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Definition of Chickenpox
Chickenpox is a common illness that causes an itchy rash and red spots or blisters (pox) all over the body. It is most common in children, but most people will get chickenpox at some point in their lives if they have not had the chickenpox vaccine.
Chickenpox usually isn't serious in healthy children. But it can cause problems for pregnant women, newborns, teens and adults, and people who have immune system problems that make it hard for the body to fight infection.
After you have had chickenpox, you are not likely to get it again. But the virus stays in your body long after you get over the illness. If the virus becomes active again, it can cause a painful viral infection called shingles.
Symptoms of Chickenpox
The first symptoms of chickenpox often are a fever, a headache, and a sore throat. You or your child may feel sick, tired, and not very hungry. The chickenpox rash camera usually appears about 1 or 2 days after the first symptoms start. Some children get the chickenpox rash without having a fever or other early symptoms.
It usually takes 14 to 16 days to get the symptoms of chickenpox after you have been around someone with the virus. This is called the incubation period.
After a chickenpox red spot appears, it usually takes about 1 or 2 days for the spot to go through all its stages. This includes blistering, bursting, drying, and crusting over. New red spots will appear every day for up to 5 to 7 days.
Causes of Chickenpox
Chickenpox is caused by the varicella-zoster virus. It can spread easily. You can get it from an infected person who sneezes, coughs, or shares food or drinks. You can also get it if you touch the fluid from a chickenpox blister.
A person who has chickenpox can spread the virus even before he or she has any symptoms. Chickenpox is most easily spread from 2 to 3 days before the rash appears until all the blisters have crusted over.
You are at risk for chickenpox if you have never had the illness and have not had the chickenpox vaccine. If someone you live with gets chickenpox, your risk is even higher because of the close contact.
Diagnosis of Chickenpox
The diagnosis of varicella is primarily clinical, with typical early "prodromal" symptoms, and then the characteristic rash. Confirmation of the diagnosis can be sought through either examination of the fluid within the vesicles of the rash, or by testing blood for evidence of an acute immunologic response.
Vesicular fluid can be examined with a Tsanck smear, or better with examination for direct fluorescent antibody. The fluid can also be "cultured", whereby attempts are made to grow the virus from a fluid sample. Blood tests can be used to identify a response to acute infection (IgM) or previous infection and subsequent immunity (IgG).
Prognosis of Chickenpox
Prior to the introduction of a chickenpox vaccine program, approximately 4 million cases occurred annually in the United States; 10,000 patients were hospitalized annually, and an average of 100 deaths occurred. The majority of deaths occurred in those who had no identifiable risk factor (for example, cancer, HIV/AIDS). Chickenpox should not be viewed as a childhood "rite of passage" and is not merely an inconvenience.
Treatment of Chickenpox
The medical management of Chicken Pox and Shingles in a healthy host is directed towards reduction of the risks of complications, as the disease is essentially self-limited. Hygiene is very important, including bathing, astringent soaks and closely cropped fingernails to avoid secondary bacterial infections. Paracetamol should be used to reduce fever. Acyclovir is the drug of choice for both Chicken Pox and Herpes Zoster. The therapy should be started within 24 hours of the onset of the rash.
In children 2 to 16 years of age, the oral dosage is 20 mg/kg, 4 times a day for 5 days (maximum of 800 mg 4 times a day). Adolescents and adults can receive up to 800 mg 5 times a day. For Chicken Pox Pneumonia, intravenous Acyclovir or Vidarabine is of value, though excellent supportive nursing care is mandatory.
Prevention of Chickenpox
The spread of chickenpox can be prevented by isolating affected individuals. Contagion is by exposure to respiratory droplets, or direct contact with lesions, within a period lasting from three days prior to the onset of the rash, to four days after the onset of the rash. The chickenpox virus (VZV) is susceptible to disinfectants, notably chlorine bleach (i.e., sodium hypochlorite). Also, like all enveloped viruses, VZV is sensitive to desiccation, heat and detergents. Therefore these viruses are relatively easy to kill.
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