It is a very common disease that is caused by the varicella zoster virus. It causes itchy rash and bumps and red spots (pox) throughout the body. It is more common among children, however it is possible to contract chickenpox later in life, in the event that one hasn’t had the vaccine for chickenpox.
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It is usually a mild, self-limiting illness for healthy children, but it can pose a threat to pregnant mothers, newborns, adult and those with lower immunity.
What is the cause?
The Varicella-zoster virus
What is the time frame for incubation?
10 to 21 days
How long is it before one becomes Infected?
The virus is extremely infective for the first 1-2 weeks prior to beginning of rash. It can last for 7 days following the manifestation vesicles , until scabbing begins to occur.
What is the method of transmission?
The virus is extremely contagious. It spreads primarily through by air (through the respiratory secretions that result from coughing or the sneezing) however, it can also be transmitted through direct contact with the fluid that comes from the vesicles.
What exactly are Clinical Features?
The symptoms of chickenpox are usually high fever, body pains along with headache and a general feelings of fatigue. Other signs may include fatigue and decrease in appetite. The common rash of chickenpox typically occurs between 1 and 2 days after. The fever typically subsides after the rash has fully developed. Sometimes, there is an appearance of a rash but not any of the usual symptoms.
The rash of chickenpox can go through several phases. It typically appears as a reddish-colored bump or blister, but then it bursts, it dries out and forms a crust over. New lesions form in groups on crops for between 4 and 7 days. The scalp faces, limbs, and trunk can develop the rash, while avoiding the soles and palms. Sometimes, there is an infection of the mucosa oral as well as the conjunctiva (outer covering of the eyes).
What are the potential complications?
1. Bacterial skin infections that are secondary to bacterial infections of the vesicles/rash can occur. If it occurs, antibiotics are typically required.
2. Encephalitis – inflammation of cerebellum, which causes cerebella ataxia acute (mainly for young children) and diffuse Encephalitis (mainly among adults)
3. Pneumonia is more common for adulthood (about one:400 instances)
4. Hepatitis This is usually seen when you are immunocompromised
5. Reye syndrome – is seen in children who are exposed to aspirin
6. Infection in pregnancy:
(i) Infection by the chickenpox virus during early pregnancy (8 between 8 and 20 weeks) is associated with an 2% chance for congenital malformation.
(ii) Infections in the last stages of pregnancy can lead to the baby to contracting herpes zoster.
(iii) (iii) If the mom is diagnosed with chickenpox within five days prior to the delivery and 48 hours following delivery, the baby is at risk of developing severe neonatal infections and VZIG prophylaxis is suggested.
What is the best way to diagnose it?
The doctor will inquire about your symptoms before proceeding to conduct an examination. This usually is enough to determine the presence of chickenpox. When it is in the beginning stage, it can be challenging for your physician to verify the diagnosis, and you could be asked to visit to your doctor within just 24 hours.
In rare cases in the event of the need for a more prompt verification of the diagnosis (eg. in the case of a pregnant mother when VZIG use is thought to be) or in unusual cases, the detection of antigens from viruses via the use of immunofluorescence (IF) and polymerase chain reaction (PCR) is possible with vesicular liquid or cell smears.
What is the best way to treat it?
The most straightforward cases can be treated by taking anti-pyretics (for the pain and fever) and anti-histamines (for itching). Anti-virals (eg. Acyclovir, Famciclovir and Valcyclovir) can be employed to treat chicken pox and, in cases that are not complicated it has been demonstrated to have a shorter period of new lesions, less lesions, and faster healing, however only if taken within 24 to 48 hours after the first rash appearing. Anti-virals that are administered orally are advised for children suffering from underlying skin conditions like eczema, babies or adults, as well as smokers, as those with these conditions are at a greater chance of complications from chickenpox. Acyclovir intravenous is prescribed to those with immunocompromised.
Prevention and Control of Infections
Cleanliness and the isolation of those suffering from the disease is essential to stop the spread of the chickenpox. It is possible to transmit the virus through respiratory droplets or through direct contact with lesions during the period of infection (see the previous paragraph). Fortunately, the varicella disease is apprehensive to desiccation, disinfectants and heat, therefore simple measures of hygiene like washing hands with soap may eliminate the virus.
Vaccination:
The varicella vaccine can help prevent one from getting chickenpox. It is advised for people who are not immune to chickenpox. This is especially true for those at a higher chance of contracting the disease (e.g. health professionals and people who live in institutions).
The dosage regimens for vaccines are as the following:
(i) For children (i.e. younger than 13 years old) age) 2 doses are recommended. First dose between 12 and 15 months, followed by the 2nd dose between 4 and 6 years old.
(ii) Adults and children over 13 years: two doses of medication are needed at intervals of 4 to 6 weeks.
Since the chickenpox vaccine an attenuated live virus vaccine It should not be administered to those who are immunocompromised severely or pregnant women.