Chickenpox (patient information): Difference between revisions
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*Because chickenpox is airborne and very contagious before the rash even appears, it is difficult to avoid. | *Because chickenpox is airborne and very contagious before the rash even appears, it is difficult to avoid. | ||
*A vaccine to prevent chickenpox is part of a child's routine [[immunization]] schedule. | *A vaccine to prevent chickenpox is part of a child's routine [[immunization]] schedule. | ||
*The vaccine usually prevents the chickenpox disease completely or makes the illness very mild. | *The vaccine usually prevents the chickenpox disease completely or makes the illness very mild. | ||
Revision as of 13:50, 13 June 2017
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Chickenpox |
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Chickenpox On the Web |
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For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2] Assistant Editor-in-Chief: Alexandra M. Palmer
Overview
Chickenpox is a viral infection in which a person develops extremely itchy blisters all over the body. It used to be one of the classic childhood diseases. However, it has become much less common since the introduction of the chickenpox vaccine.
What are the symptoms of Chickenpox ?
Most children with chickenpox have the following symptoms before the rash appears:
The chickenpox rash occurs about 10 to 21 days after coming into contact with someone who had the disease. The average child develops 250 to 500 small, itchy, fluid-filled blisters over red spots on the skin.
The blisters are usually first seen on the face, chest, back, scalp and then to the rest of the body.
After a day or two, the blisters become cloudy and then scab. Meanwhile, new blisters form in groups. They often appear in the mouth, in the vagina, and on the eyelids.
Children with skin problems, such as eczema, may develop thousands of blisters.
Most pox will not leave scars unless they become infected with bacteria from scratching.
Some children who have had the vaccine will still develop a mild case of chickenpox. They usually recover much more quickly and have only a few pox (fewer than 30). These cases are often harder to diagnose. However, these children can still spread chickenpox to others.
What causes Chickenpox?
Chickenpox is caused by the varicella-zoster virus, a member of the Herpesviridae family. The same virus also causes herpes zoster (shingles) in adults.
Chickenpox can be spread very easily to others. You may get chickenpox from touching the fluids from a chickenpox blister, or if someone with the disease in your vicinity coughs or sneezes. Even those with mild illness may be contagious.
A person with chickenpox becomes contagious 1 to 2 days before their blisters appear. They remain contagious until all the blisters have crusted over.
Most cases of chickenpox occur in children younger than 10. The disease is usually mild, although serious complications sometimes occur. Adults and older children usually get sicker than younger children.
Children whose mothers have had chickenpox or have received the chickenpox vaccine are not very likely to catch it before they are 1 year old. If they do catch chickenpox, they often have mild cases. This is because antibodies from their mothers' blood help protect them. Children under 1 year old whose mothers have not had chickenpox or the vaccine can get severe chickenpox.
Severe chickenpox symptoms are more common in children whose immune system does not work well because of an illness or medicines such as chemotherapy and steroids.
Who is at highest risk?
Since chickenpox is contagious, anyone in close proximity to someone with the disease is at risk.
Diagnosis
Your health care provider can usually diagnose chickenpox by looking at the rash and asking questions about the person's medical history. Small blisters on the scalp usually confirm the diagnosis.
Laboratory tests can help confirm the diagnosis, if needed.
Antibody Testing
When an individual is exposed to VZV, their immune system responds by producing antibodies to the virus. Laboratory tests detect and measure the level of two classes of VZV antibodies in the blood namely IgM and IgG.
IgM
- First antibodies to be produced in response to the infection.
- Can be detected within a week or two post exposure.
- The levels of IgM antibodies rises for a short period of time and then falls below detectable levels.
- Post-Infection, in the future, the IgM levels rise only when the latent VZV is reactivated.
IgG
- Produced several weeks after the initial exposure.
- IgG levels rise during active infection and then the levels become stable as the VZV infection gets resolves and as the virus gets inactivated.
- Provides Long-Term protection
When to seek urgent medical care?
Call your health care provider or visit your nearest hospital if you think that your child has chickenpox or if your child is over 12 months of age and has not been vaccinated against chickenpox.
Treatment options
- Treatment involves keeping the person as comfortable as possible. Here are things to try:
- Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching.
- Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area.
- Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath.
- Apply a soothing moisturizer after bathing to soften and cool the skin.
- Avoid prolonged exposure to excessive heat and humidity.
- Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects such as drowsiness.
- Try over-the-counter hydrocortisone cream on itchy areas.
- Medications that fight the chickenpox virus are available but not given to everyone. To work well, the medicine usually must be started within the first 24 hours of the rash.
- Antiviral medication is not usually prescribe to otherwise healthy children who do not have severe symptoms. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medication if it is given early.
- Antiviral medication may be very important in those who have skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or who have recently taken steroids.
- DO NOT GIVE aspirin or ibuprofen to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reyes syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used.
- In order to prevent the risk of infection from scratching, especially during overnight, the use of clean gloves or socks on hands is recommended.
- A child with chickenpox should not return to school or play with other children until all chickenpox sores have crusted over or dried out. Adults should follow this same rule when considering when to return to work or be around others.
- Due to the excessive drying nature, Calamine Lotion which was prescribed traditionally is not recommended anymore.
- Some doctors also give antiviral medicines to people in the same household who also develop chickenpox, because they will usually develop more severe symptoms.
What to expect (Outlook/Prognosis)?
Usually, a person recovers without complications.
Once you have had chickenpox, the virus usually remains dormant or asleep in your body for your lifetime. About 1 in 10 adults will have shingles when the virus reemerges during a period of stress.
Possible complications
Rarely, serious bacteria infections such as encephalitis have occurred. Other complications may include:
- Reye's syndrome (Associated with the use of Aspirin)
- Myocarditis
- Pneumonia
- Transient arthritis
- Cerebellar ataxia may appear during the recovery phase or later. This involves a very unsteady walk.
- Women who get chickenpox during pregnancy can pass the infection to the developing baby. Newborns are at risk for severe infection.
- Most Common Complications are Secondary Skin Infections which when left untreated lead to pneumonia and septicemia.
Prevention
- Coughing and Sneezing should be kept covered and the use of any cloth or towels should be limited only to the child and not to be shared by others.
- Always maintain hand hygiene by washing hands often and after attending to a child with chickenpox.
- Refrain from sending the child to school or a gathering where the child may come into contact with other children so as to avoid the spread of the infection.
- Because chickenpox is airborne and very contagious before the rash even appears, it is difficult to avoid.
- A vaccine to prevent chickenpox is part of a child's routine immunization schedule.
- The vaccine usually prevents the chickenpox disease completely or makes the illness very mild.
- Talk to your Health Care Provider if you think your child might be at high risk for complications and might have been exposed. Immediate preventive measures may be important. Giving the vaccine early after exposure may still reduce the severity of the disease.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/001592.htm Template:WH Template:WS