What happens if you come into contact with chickenpox whilst pregnant?

In the UK, unlike the US, we don’t vaccinate against chickenpox which is seen as a childhood disease as it is most commonly caught by children. Yet children can grow up having avoided catching it.

I should know as I am someone who has never had chickenpox, I didn’t even catch it when my brother did when he was 18 and I was 14. I didn’t even catch it when my daughters caught it. Becky, Ruby and Rhian caught it in 2013 and Reese caught it earlier this year. My son and hubby have yet to have it too.

I remember when my eldest daughter was 1 I actually spoke to the dr about having the chickenpox vaccine as I had visions of catching it when my children did. The dr said I would have to have a blood test to check whether I was immune or not, but before I could organise the test I fell pregnant with my third child. Then I forgot all about organising it.

For many years I seemed safe, I managed to avoid chickenpox and so did the children.

chickenpox

Then, they caught it, at the worst time they could. The girls caught chickenpox when I was pregnant with my 5th!

I remember when Ruby came out in spots, she was 6 at the time and the 10th to catch it in her class. I began to panic. What about my unborn baby? What would happen if I caught chickenpox and came down with it? Were there any complications which I could pass on to the baby. I knew that rubella was bad whilst pregnant and that’s why I was vaccinated as a teenager. But what about chickenpox?

Are there any risks associated with chickenpox and pregnancy?

I managed to find some information on the NHS Choices website which stated that:
whilst complications for the pregnant woman are rare, they can include pneumonia (with a greater risk of catching it if you smoke) inflammation of the brain (encephalitis) and liver (hepatitis) and in extremely rare cases can be fatal.”

But what about the baby? Was the baby at risk? The answer is yes, the baby is the most at risk of complications caused by chickenpox and the complications vary by how many weeks pregnant you are when you catch it.

  • Before 28 weeks -Although there is no evidence that it increases your risk of miscarriage, there is a small risk that the baby can develop foetal varicella syndrome (FVS). FVS can damage the baby’s skin, eyes, legs, arms, brain, bladder or bowel.
  • Between 28 and 36 weeks – The virus stays in the baby’s body but doesn’t cause any symptoms. However, it could become active in the first few years of the baby’s life, causing shingles.
  • After 36 weeks – Then the baby may be infected and could be born with chickenpox.
  • Within 7 days of birth – If you develop chickenpox around the time of the birth and the baby is born within seven days of your rash developing then there is a risk of your baby developing severe chickenpox which can be fatal.

As soon as I realised my daughter had chickenpox I phoned my local GP surgery for advice and was told to go in for a blood test to test my immunity. It came back that I had no immunity and that I was at risk of catching chickenpox which could cause complications. My GP actually chased up my results to make sure we had them that day as it was a Friday and he didn’t want to leave me too long in case I wasn’t immune, which it turned out I wasn’t.

No Immunity to Chickenpox. What Next?

Because I had no immunity to chickenpox there was one option to try and prevent me catching it, baring in mind I had already been exposed as my children were contagious before the spots appeared. This meant that I had two options, I could do nothing and pray I didn’t catch chickenpox or I could have an antibody injection to try and boost my immune system with some chickenpox immunity. The injection is an injection of chickenpox antibodies called Varicella Zoster Immune Globulin (VZIG).

The VZIG injection helps to boost your immune system for a short time but won’t necessarily stop chickenpox developing. It can usually be given up to 10 days after contact with chickenpox, as long as you haven’t developed a rash or blisters. The injection doesn’t work once chickenpox has developed and it is not known whether the VZIG injection helps reduce the risk of FVS in the unborn baby.

I had to decide quickly, which way to go. If I went down the injection route then I only had a 10-day window and because chickenpox is contagious before the spots appear, the window began 2 days earlier.

I agreed to the injection and it was arranged for me to travel to the hospital on Monday as it had to be given in a hospital.

As every pregnant woman knows, pregnancy isn’t glamorous. We’re poked and prodded in areas where the sun doesn’t shine and when we actually give birth we can end up with a room full of people (not that we care at the time!) and this injection wasn’t very glamorous either. There I was, holding my arm out, ready for an injection, when I was told that it had to be given in my bottom! Oh the joys, men really don’t know how much indignity we have to suffer to give them children!

pain in your bum cartoon

I have NEVER had an injection in my bottom before, not even when I was injecting myself with insulin whilst pregnant with my 4th (gestational diabetes) and my 5th (type 2 diabetes) as I used my thigh. So I had to lie there, with my bottom exposed, but thankfully it didn’t hurt too much and it didn’t prevent me from sitting down afterwards, which was a great relief with a journey home of over an hour!

What exactly was the injection and how does it work?

According to the leaflet which came with the injections, the injection I had is known as Human Varicella-Zoster Immunoglobulin and is made from the blood plasma from screened donors who have had chickenpox and whose blood contains a large dose of antibodies. Antibodies are the fighters in your blood which the body produces when it feels it is under attack and these antibodies are trained to provide protection from chickenpox.

As well as being given to pregnant women who have come into contact with chickenpox whilst not immune, it can be given to newborn babies whose mother develops chickenpox within 7 days before or 7 days after the baby’s birth, or newborn babies who come into contact with chickenpox when their mother isn’t immune (so hasn’t passed on the antibodies to her baby).

It can also be given to adults and children who are not immune and come into contact with chickenpox who have a reduced immune system or by certain medications or certain treatments. As those are the people most at risk from chickenpox and serious and life-threatening complications.

I asked the nurse whether this injection would make me contagious and I was reassured it wouldn’t so I could go to work that afternoon and I also asked how long the protection would last. Sadly, this is only 3 weeks and should one of my other children come down with chickenpox or I be exposed another way after 3 weeks then I will have to have another injection.

There is also the risk of side effects, just like with any medication, but thankfully I didn’t suffer from any.

Side effects that may occur are;

  • Short term swelling, warmth, pain, redness, wound itching or rash at the injection site.
  • Allergic reactions which may be serious with difficulty breathing or dizziness.
  • Feeling lightheaded, fainting or feeling faint.
  • A headache.
  • Chills, fever.
  • Itching, redness of the skin.
  • Rapid heartbeat.
  • Feeling or being sick.
  • Joint pains.

Another thing I have to be aware of is that this medicine is made from human blood or plasma. This means there have been certain measures put in place to prevent infections being passed on to patients, these include careful selection of blood and plasma donors to make sure those at risk of carrying infections are excluded, and the testing of each donation and pools of plasma for signs of virus/infections.

Manufacturers of these products also include steps in the processing of the blood or plasma that can inactivate or remove viruses. Despite these measures, when medicines prepared from human blood or plasma are administered, the possibility of passing on infection cannot be totally excluded. This also applies to any unknown or emerging viruses or other types of infections.

The measures taken are considered effective for enveloped viruses such as HIV, Hepatitis B and Hepatitis C. The measures that are taken may be of limited value against non-enveloped viruses such as Hepatitis A and Parvovirus B19. Immunoglobulins have not been associated with Hepatitis A or Parvovirus B19 infections possibly because the antibodies against these infections, which are contained in the product, are protective.

Despite these risks, since chickenpox in pregnancy, in newborn babies or in patients whose immune system is not working fully can have serious effects on health, the expected benefits of your medicine will usually be greater than the risks of suffering any harmful side effects.

Can you still give blood after having this injection?

Since only about 10% of the UK population hasn’t had chickenpox, there isn’t much information about this injection and what will happen if you come into contact with chickenpox whilst pregnant and I struggled to find information back when I was the one at risk.

In fact, so little information is known that the nurse who gave me the injection couldn’t answer my questions and she had to ask the head midwife and she didn’t know if I was now contagious and how long would the protection last, (both of which are covered in this post already after I found out the information myself). I even phoned NHS Give Blood for information on whether this injection could mean you cannot give blood in the future as I know if you have had a blood transfusion you cannot give blood and I wondered whether the same rules applied to an injection made from blood. Their advice was to mention it when you next give blood (which the earliest it could be is when your baby is 6mths) as it would have to be considered on a personal basis based on your history, how many injections you have had and when.

 

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