risk of contact has been increased in hospitals in the past, because of visiting siblings who have not yet had chickenpox. In this environment, there was a relative enrichment for exposure to young children who were more likely not to have had the disease. Of course, this picture has changed significantly with the widespread introduction of varicella vaccine, which is usually given at 12 to 18 months of age. In addition, as postpartum care practices have shifted more to babies rooming-in with their mothers, most siblings are not interacting with babies other than their own sibling.

Exposures do occur and babies do develop chickenpox. In term infants the disease is usually mild, especially if their mother is immune to varicella herself. For these babies, no specific intervention or therapy is required, other than observation. If the baby is premature or if the mother is not known to be varicella immune, many authors recommend antiviral therapy with acyclovir, although this recommendation remains controversial.

It is rare for babies to acquire nosocomial chickenpox in the neonatal nursery (1), because most nearly 95% of mothers have had chickenpox in the past, and have passively immunized their baby during the third trimester of gestation. The risk of infection is increased in premature infants because this protection is lacking. If a baby does develop disease, they should be transferred out of the nursery and placed in strict isolation, and given antiviral therapy according to the guidelines noted above. Specific therapy is indicated for infants who have been in contact with the index case. Babies who are premature and less than 28 weeks of gestation, or greater than 28 weeks gestation but borne by a mother who is not varicella immune, then the baby should be given Varicella Immune Globulin (VZIG) to provide passive immunoprophylaxis. There is no recommendation to give VZIG to term infants whose mothers are non-immune, but special circumstances in special cases may make this therapy worthwhile (2).

Vaccination for varicella has been available since 1995 in the United States (3). The vaccine is given at 12 to 18 months of age, and has been shown to have an efficacy of 70% after household exposure and a 95% efficacy in preventing severe disease. The long-term immunity is still under investigation, as are the risks of fetal injury if a woman receives the vaccine during pregnancy. As the population becomes immune via immunization, the incidence of the native disease should continue to decrease. In the span of a few years, the incidence in school age children has nearly disappeared.