Chickenpox (patient information): Difference between revisions
No edit summary |
No edit summary |
||
| Line 19: | Line 19: | ||
==Overview== | ==Overview== | ||
[[Chickenpox]] is one of the classic childhood diseases. It is also one of the most [[contagious]] diseases. The affected child or adult may develop hundreds of itchy, fluid-filled [[blisters]] that burst and form crusts. [[Chickenpox]] is caused by a [[virus]]. | [[Chickenpox]] is one of the classic childhood diseases. It is also one of the most [[contagious]] diseases. The affected child or adult may develop hundreds of itchy, fluid-filled [[blisters]] that burst and form crusts. [[Chickenpox]] is caused by a [[virus]]. | ||
The [[virus]] that causes [[chickenpox]] is [[varicella-zoster]], a member of the [[herpes virus]] family. The same [[virus]] also causes [[Herpes zoster| shingles (herpes zoster)]] in adults. | The [[virus]] that causes [[chickenpox]] is [[varicella-zoster]], a member of the [[herpes virus]] family. The same [[virus]] also causes [[Herpes zoster| shingles (herpes zoster)]] in adults. | ||
==What are the symptoms of Chickenpox?== | ==What are the symptoms of Chickenpox?== | ||
Most children with [[chickenpox]] act sick with vague symptoms, such as a [[fever]], [[headache]], [[tummy ache]], or [[loss of appetite]], for a day or two before breaking out in the classic pox [[rash]]. These symptoms last 2 to 4 days after breaking out. | Most children with [[chickenpox]] act sick with vague symptoms, such as a [[fever]], [[headache]], [[tummy ache]], or [[loss of appetite]], for a day or two before breaking out in the classic pox [[rash]]. These symptoms last 2 to 4 days after breaking out. | ||
The average child develops 250 to 500 small, itchy, fluid-filled [[blisters]] over red spots on the skin (“dew drops on a rose petal”). The [[blisters]] often appear first on the [[face]], trunk, or [[scalp]] and spread from there. Appearance of the small [[blisters]] on the [[scalp]], found in 80% of cases, clinches the [[diagnosis]]. After a day or two, the [[blisters]] become cloudy and then [[scab]]. Meanwhile, new crops of [[blisters]] spring up in groups. The pox often appear in the [[mouth]], in the [[vagina]], and on the [[eyelids]]. Children with skin problems such as [[eczema]] may get more than 1,500 pox. | The average child develops 250 to 500 small, itchy, fluid-filled [[blisters]] over red spots on the skin (“dew drops on a rose petal”). The [[blisters]] often appear first on the [[face]], trunk, or [[scalp]] and spread from there. Appearance of the small [[blisters]] on the [[scalp]], found in 80% of cases, clinches the [[diagnosis]]. After a day or two, the [[blisters]] become cloudy and then [[scab]]. Meanwhile, new crops of [[blisters]] spring up in groups. The pox often appear in the [[mouth]], in the [[vagina]], and on the [[eyelids]]. Children with skin problems such as [[eczema]] may get more than 1,500 pox. | ||
Most pox will not leave [[scars]] unless they become contaminated with [[bacteria]] from scratching. | Most pox will not leave [[scars]] unless they become contaminated with [[bacteria]] from scratching. | ||
Some children who have had the [[vaccine]] will still develop a mild case of [[chickenpox]]. They usually recover much quicker and only have a few pox (< 30). These often do not follow the classic descriptions of the [[disease]]. However, these mild, post-vaccine cases are [[contagious]]. | Some children who have had the [[vaccine]] will still develop a mild case of [[chickenpox]]. They usually recover much quicker and only have a few pox (< 30). These often do not follow the classic descriptions of the [[disease]]. However, these mild, post-vaccine cases are [[contagious]]. | ||
==What are the causes of Chickenpox?== | ==What are the causes of Chickenpox?== | ||
In a typical scenario, a young child is covered in pox and out of school for a week. The first half of the week the child feels miserable from intense itching; the second half from boredom. Since the introduction of the [[chickenpox vaccine]], classic [[chickenpox]] is much less common. | In a typical scenario, a young child is covered in pox and out of school for a week. The first half of the week the child feels miserable from intense itching; the second half from boredom. Since the introduction of the [[chickenpox vaccine]], classic [[chickenpox]] is much less common. | ||
[[Chickenpox]] is extremely contagious, and can be spread by direct contact, droplet transmission, and airborne transmission. Even those with mild illness after the [[vaccine]] may be [[contagious]]. | [[Chickenpox]] is extremely contagious, and can be spread by direct contact, droplet transmission, and airborne transmission. Even those with mild illness after the [[vaccine]] may be [[contagious]]. | ||
When someone becomes infected, the pox usually appear 10 to 21 days later. People become [[contagious]] 1 to 2 days before breaking out with pox. They remain contagious while uncrusted blisters are present. | When someone becomes infected, the pox usually appear 10 to 21 days later. People become [[contagious]] 1 to 2 days before breaking out with pox. They remain contagious while uncrusted blisters are present. | ||
Once you catch [[chickenpox]], the [[virus]] usually remains in your body for your lifetime, kept in check by the [[immune system]]. About 1 in 10 adults will experience [[shingles]] when the [[virus]] re-emerges during a period of [[stress]]. | Once you catch [[chickenpox]], the [[virus]] usually remains in your body for your lifetime, kept in check by the [[immune system]]. About 1 in 10 adults will experience [[shingles]] when the [[virus]] re-emerges during a period of [[stress]]. | ||
Most cases of [[chickenpox]] occur in children younger than ten. The disease is usually mild, although serious complications sometimes occur. Adults and older children usually get sicker than younger children do. | Most cases of [[chickenpox]] occur in children younger than ten. The disease is usually mild, although serious complications sometimes occur. Adults and older children usually get sicker than younger children do. | ||
Children under one year of age whose mothers have had [[chickenpox]] are not very likely to catch it. If they do, they often have mild cases because they retain partial [[immunity]] from their mothers' blood. Children under one year of age whose mothers have not had [[chickenpox]], or whose inborn [[immunity]] has already waned, can get severe [[chickenpox]]. | Children under one year of age whose mothers have had [[chickenpox]] are not very likely to catch it. If they do, they often have mild cases because they retain partial [[immunity]] from their mothers' blood. Children under one year of age whose mothers have not had [[chickenpox]], or whose inborn [[immunity]] has already waned, can get severe [[chickenpox]]. | ||
The pox are worse in children who have other skin problems, such as [[eczema]] or a recent [[sunburn]]. | The pox are worse in children who have other skin problems, such as [[eczema]] or a recent [[sunburn]]. | ||
Complications are more common in those who are immunocompromised from an illness or medicines like [[chemotherapy]]. Some of the worst cases of [[chickenpox]] have been seen in children who have taken [[steroids]] during the incubation period, before they have any symptoms. | Complications are more common in those who are immunocompromised from an illness or medicines like [[chemotherapy]]. Some of the worst cases of [[chickenpox]] have been seen in children who have taken [[steroids]] during the incubation period, before they have any symptoms. | ||
| Line 59: | Line 48: | ||
==Treatment options== | ==Treatment options== | ||
In most cases, it is enough to keep children comfortable while their own bodies fight the illness. Oatmeal baths in lukewarm water provide a crusty, comforting coating on the skin. An oral [[antihistamine]] can help to ease the [[itching]], as can topical lotions. Lotions containing [[antihistamines]] are not proven more effective. Trim the fingernails short to reduce secondary infections and scarring. | In most cases, it is enough to keep children comfortable while their own bodies fight the illness. Oatmeal baths in lukewarm water provide a crusty, comforting coating on the skin. An oral [[antihistamine]] can help to ease the [[itching]], as can topical lotions. Lotions containing [[antihistamines]] are not proven more effective. Trim the fingernails short to reduce secondary infections and scarring. | ||
Safe [[antiviral]] medicines have been developed. To be effective, they usually must be started within the first 24 hours of the rash. For most otherwise healthy children, the benefits of these medicines may not outweigh the costs. Adults and teens, at risk for more severe symptoms, may benefit if the case is seen early in its course | Safe [[antiviral]] medicines have been developed. To be effective, they usually must be started within the first 24 hours of the rash. For most otherwise healthy children, the benefits of these medicines may not outweigh the costs. Adults and teens, at risk for more severe symptoms, may benefit if the case is seen early in its course | ||
In addition, for those with skin conditions (such as [[eczema]] or recent [[sunburn]]), lung conditions (such as [[asthma]]), or those who have recently taken [[steroids]], the [[antiviral]] medicines may be very important. The same is also true for adolescents and children who must take [[aspirin]] on an ongoing basis. | In addition, for those with skin conditions (such as [[eczema]] or recent [[sunburn]]), lung conditions (such as [[asthma]]), or those who have recently taken [[steroids]], the [[antiviral]] medicines may be very important. The same is also true for adolescents and children who must take [[aspirin]] on an ongoing basis. | ||
Some doctors also give [[antiviral]] medicines to people in the same household who subsequently come down with [[chickenpox]]. Because of their increased exposure, they would normally experience a more severe case of [[chickenpox]]. | Some doctors also give [[antiviral]] medicines to people in the same household who subsequently come down with [[chickenpox]]. Because of their increased exposure, they would normally experience a more severe case of [[chickenpox]]. | ||
| Line 76: | Line 62: | ||
==Prevention of Chickenpox== | ==Prevention of Chickenpox== | ||
Because [[chickenpox]] is airborne and very contagious before the rash appears, it is difficult to avoid. It is possible to catch [[chickenpox]] from someone on a different aisle in the supermarket, who doesn’t even know they have [[chickenpox]]! | Because [[chickenpox]] is airborne and very contagious before the rash appears, it is difficult to avoid. It is possible to catch [[chickenpox]] from someone on a different aisle in the supermarket, who doesn’t even know they have [[chickenpox]]! | ||
A [[chickenpox vaccine]] is part of the routine [[immunization]] schedule. It is about 100% effective against moderate or severe illness, and 85-90% effective against mild [[chickenpox]]. Parents often express concern that the [[immunity]] from the [[vaccine]] might not last. The [[chickenpox vaccine]], though, is the only routine [[vaccine]] that does not require a booster. However, a higher dose of the [[vaccine]] given later in life may reduce the incidence of [[herpes zoster]] ([[shingles]]). Reimmunization with the high dose is currently being considered by [[vaccination]] experts. | A [[chickenpox vaccine]] is part of the routine [[immunization]] schedule. It is about 100% effective against moderate or severe illness, and 85-90% effective against mild [[chickenpox]]. Parents often express concern that the [[immunity]] from the [[vaccine]] might not last. The [[chickenpox vaccine]], though, is the only routine [[vaccine]] that does not require a booster. However, a higher dose of the [[vaccine]] given later in life may reduce the incidence of [[herpes zoster]] ([[shingles]]). Reimmunization with the high dose is currently being considered by [[vaccination]] experts. | ||
Talk to your doctor if you think your child might be at high risk for complications and might have been exposed. Immediate preventive measures may be important. [[Vaccine]] given early after exposure may still reduce the severity of the disease. | Talk to your doctor if you think your child might be at high risk for complications and might have been exposed. Immediate preventive measures may be important. [[Vaccine]] given early after exposure may still reduce the severity of the disease. | ||
Revision as of 14:00, 30 July 2011
For the WikiDoc page for this topic, click here Template:DiseaseDisorder infobox
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Alexandra M. Palmer
Overview
Chickenpox is one of the classic childhood diseases. It is also one of the most contagious diseases. The affected child or adult may develop hundreds of itchy, fluid-filled blisters that burst and form crusts. Chickenpox is caused by a virus. The virus that causes chickenpox is varicella-zoster, a member of the herpes virus family. The same virus also causes shingles (herpes zoster) in adults.
What are the symptoms of Chickenpox?
Most children with chickenpox act sick with vague symptoms, such as a fever, headache, tummy ache, or loss of appetite, for a day or two before breaking out in the classic pox rash. These symptoms last 2 to 4 days after breaking out. The average child develops 250 to 500 small, itchy, fluid-filled blisters over red spots on the skin (“dew drops on a rose petal”). The blisters often appear first on the face, trunk, or scalp and spread from there. Appearance of the small blisters on the scalp, found in 80% of cases, clinches the diagnosis. After a day or two, the blisters become cloudy and then scab. Meanwhile, new crops of blisters spring up in groups. The pox often appear in the mouth, in the vagina, and on the eyelids. Children with skin problems such as eczema may get more than 1,500 pox. Most pox will not leave scars unless they become contaminated with bacteria from scratching. Some children who have had the vaccine will still develop a mild case of chickenpox. They usually recover much quicker and only have a few pox (< 30). These often do not follow the classic descriptions of the disease. However, these mild, post-vaccine cases are contagious.
What are the causes of Chickenpox?
In a typical scenario, a young child is covered in pox and out of school for a week. The first half of the week the child feels miserable from intense itching; the second half from boredom. Since the introduction of the chickenpox vaccine, classic chickenpox is much less common. Chickenpox is extremely contagious, and can be spread by direct contact, droplet transmission, and airborne transmission. Even those with mild illness after the vaccine may be contagious. When someone becomes infected, the pox usually appear 10 to 21 days later. People become contagious 1 to 2 days before breaking out with pox. They remain contagious while uncrusted blisters are present. Once you catch chickenpox, the virus usually remains in your body for your lifetime, kept in check by the immune system. About 1 in 10 adults will experience shingles when the virus re-emerges during a period of stress. Most cases of chickenpox occur in children younger than ten. The disease is usually mild, although serious complications sometimes occur. Adults and older children usually get sicker than younger children do. Children under one year of age whose mothers have had chickenpox are not very likely to catch it. If they do, they often have mild cases because they retain partial immunity from their mothers' blood. Children under one year of age whose mothers have not had chickenpox, or whose inborn immunity has already waned, can get severe chickenpox. The pox are worse in children who have other skin problems, such as eczema or a recent sunburn. Complications are more common in those who are immunocompromised from an illness or medicines like chemotherapy. Some of the worst cases of chickenpox have been seen in children who have taken steroids during the incubation period, before they have any symptoms.
Who is at highest risk?
Since chickenpox is contagious, anyone in close proximity to someone with the disease is at risk.
How to know you have Chickenpox?
Chickenpox is usually diagnosed from the classic rash and the child's medical history. Blood tests, and tests of the pox blisters themselves, can confirm the diagnosis if there is any question.
When to seek urgent medical care
Call your health care provider 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
In most cases, it is enough to keep children comfortable while their own bodies fight the illness. Oatmeal baths in lukewarm water provide a crusty, comforting coating on the skin. An oral antihistamine can help to ease the itching, as can topical lotions. Lotions containing antihistamines are not proven more effective. Trim the fingernails short to reduce secondary infections and scarring. Safe antiviral medicines have been developed. To be effective, they usually must be started within the first 24 hours of the rash. For most otherwise healthy children, the benefits of these medicines may not outweigh the costs. Adults and teens, at risk for more severe symptoms, may benefit if the case is seen early in its course In addition, for those with skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or those who have recently taken steroids, the antiviral medicines may be very important. The same is also true for adolescents and children who must take aspirin on an ongoing basis. Some doctors also give antiviral medicines to people in the same household who subsequently come down with chickenpox. Because of their increased exposure, they would normally experience a more severe case of chickenpox.
DO NOT USE ASPIRIN for someone who may have chickenpox. Use of aspirin has been associated with Reyes Syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen may be used.
Diseases with similar symptoms
Where to find medical care for Chickenpox
Directions to Hospitals Treating Chickenpox
Prevention of Chickenpox
Because chickenpox is airborne and very contagious before the rash appears, it is difficult to avoid. It is possible to catch chickenpox from someone on a different aisle in the supermarket, who doesn’t even know they have chickenpox! A chickenpox vaccine is part of the routine immunization schedule. It is about 100% effective against moderate or severe illness, and 85-90% effective against mild chickenpox. Parents often express concern that the immunity from the vaccine might not last. The chickenpox vaccine, though, is the only routine vaccine that does not require a booster. However, a higher dose of the vaccine given later in life may reduce the incidence of herpes zoster (shingles). Reimmunization with the high dose is currently being considered by vaccination experts. Talk to your doctor if you think your child might be at high risk for complications and might have been exposed. Immediate preventive measures may be important. Vaccine given early after exposure may still reduce the severity of the disease.
What to expect (Outlook/Prognosis)
The outcome is generally excellent in uncomplicated cases. Encephalitis, pneumonia, and other invasive bacterial infections are serious, but rare, complications of chickenpox.