Chicken Pox, also known as Varicella, is an acute and highly contagious disease. The viral infection is transferred from one person to another through direct contact with the broken chickenpox blisters and through airborne droplets. People who have never had chickenpox can get infected just by being in a room with someone who has the disease. There is universal susceptibility to the virus in those not previously infected.
These pocks break out in many without any illness or previous sign—in others they are preceded by a little degree of chillness, lassitude, cough, broken sleep, wandering pains, loss of appetite, and feverishness for three days…. On the first day of the eruption they are reddish. On the second day there is at the top of most of them a very small bladder, about the size of a millet-seed.
This viral disease is characterized by dry itching (pruritus) and a skin rash with fluid-filled blisters that burst and form crusts. The onset of the chickenpox rash may be preceded by a day of mild fever and weakness. The infectious period lasts from about three days before the rash appears until all the blisters have formed scabs. The incubation period between being infected with chickenpox until the disease breaks out and symptoms appear is 10 to 21 days.
Most children have been infected with the virus by the age of 10. After infection, lifelong immunity against recurrent infection is usually present. However, a person with a history of chickenpox may develop shingles (herpes zoster) later in life. In India, it usually occurs in the first six months of the year.
What are the causes of Chicken Pox?
Chickenpox seldom causes scarring, but when it does, the scars most often occur around the eyes and consist of a small depression. Chickenpox lesions can become infected, usually from scratching and most frequently with a bacteria called Staphylococcus. These secondary infections may be severe enough to require hospitalization. The virus is contained in the body fluids and in the lesions of skin and mucosa.
It is transmitted from person to person by droplet infection through the respiratory tract. Rarely the condition may be caused by exposure to a case of Herpes Zoster.
What are the symptoms of Chicken Pox?
- Achiness and fever (before the disease breaks out).
- Fatigue, irritability and sore throat.
- Rashes break out on the day the fever starts.
- A skin rash or lesion on the chest, back, shoulders, scalp, or other areas.
- Lesions on the mouth, vagina, rectum, eye, or other mucus membranes.
- Itchy, blistering rash develops into as many as 250-500 blisters within couple of hours.
- Crusting, after the blister breaks, occurs after two to four days.
- Crusts become progressively darker with time and form scale like structure called scab. Scabs fall off in about nine to 13 days.
These symptoms are mild in young children. Chickenpox lasts seven to ten days in children and longer in adults. Adults can feel very ill and take longer to recover. They are also more likely than children to suffer complications.
How can we diagnose Chicken Pox?
- The diagnosis is made by observing the symptoms and the typical appearance of the rash.
- Laboratory diagnosis is seldom required because of clear-cut clinical signs.
- Examination of the fluid present within the lesion under the microscope shows characteristic round particles. Scrapings from the floor of the lesion show, what are called, Giant cells.
How can Chicken Pox be treated?
- Isolation of the patient for about 6 days after the onset of rashes and disinfecting the articles soiled by nose and throat discharge of the patient are the usual control measures.
- The treatment mostly consists of easing the symptoms.
- Remember that infected person will be contagious until all the blisters have scabs and when new blisters have stopped appearing. They should stay at home while they are infectious.
- Avoid scratching the blisters because of the risk of infection.
- Cut the nails short or make the patient wear gloves.
- Pay attention to personal hygiene.
- Calamine lotion will help to relieve the itching.
Keep the patient in cold surroundings as heat and sweat may make the itching worse.
In attacks of chickenpox where the itching is so serious that the child’s sleep is totally disturbed, antihistamine medications with a heavily sedative effect can be used. Antihistamines are medication for allergic reactions, motion sickness or insomnia.
What complications might arise?
Bacteria may infect the blisters.
Occasionally scars may remain at the site of the blisters.
Conjunctivitis.
Pneumonia.
In very rare cases, chickenpox can result in complications such as meningitis or encephalitis (inflammation of the membranes of the brain or the brain itself), inflammation of the heart (myocarditis) or Reye’s syndrome.
Future prospects
Once a person has had chickenpox, he will have immunity to the disease for the rest of his life. However, the virus may return later in life as shingles. A person who has active shingles can infect others with chickenpox, but cannot give shingles to someone else.
Who is at risk of complications?
Pregnant women who have not had chickenpox.
People with a weak immune system, such as those with acute or chronic leukaemia or HIV.
Patients taking medication to suppress their immune system, such as long-term oral steroids.
Those in the at-risk group who are exposed to the varicella-zoster virus can be given an injection of varicella-zoster-immunoglobin to boost their immunity. In some countries, vaccination against chickenpox is available.
Drugs used
In serious cases of chickenpox in people with a weak immune system, aciclovir which works specifically against chickenpox, can be used.
The drug should help reduce the severity of chickenpox symptoms, especially in older children and teenagers if taken within 24 hours of the rash’s first appearance. It may also be prescribed in severe cases or in people who are immuno-suppressed. An alternative antiviral agent is vidarabine.
Frequently asked questions about Chicken Pox :
Which doctor should I consult if I happen to get chicken pox?
You can see a general physician or an infection specialist.
Can chicken pox be prevented?
Yes, chicken pox vaccines are available. Vaccination can prevent the onset of the disease.
Can I get chicken pox from touching a person with it?
No, it is spread through the respiratory route.
Are the scabs infectious?
No the scabs are not infectious.
Glossary
Pneumonia : A disease of the lungs characterized by inflammation.
Encephalitis : Inflammation of the membranes of the brain or the brain itself.
