1. Molly C. Berkoff, MD, MPH 2. Wallace D. Brown, MD 1. Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. 1. Acyclovir for Treating Varicella in Otherwise Healthy Children and Adolescents. Klassen TP, Hartling L. Cochrane Database Syst Rev. 2005;(4):CD002980 2. FDA Approval of an Extended Period for Administering VariZIG for Postexposure Prophylaxis of Varicella. MMWR Morb Mortal Wkly Rep . 2012;61(12):212 3. Prevention of Varicella: Recommendations for Use of Varicella Vaccines in Children, Including a Recommendation for a Routine 2-Dose Varicella Immunization Schedule. American Academy of Pediatrics Committee on Infectious Diseases. Pediatrics. 2007;120(1):221–231 [OpenUrl][1][Abstract/FREE Full Text][2] 4. Changing Varicella Epidemiology in Active Surveillance Sites-United States, 1995–2005. Guris D, Jumaan AO, Mascola L, et al. J Infect Dis. 2008:197(suppl 2):S71–S75 Formerly a common childhood infection that affected almost all children, varicella (chickenpox) is now relatively uncommon because of successful prevention with universal vaccination. Before available immunization, approximately 4 million cases of varicella disease were reported annually. By 2005, active surveillance sites documented a decrease in the incidence of varicella of approximately 90%. Varicella is the primary clinical manifestation of infection with varicella-zoster virus. The initial infection with the virus occurs from exposure to an infected person, and transmission occurs through contact with the respiratory tract, conjunctiva, and skin lesions. Approximately 80% to 90% of susceptible individuals will acquire the infection after exposure to an infected individual. After an incubation period of 10 to 21 days, an infected individual may experience a brief prodrome, including fever and malaise, for 2 days before the development of a pruritic rash containing 250 to 500 lesions in an unimmunized person. Lesions appear in crops and contain vesicles on an erythematous base, which eventually scab. Children who have been immunized and have breakthrough varicella typically will have fewer lesions (<50 … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft.stitle%253DPediatrics%26rft.issn%253D0031-4005%26rft.aulast%253DCommittee%2Bon%2BInfectious%2BDiseases%26rft.auinit1%253D%2B%26rft.volume%253D120%26rft.issue%253D1%26rft.spage%253D221%26rft.epage%253D231%26rft.atitle%253DPrevention%2Bof%2BVaricella%253A%2BRecommendations%2Bfor%2BUse%2Bof%2BVaricella%2BVaccines%2Bin%2BChildren%252C%2BIncluding%2Ba%2BRecommendation%2Bfor%2Ba%2BRoutine%2B2-Dose%2BVaricella%2BImmunization%2BSchedule%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2007-1089%26rft_id%253Dinfo%253Apmid%252F17606582%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=120/1/221&atom=%2Fpedsinreview%2F34%2F11%2F537.atom