Varicella-zoster Virus Infection in Children and Adolescents

Adebola Adesoye, PharmD; Linda Nwachukwu; Muideen Adigun, PharmD, BCPS; Alexander Oladele


US Pharmacist. 2014;39(5):39-43. 

In This Article

Abstract and Introduction


Varicella-zoster virus is responsible for causing a primary varicella infection (chickenpox) and a secondary herpes zoster infection (shingles). Although varicella typically manifests as a mild disease in otherwise healthy children, it can also manifest as a moderate-to-severe disease, most notably in immunocompromised and adult hosts. Acyclovir is the antiviral agent of choice for the management of varicella infections. However, in acyclovir-resistant varicella infections, foscarnet is the recommended antiviral agent for use. Routine vaccination with Varivax has been very effective in reducing chickenpox incidence in the United States; it confers immunity and also reduces clinical manifestation of the illness.


Varicella-zoster virus (VZV) is a double-stranded DNA virus that belongs to the Alpha-herpesvirinae subfamily of the Herpesviridae family of eight herpes viruses. It is responsible for an infection that manifests as separate illnesses in two phases of the human life cycle: 1) a primary infection, varicella (chickenpox), typically in childhood; and 2) a secondary herpes zoster (HZ) infection (shingles) through reactivation of the latent virus in the central nervous system (CNS), typically in the elderly. This article aims to review the epidemiology, clinical manifestations, complications, management, and prevention of childhood chickenpox, including recent advances in therapeutic management of varicella and CDC recommendations.