I am a 33 year old female who has had type 1 diabetes for over 11 years, and I use an insulin pump. I was exposed to a child who has chickenpox. I did not come in direct contact with the child, but was in the same room with her. She began breaking out with sores five or six days ago. I have never had this illness and was tested a couple of years ago which showed I have no immunity, and I have never had the vaccine. Should I be concerned about my exposure to chickenpox? I read that people at high risk (adults and those with certain chronic illnesses) should contact their physician as soon as they recognize symptoms or are aware of exposure to this illness. I also read that there is treatment available called immune globulin that can provide “passive immunity” and reduce the severity of the illness. Do I need to do something immediately or just wait and see? I hate to be too cautious, but if there is cause for concern and treatment is available, I’d like to know what to do. I do not have a physician yet, because I recently relocated, but I have an appointment to see an endocrinologist in about two weeks.

Your questions are good and difficult to answer in a brief manner. It is true that there is immune globulin to passively protect you from varicella (chickenpox) infection. In addition, there is a vaccine for varicella. However, the vaccine is not FDA-approved. Finally, there is a prophylactic course of Acyclovir available to patients. The Acyclovir has not been studied broadly and is not an approved use of the medication. Lastly, your immediate status with regard to your immunity to the virus has not been studied for a year. All this means that you need to contact an infection control officer or infectious disease specialist near you for a more complete description of the risks and benefits of therapy. In the end, if your diabetes is well controlled, I’m not sure that the risk, hassle, and expense of the therapies offers you a more favored route over wait and see. There is not a lot of clinical data to clearly direct your course of treatment, at present. In the end, I believe your questions should be directed to the health care professionals stated above.

JTL

[Editor’s comment: Contact either your new endocrinologist or a Public Health Nurse in your county with your question, and see if they can call the infectious disease experts and help you with getting an answer to your question.

WWQ]