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CHICKENPOX

What is Chickenpox ?

This is a very common, but usually mild, childhood disease. In adults it can be more severe. It is caused by a virus called Varicella zoster. The disease occurs mainly in autumn and winter. The virus spreads mainly by droplets from infectious mucus from the mouth and nose. In healthy children the disease is usually mild and considered as a mere inconvenience.

Fifteen to 20 days after being infected, the patient has a mild fever for about 3 days and a characteristic rash affecting first the trunk and then spreading to the rest of the body. This starts as itchy red spots which gradually fill with a clear fluid to form blisters. Later they form scabs or crusts which fall off within 10 days. The rash comes in crops so that spots of different age are seen side by side. One attack of chickenpox gives protection against the disease for life. However, shingles, another form of the disease caused by the same Varicella zoster virus, may later occur in adults. Chickenpox in adults may be more severe than in children. In patients who have poor defences against infection because of conditions such as in leukaemia, the disease may also be severe. If chickenpox occurs in a pregnant woman just before delivery the unprotected newborn baby may rarely suffer severely from the disease. Laboratory tests are not usually needed as the diagnosis can be made just by examining the patient.

How does Chickenpox occur ?

The virus enters the body through the air passages, and multiplies in the lining of the nose and throat. It then spreads through the blood to various parts of the body including the skin where it causes the characteristic rash.

Why does Chickenpox occur ?

People who have not had the disease previously are likely to get the illness if they come into contact with the virus.

Treatment Involved for Chickenpox

In children it is a mild illness. Bed rest for a few days, paracetamol to reduce fever and calamine lotion to relieve itching of the skin spots are recommended. Sometimes antihistamines are given to provide relief of the itching. Good personal hygiene is important. Keep the nails short and clean to avoid the risk of a bacterial infection of the skin sores. If this happens, pus develops in the skin. This may need antibiotics. In adults, chickenpox may be more severe and recovery may take longer. Your doctor may prescribe an anti-viral drug, acyclovir. It has been shown to be effective in reducing the length of the illness and the number of spots if given early in the course of the disease. A vaccine is available for chickenpox but it is not routinely available and not licensed in the UK. Infection with chickenpox in a pregnant woman can cause abnormalities in the unborn baby. This is more of a problem before the 20th week of pregnancy. It may also be a problem in the five days before and two days after delivery. If a pregnant woman has had a contact with a chickenpox sufferer, then a blood test will be performed This will show if she has protection against chickenpox. If it shows that she has no protection, then an injection of Varicella Zoster immunoglobulin (VZIG) will be offered. It does not prevent the infection but will lessen it. Its supplies are limited as it depends on suitable human donors.

During Treatment for Chickenpox

The symptoms usually settle within 2 weeks. You are infectious from approximately 2 days before the rash appears until the spots have crusted. At present there is no vaccine available against chickenpox. Scratching of the skin spots should be avoided as this may cause bacterial infection and possibly leave permanent scars. Some patients, especially the elderly or those with other illnesses, may develop pneumonia . This causes breathing difficulties, cough and fever, and requires treatment in hospital with special anti-viral drugs. Rarely inflammation of the brain may occur. This produces severe headache and sensitivity to light. The doctor must be contacted.

If Chickenpox is Left Untreated

The illness always subsides by itself as long as no complications have occurred.

Effects on Family of Chickenpox

It is very difficult to stop the spread of chickenpox in the home. Adults who have not had the disease should avoid contact with affected patients. So should pregnant women. The patient continuous to be infectious until all the spots have crusted. This usually takes about 6 days after the rash has appeared although all the spots will take 2-3 weeks to heal.