Chickenpox

Chickenpox: Description:An acute contagious disease, usually occurring in children, caused by the varicella-zoster virus genus, Varicellovirus, a member of the family Herpesviridae, and marked by a sparse eruption of papules, which become vesicles and then pustules, like that of smallpox although less severe and varying in stages, usually with mild constitutional symptoms; incubation period is about 14-17 days.Alternative Name: Varicella.ChickenpoxChickenpox is a viral infection caused by the Herpes varicella zoster virus. This virus is spread form one person to another in one of two ways:By direct contact with the actual rash.
  • Through the air by coughing or sneezing, just like a cold.
The incubation period (from exposure to onset of symptoms) is 14 to 24 days. The initial symptoms are mild fever and headaches. Younger children may seem generally grouchy.These are followed within hours by the appearance of a typical rash. Crops of red spots appear which quickly develop central fluid-filled blisters that are intensely itchy. After a couple of days these scab over and dry up. The rash mostly affects the trunk, but may appear anywhere on the body, including the scalp and the mouth.Most cases of chickenpox occur in children younger than 10. The disease is usually mild, although serious complications sometimes occur. Adults and older children usually get sicker than younger children do.When someone becomes infected, the pox usually appears 10 to 21 days later. People become contagious 1 to 2 days before breaking out with pox. They remain contagious while uncrusted blisters are present.Children whose mothers have had chickenpox or have received the chickenpox vaccine are not very likely to catch it before they are 1 year old. If they do catch chickenpox, they often have mild cases. This is because antibodies from their mothers' blood help protect them. Children under 1 year old whose mothers have not had chickenpox or the vaccine can get severe chickenpox.Since Chicken Pox has a high secondary attack rate, people susceptible to Chicken Pox should avoid coming into contact with patients suffering from the infection. Prophylaxis for children is of little relevance as Chicken Pox is usually a benign disease.Chickenpox can be more serious in adults than in children, and adults with the virus are more likely to be admitted into hospital. Approximately 5-14% of adults with chickenpox develop lung problems, such as pneumoniaIf you are pregnant, chickenpox can occasionally cause complications for both you and your baby. The risk of you developing pneumonia is slightly higher if you are pregnant.However, vaccination is available for the prevention of Chicken Pox and is generally recommended between 10 - 12 years of age for children who have not had Chicken Pox before. This is also advised for immunocompromised patients who have not been previously exposed to Chicken Pox. Varicella Zoster Immuno Globulin (VZIG) and Varicella Zoster Immune Plasma (VZIP) are useful in preventing or ameliorating symptomatic Chicken Pox in high-risk individuals.Symptoms:The most commonly recognized symptom of chickenpox is a red rash, which covers the body. However, before developing a rash, you or your child may experience some mild flu-like symptoms include:Fever.
  • Nausea.
  • Aching, painful muscles.
  • Headache.
  • Generally feeling unwell.
  • Loss of appetite
Rashes are generally appears on:Behind the ears.
  • On the face.
  • Over the scalp.
  • Under the arms.
  • On the chest and stomach.
  • On the arms and legs.
The rash starts as small, itchy, red spots. After approximately 12-14 hours, these spots develop into fluid-filled blisters, which are intensely itchy.Causes and Risk factors:Chicken pox is a highly infectious and very common childhood disease. It is caused by the varicella zoster virus, a member of the herpes family of viruses. It is usually a mild, self-limiting disease in healthy children but it can be severe if contracted by babies, immune-suppressed children or adults.Chickenpox occurs mostly during the end of the winter and the beginning of the spring. It generally affects children aged from 2 to 8 and can take the form of epidemics.Children under 10 years old are the main target of chicken pox. Adults can catch chicken pox as well, but this is very rare. Once you have had chicken pox, you can not develop it again. However, if you have not had chicken pox by the time you were ten, then things do not look so good. Older children and adults that develop chicken pox risk more severe complications. Winter and spring are the most common seasons for chicken pox. There are also some people that are more vulnerable to chicken pox than others. For example kids that are immunosuppressed or newborns are especially vulnerable to chicken pox.Risk Factors:People at risk of contracting chickenpox include anyone who hasn't been vaccinated or who has never had the disease. People who've been vaccinated against chickenpox are usually immune to the virus. The same is true of anyone who has had chickenpox in the past.
  • People with weakened immune systems or pregnant women who have never contracted the virus also are at greater risk for severe illness and complications.
  • Live with someone who has chickenpox.
  • Work or play indoors for more than 1 hour with someone who has chickenpox.
  • Are in the hospital and share a room with someone who later develops chickenpox or are cared for by a staff member who later develops chickenpox.
Diagnosis:History and physical examination usually aid the diagnosis of Chicken Pox. The characteristic skin rash with itching and low grade fever helps to make the diagnosis.In most cases of chickenpox and shingles, the symptoms alone are enough for a health care provider to make a diagnosis. If the symptoms are not straightforward in some patients, such as those who are immunosuppressed, the doctor performs additional tests to detect the virus. The tests usually aim to distinguish between varicella-zoster and herpes simplex viruses.Virus Culture: A viral culture uses specimens taken from the blister, fluid in the blister, or sometimes spinal fluid. They are sent to a laboratory, where it takes 1 - 14 days to detect the virus in the preparation made from the specimen. It is also sometimes used in vaccinated patients to determine if a varicella-like infection is caused by a natural virus or by the vaccine. This test is useful, but it is sometimes difficult to recover the virus from the samples.Immunofluorescence Assay: Immunofluorescence is a diagnostic technique used to identify antibodies to a specific virus. In the case of herpes zoster, the technique uses ultraviolet rays applied to a preparation composed of cells taken from the zoster blisters. The specific characteristics of the light as seen through a microscope will identify the presence of the antibodies. This test is less expensive than a culture, more accurate, and results are faster.Polymerase Chain Reaction (PCR): Polymerase chain reaction (PCR) techniques use a piece of the DNA of the virus, which is then replicated millions of times until the virus is detectable. This technique is expensive but is useful for unusual cases, such as identifying infection in the central nervous system.Treatment:Initial Treatment:In most cases, it is enough to keep children comfortable while their own bodies fight the illness. An oral antihistamine can help to ease the itching, as can topical lotions. Lotions containing antihistamines are not proven more effective.The most common lotion used for chicken pox is Calamine lotion. This or any similar over-the-counter preparation can be applied to the blisters to help dry them out and soothe the skin.Over-the-counter and prescription antihistamines may be used to control severe itching. Diphenhydramine (Benadryl) is available over-the-counter and hydroxyzine (Atarax) is available by prescription. Both of these antihistamines cause drowsiness and may be helpful at night to help the patient sleep. The newer antihistamines such as loratadine (Claritin), certrizine (Zyrtec), and fexofenadine (Allegra) can be used to control itching but do not cause drowsiness.In addition, for those with skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or those who have recently taken steroids, the antiviral medicines may be very important. The same is also true for adolescents and children who must take aspirin on an ongoing basis. Do not use aspirin for someone who may have chickenpox.The chicken pox vaccine is recommended for all children between the ages of 18 months and adolescence who have not yet had chicken pox. Studies have also shown that the vaccine can prevent chicken pox or reduce the severity of the illness if it is given with 3-5 days of exposure to an infected person.The chickenpox vaccine is a live attenuated vaccine. This means the live, disease-producing virus was modified, or weakened, in the laboratory to produce an organism that can grow and produce immunity in the body without causing illness.Tens of millions of doses of varicella vaccine have been given in the United States, and studies continue to show that the vaccine is safe. Serious side effects are very rare. Possible side effects are generally mild and include redness, stiffness, and soreness at the injection site.Person who should not receive the vaccine include:Persons with weakened immune systems and those with life-threatening allergies to gelatin or the antibiotic neomycin should not receive this vaccine.
  • Persons who had a severe allergic reaction to a prior dose of this vaccine should not receive a second dose.
  • Pregnant women and women attempting to become pregnant should not receive this vaccine, as the possible effects on fetal development are unknown. However, non-pregnant women of childbearing age who have never had the disease may be immunized against chickenpox to avoid contracting the disease while pregnant.
Medicine and medications:Varicella-zoster immune globulin (VZIG), Acyclovir, Valacyclovir, Valtrex, Famvir, Zovirax, Famciclovir,Note: The following drugs and medications are in some way related to, or used in the treatment. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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