Chickenpox is a viral infection. It is characterized by itchy rashes which are highly infectious. It spreads through local contact and is thus contagious. It generally occurs in children. However, adults are susceptible to it as well. People who haven’t suffered from it before, are at a greater risk. Similarly, non-vaccinated persons, persons with HIV, on steroids are more prone to it.
How does it occur?
It occurs by a virus, termed as Varicella Zoster virus. The infection is transmitted mainly through close body contact. It can also be transmitted through coughing or sneezing. Mother to child transmission (through the placenta and breastfeeding) and contact with fomites (Doorknobs, handkerchiefs, etc), are infrequent modes of spread.
The incubation period (from the entry of virus to symptoms) is 10-20 days.
Fever, loss of appetite/anorexia, coughing, fatigue and malaise.
It is accompanied by a typical rash of chickenpox. Firstly, there are red papules that are scattered over the body. They develop into fluid-filled vesicles. The vesicles are itchy and rupture due to scratching or on their own. Once ruptured the fluid oozes out and dries. The desiccated vesicles are turned into scabs and crusts.
All three are seen as they are the progressive sequelae of the rash. They generally last for a week before it heals on their own. Once disturbed manually, they may remain permanently as scars.
Complications include spread to the brain (encephalitis), lungs (pneumonia), secondary infections, etc.
Shingle is a latent infection in the nerves. It reactivates in elderly people, who have decreased immunity. It is painful and characterized by blisters.
The chickenpox vaccine is the only primary prevention measure. Varivax vaccine is generally given. It is not covered the Immunisation Schedule of India and is thus not mandatory. Two doses in children, first: between 12-16 months of age and second: between 4-6 years of age are given. In older children, two doses given 3 months apart are given. In adults who are at risk (high school teachers, health workers, military personnel) should receive 2 doses, 4-8 weeks apart.
Shingrix and Zostavax vaccines are indicated for adults above the age of 50 and 60 years respectively. They are used for prophylaxis against Shingles.
Treatment for Chickenpox: A Viral Infection
It generally resolves in 7-10 days and is self-limiting. Adequate hydration helps get rid of the virus faster.
Antihistaminics like Paracetamol, Ibuprofen relieve pain, itching and the inflammation. They also help reduce fever in children. It is safe in pregnancy.
Aspirin should not be given as it leads to Reye’s syndrome (hepatic failure).
Calamine lotions, cool baths help soothe the itchy skin. Scratching is strictly not recommended. It leads to bacterial infection and the local spread of disease.
Anti-viral acyclovir is prescribed in severe cases of chickenpox and those having complications (MCO-cutaneous lesions, anal lesions, encephalitis, etc). The therapy is for 7 days, 5 tablets a day.