HOME
ABOUT IAC
CONTACT
A-Z INDEX
DONATE
SHOP
SUBSCRIBE
Immunization Action Coalition
Unprotected People Stories 
General
Chickenpox (varicella)
Diphtheria
Hepatitis A
Hepatitis B
Hib
Human Papillomavirus (HPV)
Influenza
Measles
Meningococcal
Mumps
Pertussis (whooping cough)
Pneumococcal
Polio
Rabies
Rotavirus
Rubella
Shingles (zoster)
Tetanus
Yellow Fever
Stories by Disease
Stories by Number

Unprotected People Reports: Chickenpox

Three Fatal Varicella Cases in Unvaccinated Young Women 

Click here for a fully-formatted PDF version of this report.
Three fatal varicella cases in young adult women were reported to CDC by state health departments during January-April 1997. All three women were susceptible to varicella, unvaccinated, and infected by exposure to unvaccinated preschool-aged children who had contracted varicella. These three cases appeared in the MMWR, May 16, 1997, vol. 46, no.19 and are reprinted below.
Note: There are approximately 100 deaths and 10,000 hospitalizations from varicella each year in the United States. The ACIP recommends that all susceptible children (12 months of age and older) and all susceptible adults be vaccinated. Please recommend varicella vaccine to your susceptible patients of all ages.
Case 1: Death of a 23-year-old woman
On January 19, 1997, a 23-year-old woman in good health had onset of a classic varicella rash. In early January, her 2- and 5-year-old unvaccinated children had had varicella. On January 22, she had onset of shortness of breath and  hemoptysis. When she was admitted to a local hospital on  January 23, a chest radiograph indicated diffuse alveolar density consistent with varicella pneumonia, and treatment was initiated with oxygen and intravenous acyclovir. Her condition worsened, and she required intubation several hours after admission. Because of increasing respiratory distress, she was transferred to a referral hospital where treatment continued with oxygen, antibiotics, and intravenous acyclovir.On January 31, her rash became hemorrhagic, and she developed disseminated intravascular coagulation (DIC) and renal failure, followed by progression to multiple system failure; she died on February 2. Varicella zoster virus was cultured from skin lesions and from a tracheal aspirate.

Case 2: Death of a 25-year-old woman
On March 11, 1997, a 25-year-old woman in good health had onset of a classic varicella rash, fever, and headache. Her 4-year-old unvaccinated child had had onset of a varicella rash on February 23. On March 12, the woman had onset of cough, and on March 13, shortness of breath. On March 14, she sought care at a local emergency department (ED) because of increasing respiratory difficulty and confusion. Chest radiograph indicated bilateral infiltrates consistent with varicella pneumonia, and arterial blood gases indicated hypoxemia. Varicella encephalitis and pneumonia were diagnosed; she was admitted to the hospital, and treatment was initiated with oxygen and intravenous acyclovir. Four hours after admission, her respiratory difficulty increased, and she required intubation. On March 15, a computerized tomography of the brain revealed severe, diffuse cerebral edema, and she developed renal failure and coma. On March 16, she was transferred to a referral hospital for renal dialysis; an electroencephalogram indicated absence of electrical brain activity, and repeat chest radiographs indicated diffuse infiltrates. She died on March 17.

Case 3: Death of a 32-year-old woman
On April 3, 1997, a 32-year-old woman with Crohn's disease sought medical evaluation at a local ED because of onset of abdominal and back pain. On March 7, therapy was initiated with 40 mg prednisone daily for an exacerbation of her Crohn's disease. By April 3, her steroid therapy had been tapered to 20 mg prednisone daily. On physical examination, she had mild, generalized abdominal tenderness with no specific signs or abdominal guarding. She was afebrile, and a white blood cell (WBC) count was normal. A benign abdominal syndrome was presumptively diagnosed, and she was discharged.

Her symptoms persisted, and on April 4, she sought medical evaluation at the office of her health-care provider. Findings on physical examination were unchanged. Although an abdominal radiograph, abdominal and pelvic ultrasounds, and a WBC count were normal, because of her underlying medical condition, she was referred for surgical consultation. On April 5, the abdominal pain persisted, and she returned to the ED for evaluation. A WBC count was 15,000/mm3 (normal: 3200-9800/mm3), and she was admitted to the hospital. Diagnoses of colitis and ileitis with possible perforation and intraabdominal abscess were considered, and treatment was initiated with broad-spectrum antibiotics. On physical examination, a maculopapular, vesicular rash with crusted lesions was observed on her trunk, head, and neck. Varicella was presumptively diagnosed, and she was placed in isolation. The patient reported that she had had onset of a mild macular, nonpruritic rash on her back on April 3 and that she had been exposed on March 12 and 13 to her 4-year-old unvaccinated niece with varicella. On April 6, the vesicles became hemorrhagic, and she began bleeding from intravenous sites. She rapidly developed hypotension and DIC, and died from shock the same day. On autopsy, evidence of viral inclusion bodies in multiple organs was consistent with varicella, and varicella was determined to be the cause of death.
 
11/5/98 • REPORT #4
Disclaimer: The Immunization Action Coalition (IAC) publishes Unprotected People Reports for the purpose of making them available for our readers' review. We have not verified the content of this report.
 
- Guide to immunize.org -
A-Z INDEX
ABOUT IAC
IAC in the News
Staff
IAC History through Film
ACIP
RECOMMENDATIONS
ADOLESCENT VACCINATION
ADULT VACCINATION
ADULT VACCINATION GUIDE
ASK THE EXPERTS
Administering Vaccines
COVID-19 & Routine Vac
Hepatitis B
MMR
Storage and Handling
>> view all
BECKY PAYNE AWARD
BILLING & CODING
BIRTH DOSE GUIDEBOOK
CALENDAR OF EVENTS
CDC INFORMATION
CDC SCHEDULES
CLINIC TOOLS
Administering Vaccines
Adolescent Vaccination
Adult Vaccination
Screening for Contraindications
Vaccination and COVID-19
Vaccine Recommendations
Vaccine Storage & Handling
>> view all
COALITIONS FOR
IMMUNIZATION
CONTRIBUTE TO IAC
COVID-19 RELATED
Ask the Experts: COVID-19
   & Routine Vac
Clinic Tools: Vaccination and
   COVID-19
Repository of Resources
DEAR COLLEAGUE LETTERS
16-year-old Visit
HPV
MenACWY Dose #2
DONATE TO IAC
EDUCATIONAL MATERIALS
EMAIL NEWS SERVICES
E-NEWSLETTER: IAC EXPRESS
EXEMPTIONS
FAQs
FAVORITES
FDA PACKAGE INSERTS
FILMS ABOUT IAC
GIVE BIRTH TO THE
END OF HEP B
HANDOUTS FOR
PATIENTS & STAFF
View All Materials
Administering Vaccines
Adolescent Vaccination
Adult Vaccination
Contraindications / Precautions
Documenting Vaccination
Healthcare Personnel
Managing Vaccine Reactions
Parent Handouts
Pregnancy and Vaccines
Q&As: Diseases and Vaccines
Q&As: Easy-to-Read
Schedules for Patients
Screening Checklists
Standing Orders Templates
Storage & Handling
Strategies & Policies
Temperature Logs
Top Handouts
Vaccine Confidence
Vaccine Recommendations
>> view all
HEP B BIRTH DOSE
HONOR ROLLS
Hep B Birth Dose
Mandatory Flu Vaccination for HCP
MenB Vaccination for Colleges
IAC EXPRESS
Subscribe to IAC Express
IMAGE LIBRARY
LAWS AND MANDATES
MANUFACTURERS
MASS VACCINATION
RESOURCES
NATIONAL ADULT &
INFLUENZA
IMMUNIZATION SUMMIT
NEWS & INFORMATION
NEWSLETTER SIGN UP
OFFICIAL RELEASES
ACIP
CDC
FDA
PACKAGE INSERTS
PARTNERS
PHARMACISTS
PHOTOS
POWERPOINT SLIDE SETS
PREGNANCY AND
VACCINES
PRESS ROOM
PROTECT NEWBORNS
FROM HEP B
PUBLICATIONS
IAC Express
Vaccinating Adults:
   A Step-by-Step Guide
Hepatitis B What Hospitals
   Need to Do to
   Protect Newborns
Needle Tips Archive
Vaccinate Adults Archive
Vaccinate Women Archive
REGISTRIES
SCHOOL VACCINATION REQUIREMENTS
SHOP IAC
DVD Immunization Techniques
Laminated Schedules
Patient Record Cards
Flu Vaccine Buttons and Stickers
"Vaccines Save Lives" Pins
SITE MAP
SLIDE SETS
STANDING ORDERS
STATE INFORMATION
Immunization Websites
Laws and Mandates for School Entry
Immunization Program Managers
SUBSCRIBE TO IAC EXPRESS
SUPPORT IAC
TALKING ABOUT VACCINES
Adjuvants & Ingredients
Autism
Importance of Vaccination
MMR Vaccine
Religious Concerns
Vaccine Safety
>> view all
TECHNICALLY SPEAKING
TRANSLATIONS
IAC Handouts
VISs
TRAVEL (INTERNATIONAL)
UNPROTECTED PEOPLE
STORIES
Chickenpox
Hepatitis B
Measles
Whooping Cough
>> view all
VACCINATING ADULTS:
A STEP-BY-STEP GUIDE
VACCINE INFORMATION
STATEMENTS
Translations
VACCINE
MANUFACTURERS
VACCINE POLICY &
LICENSURE
ACIP
FDA
WHO
VACCINE SAFETY
VACCINE TIMELINE
VACCINES
Hepatitis B
HPV (Human papillomavirus)
Influenza
Pertussis
Varicella
>> view all
VIDEO OF THE WEEK
VIDEO LIBRARY
VISs
Translations
WHAT'S NEW OR UPDATED AT IAC
Handouts
VISs and Translations
Web Pages
 
Immunization Action Coalition  •  2550 University Avenue West  •  Suite 415 North  •  Saint Paul, Minnesota  •  55114
tel 651-647-9009  •  fax 651-647-9131
 
 
 
This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 6NH23IP22550) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.