CHICKENPOX

What Is Chickenpox?
Also known as varicella, chickenpox is a virus that often
affects children. It is characterized by itchy, red blisters that
appear all over the body. Chickenpox was once so common it
was considered a childhood rite of passage. It is very rare to
have the chickenpox infection more than once.

Since the chickenpox vaccine was introduced in the mid-

1990s, cases have declined.

What Are the Symptoms of the

Chickenpox?

A rash is the most common symptom of the chickenpox.

However, you will be contagious several days before the rash
develops and will experience other symptoms first, such as:

 fever
 headache
 loss of appetite
About two days after you experience the symptoms
mentioned above, the rash will begin to develop. The rash
goes through three different phases before you recover from
the virus. These phases include:
 developing red or pink bumps all over your body
 bumps filled with fluid that leak
 bumps that scab over and begin to heal
The bumps on your body will not all be in the same phase at
the same time. New bumps will appear throughout your
infection. You are still contagious until all the bumps on your
body have scabbed over.

What Causes Chickenpox?

The varicella-zoster virus causes the chickenpox infection.

Most cases occur through contact with an infected person.
The virus may be contagious several days before blisters
appear, and it remains contagious until all blisters have
crusted over. It is spread through:

 saliva
 coughing
 sneezing
 contact with blisters

Who Is at Risk of Developing the Chicken

Pox?

Exposure to the virus through previous infection, vaccination,

or immunity passed from mother to newborn (immunity lasts
about three months from birth) reduces risk. Anyone who has
 not been exposed may contract the virus. Risk increases
under any of these conditions:

 You have had recent contact with an infected individual.

 You are under 12 years of age.
 You are an adult residing with children.
 You have spent time in a school or childcare facility.
 Your immune system is compromised due to illness or
medications.

How Is the Chickenpox Diagnosed?

You should always call your doctor any time you develop an
unexplained rash, especially if it is accompanied by cold
symptoms or fever. You could be affected by one of several
viruses or infections. Tell your doctor right away if you are
exposed to chickenpox while pregnant.

Many cases of chickenpox are diagnosed based on physical

exam of blisters on your (or your child’s) body. If a diagnosis
can’t be made, lab tests will confirm the cause of the blisters.

What Are Possible Complications of the

Chickenpox?

Call your doctor right away if:

 the rash spreads to your eyes

 the rash is tender and warm (signs of a bacterial
infection)
 the rash is accompanied by dizziness or shortness of
breath
When complications occur, they most often affect:

 infants
 elderly patients
 patients with weak immune systems
 pregnant women
These groups may also suffer from infections of the skin or
lungs, arthritis, or transient synovitis. Women exposed during
pregnancy may bear children with birth defects, including:

 poor growth
 small head size
 eye problems
 intellectual disabilities

How Is the Chickenpox Treated?

Most people who are diagnosed with chickenpox will be

advised to manage their symptoms while they’re waiting for
the virus to pass through the system. Parents will be told to
keep children out of school and daycare to prevent spread of
the virus. Infected adults will also be told to stay home.

Antihistamine medications or topical ointments may be

prescribed or purchased over the counter to relieve itching.
You can also soothe itching skin by:
 taking lukewarm baths
 applying unscented lotion
 wearing lightweight, soft clothing
High-Risk Patients
Antiviral drugs may be prescribed to those who experience
complications from the virus, or who are at risk for adverse
effects. High-risk patients are usually young, elderly, or have
underlying medical issues. These antiviral drugs do not cure
chickenpox. Instead, they make the symptoms less severe,
and make your body more likely to heal faster.

What Is the Long-Term Outlook?

Most cases of chickenpox resolve themselves. Patients
usually return to normal activities within one to two weeks of
diagnosis.

Chickenpox Immunity
Once chickenpox heals, most people become immune to the
virus, as varicella-zoster stays dormant in the body. In rare
cases, it may re-emerge. It is more common for shingles, a
separate disorder triggered by varicella-zoster, to present
during adulthood. If the patient’s immune system is
temporarily weakened (possibly due to advanced age or
illness), varicella-zoster may reactivate in the form of
shingles.

How Can the Chickenpox Be Prevented?

The chickenpox vaccine prevents chickenpox in 90 percent of
children who receive it. The shot should be given when your
child is between 12 and 15 months of age. A booster is given
between 4 and 6 years of age. Older children and adults who
have not been vaccinated or exposed may receive catch-up
doses of the vaccine. As chickenpox tends to be more severe
in older patients, parents who did not previously vaccinate
may opt to have the shots given later.
People who are unable to receive the vaccine can try to avoid
the virus by limiting contact with infected people. This can be
difficult, as chickenpox can’t be identified by blisters until it
has been contagious for days.

About Chickenpox
Chickenpox used to be a common childhood illness in the United States, especially in kids under age
12. It's much rarer now, thanks to the varicella vaccine that's given when kids are between 12 and 15
months old, followed by a booster shot at 4 to 6 years of age.
Caused by the varicella-zoster virus (VZV), chickenpox is very contagious. Kids who do get it might
have an itchy rash of spots all over the body and flu-like symptoms. An infected child should stay
home and rest until the rash is gone.
Kids can be protected by getting the vaccine, which greatly reduces their chances of getting
chickenpox. And vaccinated kids who do get chickenpox tend to have milder cases and quicker
recoveries compared with those who get it and weren't immunized.

Symptoms

Chickenpox often starts with a fever, headache, sore throat, or stomachache. These symptoms may
last for a few days, with the fever in the 101°-102°F (38.3°-38.8°C) range.

Chickenpox causes a red, itchy skin rash that usually appears first on the abdomen or back and face,
and then spreads to almost everywhere else on the body, including the scalp, mouth, arms, legs, and
genitals.

The rash begins as multiple small red bumps that look like pimples or insect bites, usually less than a
quarter of an inch wide. They appear in crops over 2 to 4 days and develop into thin-walled blisters
filled with fluid. The blister walls break, leaving open sores, which finally crust over to become dry,
brown scabs. The rash is very itchy, and cool baths or calamine lotion may help to manage the itching.

A hallmark of chickenpox is that all stages (red bumps, blisters, and scabs) can appear on the body at
the same time. The rash may be more extensive or severe in kids who have skin disorders
like eczemaor weak immune systems. Young kids tend to have a mild illness with fewer blisters than
older children or adults.
In rare cases, serious bacterial infections involving the skin, lungs, bones, joints, and the brain can
happen

Risk of Shingles
Anyone who has had chickenpox is at risk for developing a skin condition called shingles (herpes
zoster) later in life. After someone has had chickenpox, the virus stays dormant (sleeping) in the
nervous system for the rest of his or her life, even though the chickenpox goes away. The virus can
reactivate ("wake up") later as shingles. Symptoms include tingling, itching, or pain in one area of the
body, followed by a rash with red bumps and blisters.
Luckily, kids and teens almost always have mild cases; severe shingles cases usually affect older
people.

Kids who are vaccinated against chickenpox are much less likely to develop shingles when they get
older. If it does happen, the case of shingles is usually milder and less likely to cause complications
than in someone who wasn't immunized.

 Contagiousness

The chickenpox virus spreads both through the air (by coughing and sneezing) and by direct contact
with mucus, saliva (spit), or fluid from the blisters. Chickenpox is contagious from about 2 days before
the rash appears until all the blisters are crusted over.

A child with chickenpox should be kept out of school until all blisters have dried, usually about 1 week.
If you're unsure about whether your child is ready to return to school, ask your doctor.

Chickenpox is very contagious — most kids with a sibling who's been infected also will get it (if they
haven't already had the disease or the vaccine), showing symptoms about 2 weeks after the first child
does. To help keep it from spreading, make sure your kids wash their hands often, particularly before
eating and after using the bathroom. 

People who haven't had chickenpox or the vaccine also can catch it from someone with shingles, but
they cannot catch shingles itself. That's because shingles can only develop from a reactivation of VZV
in someone who has previously had chickenpox.
High-Risk Groups

Certain groups of people are more at risk for complications from chickenpox, including pregnant
women and anyone with immune system problems. These groups should avoid anyone who has
chickenpox.

If a pregnant woman who hasn't had chickenpox in the past develops it (especially in the first 20
weeks of pregnancy), the fetus is at risk for birth defects and the mother is at risk for more health
complications than if she'd been infected when she wasn't pregnant. If she develops chickenpox just
before or after the child is born, the newborn is at risk for serious health complications. There is no
risk to a developing baby if the mother develops shingles during pregnancy.

If a pregnant woman has had chickenpox before the pregnancy, the baby will be protected from
infection for the first few months of life, since the mother's immunity gets passed on to the baby
through the placenta and breast milk.

Those at risk for severe disease or serious complications — such as newborns whose mothers had
chickenpox at the time of delivery, patients with leukemia or immune deficiencies, and kids receiving
drugs that suppress the immune system — may be given a medicine after exposure to chickenpox to
reduce its severity.

Prevention

The chickenpox vaccine is 99% effective at preventing the VZV infection in kids. Doctors recommend
that kids receive the chickenpox vaccine twice:

1. a first injection when they're 12 to 15 months old

2. a booster shot when they're 4 to 6 years old

People 13 years of age and older who have never had chickenpox or haven't gotten the vaccine should
receive two doses of the vaccine at least 28 days apart to be protected. While few people who've been
vaccinated actually develop chickenpox, those who do tend to develop very mild cases of the condition
and recover quickly.

Healthy kids who have had chickenpox do not need the vaccine — they usually have lifelong protection
against the illness.
Treatment

Since a virus causes chickenpox, doctors won't prescribe antibiotics to treat it. However, antibiotics
may be required if the sores become infected by bacteria. This is pretty common among kids because
they often scratch and pick at the blisters.

An antiviral medicine might be prescribed for people with chickenpox who are at risk for complications.
The decision to use this will depend on a child's age and health, the extent of the infection, and the
timing of the treatment. Your doctor can tell you if the medicine is right for your child.

Dealing With Discomfort

To help relieve the itchiness, fever, and discomfort of chickenpox:

 Use cool wet compresses or give baths in cool or lukewarm water every 3 to 4 hours for the
first few days. Oatmeal bath products, available at supermarkets and drugstores, can help to
relieve itching. (Baths do not spread the rash.)

 Pat (don't rub) the body dry.

 Put calamine lotion on itchy areas (but don't use it on the face, especially near the eyes).

 Serve foods that are cold, soft, and bland because chickenpox in the mouth can make drinking
or eating difficult. Avoid feeding your child anything highly acidic or especially salty, like orange
juice or pretzels.

 Ask your doctor or pharmacist about pain-relieving creams to apply to sores in the genital
area.

 Give your child acetaminophen regularly to help relieve pain if your child has mouth blisters.

 Ask the doctor about using over-the-counter medicine for itching.

Never use aspirin to reduce pain or fever in kids with chickenpox because aspirin has been
associated with a rare but serious disease, Reye syndrome, which can lead to liver failure and even
death.
As much as possible, discourage kids from scratching. This can be difficult for them, so consider
putting mittens or socks on your child's hands to prevent scratching during sleep. Also, trim fingernails
and keep them clean to help lessen the effects of scratching, including broken blisters and infection.

Most chickenpox infections don't need special medical treatment. But sometimes, there are problems.
Call the doctor if your child:

 has fever that lasts for more than 4 days or rises above 102°F (38.8°C)
 has a severe cough or trouble breathing
 has an area of rash that leaks pus (thick, yellowish fluid) or becomes red, warm, swollen, or
sore
 has a severe headache
 is unusually drowsy or has trouble waking up
 has trouble looking at bright lights
 has difficulty walking
 seems confused
 seems very ill or is vomiting
 has a stiff neck

Call your doctor if you think your child has chickenpox and you have a question or are concerned
about a possible complication. The doctor can guide you in watching for complications and in choosing
medicine to ease itching.

If you take your child to the doctor, let the office know in advance that your child might have
chickenpox. It's important to try to avoid exposing other kids in the office — for some of them, a
chickenpox infection could cause severe complications.

Medicinal……………………………………….
Infectious Diseases / Bacteria / Viruses

Chickenpox: Symptoms, Causes, and

Prevention
Chickenpox (chicken pox), also known as varicella, is a highly contagious
infection caused by the varicella zoster virus. Although uncomfortable, most
people recover within 1-2 weeks.

Patients develop a blister-like rash, which first appears on the face and trunk, and then
spreads throughout the body. Although not life-threatening, complications can arise.

In this article, we will cover the causes, diagnosis, treatment, and the chickenpox
vaccine.

Contents of this article:

 What is chickenpox?
 Symptoms
 Causes
 Diagnosis
 Treatments
 Possible complications
 Prevention
Fast facts on chickenpox
Here are some key points about chickenpox. More detail and supporting information is
in the main article.
 Chickenpox is caused by the varicella zoster virus

 Varicella has an incubation period of 10-21 days

 Chickenpox is highly contagious

 The infection spreads in a similar way to colds and flu

 A diagnosis can normally be reached by simply observing the signs and symptoms

What is chickenpox?

The itchy rash is one of the most common signs of chickenpox

Chickenpox is mostly transmitted by direct contact with the blisters of someone who has
the varicella zoster virus, or by breathing in the virus particles from someone's blisters.

It can also be transmitted by small particles from the mouth of someone talking or
coughing.
The condition is characterized by a rash; people who develop symptoms can get 250-
500 itchy blisters.

In the majority of cases, the pox marks heal up without scarring.

An infected person is contagious about 2 days before the rash appears, and then
continues being so for another 5-7 days or until all of the blisters have become scabs.

When all the lesions have crusted over, they can no longer pass it on to others.
Individuals with weakened immune systems may be contagious for longer.

Varicella has an incubation period of between 10 and 21 days - i.e. the rash will appear
from 10 to 21 days after the patient has been exposed to the virus.

A vaccine is available for varicella. For children, 2 doses of the varicella vaccine (one
given at 12-15 months and one given at age 4-6) are 90 percent effective at preventing
chickenpox.

Symptoms of chickenpox
The following signs and symptoms are common in chickenpox:

Before the rash appears

 A general feeling of being unwell (malaise)

 Fever (usually worse in adults than children)

 Aching muscles

 Loss of appetite

 Sometimes there may be a feeling of nausea

The above symptoms are then followed by:

 An itchy rash - its severity varies considerably. Some patients may have just a few
spots, while others are covered all over the body.

 The spots, which develop in clusters, generally appear on the face, on the limbs, on
the chest, and stomach.
 Initially, there are small red spots that itch a lot. They then develop into spots with
blisters on top - these can become very itchy.

 Within about 48 hours, the blisters cloud over and start drying out (a crust develops).

 Within about 10 days, the crusts fall off on their own.

During the whole cycle, new waves of spots can appear - in such cases, the patient
might have different clusters of spots at varying stages of itchiness, dryness, and
crustiness.

More severe and unusual chickenpox symptoms

Most healthy individuals make a full recovery, as is the case with a cold or flu - just by
resting and drinking plenty of fluids. A small percentage of patients have more severe
symptoms.

If the following symptoms emerge, a doctor should be contacted:

 The skin around the spots and/or blisters becomes painful and red

 There are breathing difficulties

Causes of chickenpox
Chickenpox is caused by a virus called varicella zoster. People become infected after
being in contact with an infected child or adult.

Chickenpox is one of the most infectious diseases - people who have never had
chickenpox and have never been vaccinated are at the highest risk of infection.

Chickenpox, colds, and flu spread in a similar way. People can be infected by touching
the blisters directly; infection can also occur from breathing in particles of the virus from
the blisters or from the air around someone who is infected.

Shingles
Chicken pox and shingles are caused by the same virus. Shingles occurs when the
varicella zoster virus from a previous case of chicken pox becomes active again.
Although you cannot catch shingles, a person who has never had chickenpox or was
never vaccinated can catch chickenpox from someone with shingles. However, you
cannot get shingles from somebody with chickenpox.

Diagnosing chickenpox
A doctor or nurse will know whether a child or adult has chickenpox just by looking and
asking a couple of questions. No medical tests are required to aid in the diagnosis. On
rare occasions, chickenpox may be confused with scabies or some types of insect bites.

Treatments for chickenpox

It is important for the patient to drink plenty of fluids to prevent dehydration and aid recovery.

Chickenpox generally resolves within a week or two without treatment - there is no

medication or treatment to "cure" it.

A doctor may prescribe or advise on how to reduce symptoms of itchiness and

discomfort, and also on how to prevent the infection from spreading to other people.
Pain or fever - Tylenol (acetaminophen) may help with symptoms of high temperature
and/or pain. It is important to follow the instructions provided by the manufacturer.
Aspirin containing products should NOT be used for chickenpox as this can lead
to complications.

Pregnant women can take acetaminophen (Tylenol) at any time during their pregnancy.

Avoiding dehydration - the patient should drink plenty of fluids, preferably water, to
prevent dehydration. Some doctors recommend sugar-free popsicles or Pedialyte for
children who are not drinking enough.
Mouth soreness - sugar-free popsicles help ease symptoms of soreness if there are
spots in the mouth. Salty or spicy foods should be avoided. If chewing is painful, soup
might be a good option; make sure it is not too hot.
Itchiness - although itchiness can become severe and the urge to scratch may seem
impossible to control, it is important to keep scratching down to a minimum to prevent
future scarring of the skin. The following may help if you have a child with chickenpox:
 Keep fingernails as short as possible
 Keep fingernails clean at all times

 Place mittens or even socks over the child's hands when they go to sleep so that any
attempt at scratching during the night does not cut the skin

 Calamine lotions or oatmeal baths may help reduce symptoms of itching

 Make sure the patient wears only loose clothing

Antiviral medication - may be prescribed to pregnant females, adults if diagnosis is

made early enough, newborns, and patients with weakened immune systems. An
example of such a drug is Acyclovir.

This medication works best if it is given within 24 hours of developing symptoms.

Acyclovir reduces the severity of symptoms but does not cure the disease.

Possible complications from chickenpox

Adults are more susceptible to complications than children, but even in adults they are
rare. If the blisters become infected with bacteria, the risk of complications is greater.
Pregnant women, newborns, and infants up to 4 weeks of age, as well as those with
weakened immune systems, are more likely to suffer complications.

If the skin around the spots and blisters becomes red and tender/sore, they may have
become infected.

Some people with chickenpox can go on to develop pneumonia.

Even though complications are possible, most patients who have them make a full
recovery.

Chickenpox and pregnancy

A pregnant woman has a slightly higher risk of developing pneumonia if she has
chickenpox. There is also a risk of passing the infection on to the unborn baby.
Becoming infected during the first 20 weeks of pregnancy raises the risk of the fetus
developing fetal varicella syndrome, which can lead to scarring, eye problems, brain
drainage, and shortened arms and/or legs.
If the infection happens later in pregnancy, there is a risk that the varicella may be
transmitted directly to the baby and the baby can be born with varicella. If you become
exposed to varicella (chicken pox or shingles) while pregnant, talk to a doctor right
away.

Weakened immune systems - people with weakened immune systems could be taking
certain medications, may be suffering from cancer, or undergoing treatments, such as
radio- or chemotherapy, or have a chronic condition, such
as lupus or rheumatoid arthritis.

Complications from chickenpox may include meningitis, blood poisoning (septicemia), or

pneumonia.

Preventing chickenpox
Chickenpox vaccine - countries vary in their recommendations for the chickenpox
vaccination. Vaccination usage is much more widespread in the U.S. than in the U.K.
and many parts of Europe. In the U.K., it is recommended for certain people, such as
healthcare workers (not already immune), and those living with somebody whose
immune system is weak.

In the U.S., the chickenpox vaccine is routinely given to children

What is chickenpox?
Chickenpox (varicella) is a contagious illness that causes an itchy rash and red spots
or blisters (pox) all over the body. Chickenpox 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.
Chickenpox usually isn't a serious health problem in healthy children. But a child with
chickenpox needs to stay home from school. And you may need to miss work in order to care for
your child.
After you have had chickenpox, you aren't 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.
What causes chickenpox, and how is it
spread?
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 haven't had the chickenpox
vaccine. If someone you live with gets chickenpox, your risk is even higher because of the close
contact.

What are the symptoms?

The first symptoms of chickenpox usually develop about 14 to 16 days after contact with a
person infected with the virus. Most people feel sick and have a fever, a decreased appetite,
a headache, a cough, and a sore throat. The itchy chickenpox rash usually appears about 1 or 2
days after the first symptoms start.
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.
It usually takes about 10 days after the first symptoms before all blisters have crusted over. This
is when the person with chickenpox can return to day care, school, or work.

How is chickenpox diagnosed?

Your doctor will ask you about your symptoms and will examine you. This usually gives your
doctor enough information to find out if you have chickenpox.
A healthy child with chickenpox symptoms may not need to visit a doctor. You may be able to
describe your child's symptoms to the doctor over the phone.
Teenagers, adults, pregnant women, and people with health problems need to see a doctor for
chickenpox. This is especially important for pregnant women, since chickenpox during
pregnancy can cause birth defects or serious newborn infection.

How is it treated?
Most healthy children and adults need only home treatment for chickenpox. Home treatment
includes resting and taking medicines to reduce fever and itching. You also can soak in oatmeal
baths to help with itching.
People with long-term diseases or other health problems may need more treatment for
chickenpox. They may need immunoglobulin treatment (IG) or antiviral medicine. Your doctor
can give you these soon after you are exposed to the virus to help you feel better sooner.

How can you prevent chickenpox?

You can prevent chickenpox with the chickenpox vaccine. Children get the chickenpox vaccine
as part of their routine immunizations.
If you have been around a person who has the virus and you have not had chickenpox or
the vaccine, you still may be able to prevent the illness. Get a shot of chickenpox antibodies
(immunoglobulin) or the vaccine right away