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\s=b\Zoster immune plasma (ZIP) was given to 31 susceptible immunocompromised children one to seven days (median, two days) following household, playmate, or hospital exposures to varicella. The average amount of ZIP transfused was 7 ml/kg. Twenty-one children did not develop varicella or persistent antibodies to varicella-zoster virus (VZV).Eight (26%) of the 31 contracted clinical varicella. Seven cases were mild, but in one child, who was given ZIP seven days after exposure, visceral disease developed and the child died. Two children had subclinical varicella that was documented by persistence of VZV antibodies for at least ten months after passive immunization. Because none of the 30 children given ZIP one to six days following exposure had severe varicella, we conclude that ZIP is effective in preventing or modifying varicella in immunocompromised patients if given shortly after exposure.(Am J Dis Child 131: [693][694][695][696] 1977) Varicella can be a severe and even fatal disease in patients with cancer or immunodeficiency states.14 Because a large number of children with acute lymphocytic leukemia or renal allografts are cared for at the University of Minnesota Health Sciences Center, we found it desirable to have our own supply of zoster immune plasma (ZIP) for attempted prophylaxis of varicella in such pa¬ tients. Our experience with the use of ZIP in 31 children is the subject of this report. SUBJECTS AND METHODS PatientsThe patients had malignancy and /or primary or acquired immunodeficiency. They lacked a history of varicella and had recent intimate contact with varicella. An intimate contact was defined as a house¬ hold member with varicella, an exposure of at least an hour to a schoolmate or play¬ mate with varicella, or exposure on a hospital ward or clinic to a person with varicella. The patient was considered at risk if varicella developed in the contact within 24 hours after the exposure or if the contact had varicella lesions that were not yet crusted at the time of exposure. The patients were given ZIP intravenously in a dose of approximately 7 ml/kg as soon as possible after exposure. The recipient was given a transfusion with blood groupmatched plasma if possible. Two and four weeks after their child's exposure the parents were contacted and questioned regarding signs and symptoms in the chil¬ dren. If varicella developed, the patient was examined by a physician to confirm the diagnosis. Serum was drawn for vari¬ cella-zoster virus (VZV) antibody titers before the administration of ZIP and three to eight weeks later. Recipients of ZIP in whom varicella did not develop, but who had VZV antibodies in the second serum specimen, were tested again 3 to 14 months after exposure. This investigation was approved by the University of Minnesota Committee on the Use of Human Subjects in Research, and informed consent was obtained from parents or guardians before participation. Preparation of ZIPZoster immune plasma was obtained from healthy adults between the ages of 17 and 66 years who had had he...

RA27/3 rubella vaccine was given to 418 subjects aged 1 to 17 years in 1974, 201 of whom participated in a four-year follow-up study. Two vaccine-associated complications were reported. A 5-year-old boy had transient arthritis of the hip, and a 1-year-old boy had a pigmented macule at the inoculation site. Rubella reinfection was uncommon, occurring at most in three of our subjects. All of the 186 susceptible children seroconverted, and 182 had hemagglutination-inhibiting (HI) titers of 8 or greater at four-year follow-up (geometric mean titer, 30.3). In the four children whose HI titers declined to undetectable levels, both HI and neutralizing (Nt) antibodies had developed immediately postimmunization, and two had Nt titers at follow-up despite loss of HI antibodies. RA27/3 vaccine boosted HI titers in 15 seropositive subjects, but titers returned to preimmunization levels four years later. We concluded that RA27/3 vaccine produced durable immunity with very low rates of rubella reinfection and secondary vaccine failure during the four years since immunization.