Question

A 23 year old primi gravida stays in the same house as her school going nephew, who contracted varicella infection. The woman approached the medical centre to get tested for the same and the result for varicella antibody was negative. Which of the following statements are true?

• A. She is susceptible to zoster
• B. She is susceptible to chickenpox
• C. She is immune to chickenpox
• D. She is immune to zoster

Hint:

Negative varicella antibody means no prior VZV exposure; zoster can only occur after primary chickenpox infection establishes latency.

Answer 1

The Correct Option is B

Step 1: Understand the virology of Varicella Zoster Virus (VZV). VZV causes two distinct diseases: (1) Varicella (chickenpox) as the primary infection, and (2) Herpes Zoster (shingles) as a reactivation of latent VZV in dorsal root ganglia after a prior primary infection.

Step 2: Interpret the negative antibody result. A negative varicella antibody test means the patient has never been infected with VZV previously. She has neither had chickenpox nor carries latent virus. Therefore:

• She has no pre-existing immunity to VZV in any form.
• She cannot develop Zoster (which requires prior infection and latency of VZV).
• She is fully susceptible to contracting primary varicella (chickenpox) from her infected nephew.

Step 3: Significance in pregnancy. Varicella in pregnancy is dangerous -- it can cause maternal varicella pneumonia, congenital varicella syndrome (if infection occurs in the first 20 weeks), or neonatal varicella (if infection occurs near term). Varicella-Zoster Immunoglobulin (VZIG) should be administered promptly to seronegative pregnant contacts.

Step 4: Conclusion. Negative varicella antibody = no prior infection = susceptible to chickenpox (not zoster). Answer: She is susceptible to chickenpox.