Chickenpox (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Alexandra M. Palmer

Overview[edit | edit source]

Chickenpox infection is caused by a virus in which a person develops extremely itchy blisters all over the body. It was considered to be one of the classic diseases of the children until the development of the chickenpox vaccine.

What are the symptoms of Chickenpox?[edit | edit source]

• Most children with chickenpox have the following symptoms before the rash appears:
  • Fever
  • Headache
  • Loss of appetite
  • Fatigue
  • Malaise

• 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 associated with intense itch.

• After one or two days, the blisters become cloudy and form scabs. The newly formed blisters occur in groups. They are usually seen on the eyelids, in the mouth and in the vagina.

• Numerous blisters are observed in children suffering from eczema.

• Scars are usually not formed unless the pox is infected with bacteria from scratching.

• Despite receiving a vaccine, some children may still develop a mild case of chickenpox. Recovery is usually much quicker and they are left with only a few pox (fewer than 30). Such cases are often harder to diagnose. These children can still spread chickenpox to others.

What causes Chickenpox?[edit | edit source]

• In children, chickenpox is caused by the varicella-zoster virus of Herpes virus family. The same virus also causes herpes zoster (shingles) in adults.

• Chickenpox spreads easily to others by touching the fluids from a chickenpox blister, or if someone with chickenpox in the vicinity coughs or sneezes. People with mild illness may be contagious.

• An individual with chickenpox is contagious one to two days even before the blisters appear. Infected individuals remain contagious until all the blisters have turned into crusts.

• Most cases of chickenpox are observed in children younger than ten years old. The disease is usually mild, although serious complications sometimes occur. Older children and adolescents usually get sicker than younger children.

• Children born to mothers who have had chickenpox or who have received the chickenpox vaccine are not very likely to get chickenpox before they are 1 year old. If in case the children get chickenpox, it's often a mild form. The reason for this would be the antibodies from their mother's blood help protect the children. Children under 1-year old whose mothers have not had chickenpox in their lifetime or if they hadn't received the vaccination against chickenpox can get severe chickenpox.

• Suffering from illness or the use of medications such as in chemotherapy and the use of steroids may lead severe chickenpox symptoms more commonly in children whose immune system is compromised.

Who is at highest risk?[edit | edit source]

As chickenpox is contagious, anyone in close proximity to someone with the disease is at risk.

Diagnosis[edit | edit source]

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.

When to seek urgent medical care?[edit | edit source]

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[edit | edit source]

Treatment involves keeping the person as comfortable as possible. Here are things to try:

• It is advisable to avoid scratching or rubbing the itchy areas.
• Keeping the fingernails short in order to avoid damaging the skin from scratching.

• Prefer wearing light and loose clothes and avoid wearing rough and heavy clothes over an itchy area which may lead to an urge to scratch.

• Lukewarm baths are preferred using mild and small quantities of soap and rinse thoroughly after a bath is advised. Oatmeal or cornstarch baths are traditionally had a skin-soothing experience.

• A soothing moisturizer application after a bath is advised to soften and cool the skin.

• Prolonged exposure to excessive heat and humidity must be avoided.

• Oral antihistamines such as diphenhydramine (Benadryl) which are available over-the-counter oral are widely used but, one should be aware of the possible side effects such as drowsiness.

• hydrocortisone cream available over-the-counter is widely preferred but to help ease discomfort on itchy areas.

• Medications for chickenpox virus must be started within the first 24 hours of the rash for better treatment outcomes.
• Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medication if it is given early. Antiviral medication is not usually prescribed to otherwise healthy children who do not have severe symptoms.

• Antiviral medication may prove beneficial for 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 as Reye's syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used.

• Use of clean gloves or socks on hands is recommended in order to prevent the risk of infection from scratching, especially during the overnight.

• Children with chickenpox should not be encouraged to 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.

• Antiviral medications are also prescribed to people living in the same house as that of the infected individual. The reason being that there are more chances that they may also develop chickenpox, and they may develop more severe symptoms.

What to expect (Outlook/Prognosis)?[edit | edit source]

• 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[edit | edit source]

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[edit | edit source]

• Coughing and sneezing should be kept covered.
• The use of any cloth or towels should be limited only to the child and not to be shared by others.

• Hand hygiene to be maintained always 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[edit | edit source]

http://www.nlm.nih.gov/medlineplus/ency/article/001592.htm Template:WH Template:WS