CHICKENPOX

What is it?
Chickenpox is a highly contagious infection and is generally a disease of childhood.

How do you get it?
It spreads by inhalation of infective droplets or contact with lesions after 10-20 days.

What are the signs and symptoms?
Fever and malaise are mild in children and more marked in adults. Fluid-filled lesions, quickly rupturing to form small ulcers, may appear first in the mouth and throat. The rash begins prominently on the face, scalp, and trunk, and later involves the extremities. Pimples change in a few hours to vesicles (fluid-filled lesions) that eventually form crusts. New lesions may erupt for 1-5 days, so that all stages of the eruption are usually present simultaneously. The crusts slough in 7-14 days. The lesions are superficial and elliptical, with slightly serrated borders.

How do you diagnose it?
Diagnosis is usually made clinically, from its signs and symptoms.

What are its complications?
Pneumonia is more common in adults (especially smokers, and pregnant women) than in children and may result in acute respiratory distress syndrome (ARDS). Ischemic strokes have been recognized in the wake of chickenpox. Hepatitis occurs in a small percentage of chickenpox patients. Encephalitis is infrequent may be life-threatening. Secondary bacterial infections are common. Pitted scars are frequent sequelae. Reye's syndrome also complicates chickenpox, usually in childhood, and is associated with aspirin therapy.

When contracted during the first or second trimesters of pregnancy, chickenpox carries a very small risk of congenital malformations. If a mother develops chickenpox within 5 days after delivery, the newborn is at risk for disseminated disease and should receive varicella-zoster immune globulin (VZIG).

What can you do at home?
Patients should be isolated until primary crusts have disappeared and kept at bed rest until they are fever free. The skin should be kept clean. Paracetamol can be used to control fever.

How do you treat it?
Hospitalized patients with chickenpox should be isolated, and caregivers should wear gowns, gloves, and masks when in contact with them. Itching can be relieved with medications.

Acyclovir is an antiviral agent that can be used in chickenpox. It reduces the severity and shorten the duration of chickenpox in adults and in children. Acyclovir, if given in the first 72 hours of zoster, reduces the number of days of fever and the maximum number of lesions.

How do you prevent it?
Patients with active chickenpox should be separated from non-chickenpox infected people. They should stay away from work when active vesicles are present, typically from the tenth day after onset through the twenty-first day. A vaccine against chickenpox is also available.