It is a very common disease that is caused by the varicella zoster virus that triggers an itchy rash as well as bumps and red spots (pox) across the body. It is more common among children, however it is possible to contract chickenpox later in life, even if they have not received the chickenpox vaccination.
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The majority of cases are mild, self-limiting, and self-limiting, disease that is common in healthy children . However, it can be a problem for pregnant mothers, newborns, adult and those with an weakened immune system.
What causes it?
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 infectious for a period of 1-2 weeks prior to appearance of rash. It can last for 7-7 days following the manifestation of Vesicles up until the time when scabbing takes place.
What is the method of transmission?
The virus is extremely contagious. It spreads primarily through an airborne path (through the respiratory secretions that result from coughing or the sneezing) however, it can also be transmitted through direct contact with fluids from the vesicles.
What exactly are Clinical Features?
It is usually accompanied by a high fever, body pains as well as headaches and a general feeling of drowsiness. Other signs may include fatigue, nausea and lack of appetite. The typical rash of the disease usually occurs between 1 and 2 days after. The fever typically subsides after the rash has fully developed. There are occasions when there’s the appearance of a rash, but without any of the typical preceding symptoms.
The chickenpox rash can be seen through several phases. It typically starts 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 as well as the face, limbs, and trunk can develop the rash, while avoiding the soles and palms. There is a chance of irritation of oral mucosa as well as the conjunctiva (outer cover of the eye).
What are the possible complications?
1. Bacterial skin infections that are secondary to bacterial infections of the vesicles/rash can be present, and if it does, antibiotics are typically required.
2. Encephalitis – inflammation of cerebellum, that causes acute cerebella ataxia (mainly among youngsters) and diffuse Encephalitis (mainly for adults)
3. Pneumonia is more frequent for the adult population (about one:400 instances)
4. Hepatitis is a common occurrence for those with immunocompromised
5. Reye syndrome is a condition that occurs in children who are exposed to aspirin
6. Infection in pregnancy:
(i) Infection with chickenpox virus at the beginning of pregnancy (8 to 20 weeks) has the risk in congenital malformation.
(ii) Infections in the last stages of pregnancy can lead to the newborn to the herpes zoster virus.
(iii) (iii) If the mom is diagnosed with chickenpox within 5 days before delivery, and also within 48 hours following delivery, the baby is susceptible to severe neonatal infections and VZIG prophylaxis is recommended.
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. In the early stages, it could be challenging for your physician in confirming the diagnose, and you might be asked to come back to see your doctor in the next just 24 hours.
In rare cases when there is the need for a more prompt identification of the disease (eg. in the case of a pregnant mother when VZIG use is thought to be) or in rare instances, detection of viral antigen through an immunofluorescence (IF) and polymerase chain reaction (PCR) is possible with vesicular liquid or cell smears.
How can it be treated?
The majority of cases that are not complicated can be treated by taking anti-pyretics (for pain or fever) and anti-histamines (for itching). Anti-virals (eg. Acyclovir, Famciclovir and Valcyclovir) can be used to treat chickenpox and, in cases that are not complicated they have been proven to reduce the time between development of new lesion, less lesions, and faster healing, but only if they are started 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 patients who have an immune system disorder.
Prevention and Control of Infections
A clean and safe environment as well as separation of people suffering from infection is the most effective way to prevent the spread of the chickenpox. The virus can be transmitted via droplets of respiratory fluid, or directly contact with lesions during the period of infection (see the previous paragraph). The varicella virus is apprehensive to desiccation, disinfectants and heat, which means that simple measures of hygiene like washing hands with soap may eliminate the virus.
Vaccination:
The varicella vaccine can help prevent one from contracting chickenpox. It is advised for people who are not immune to chickenpox, particularly 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 in the following order:
(i) For children (i.e. children 13 years old) age) Two doses are required. First dose between 12 and 15 months, followed by the 2nd dose at between 4 and 6 years old.
(ii) Adults and children over 13 years: two doses of medication are needed between 4 and 6 weeks.
The chickenpox vaccination is an attenuated live virus vaccine It should not be administered to those who have a severe immunocompromised condition or pregnant women.
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