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Chickenpox

Definition


Disease: Chickenpox Chickenpox
Category: Infectious diseases
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Disease Definition:

For most children, chickenpox was once considered a rite of passage. The number of children contracting chickenpox and hospitalizations is down dramatically thanks to the development of vaccine.  

There is no way to know which infected child or adult will develop a severe case of chickenpox, which is a mild disease in most cases. But when it does occur, it's highly contagious among people who aren't immune.

The good thing is that there is a safe, effective way to prevent chickenpox and its possible complications, namely, the vaccine.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

The best-known signs of chickenpox are small, liquid-filled blisters that break open and crust over; and a red, itchy rash that may initially look like insect bites.

The chickenpox rash occurs In three stages. There will be raised pink or red bumps (papules) in the beginning, these bumps will turn into fluid-filled blisters (vesicles) and in the end the vesicles will crust over and scab. The occurrence of all three of these stages at once is also possible.

The following may precede or accompany the rash:

  • A dry cough
  • Fever
  • Headache
  • Mild headache
  • Abdominal pain or loss of appetite
  • Irritability or malaise, which is a general feeling of unease and discomfort


The back, chest, scalp and face are included in the common sites for the rash, which can spread across the entire body of the patient, even into his/her eyes, vagina and throat. New spots continue to appear for several days. However, the disease is usually mild in healthy children.

By examining the characteristic rash and by noting the presence of accompanying symptoms, the doctor can easily diagnose chickenpox, so one should consult the doctor when suspecting that he/she has chickenpox. To treat complications and lessen the severity of the disease if needed, medications may be prescribed. People should be careful to avoid waiting and so prevent the infection from spreading to others.

If any of these complications occur, a doctor should be contacted:

  • Stiff neck, shortness of breath, tremors, worsening cough, vomiting, fever higher than 103 F (39.4 C), dizziness, rapid heartbeat, disorientation or loss of muscle coordination, accompanying the rash.
  • The rash spreads to one or both eyes.
  • The rash gets very red, warm or tender, indicating a possible secondary bacterial skin infection.

Causes:

The varicella-zoster virus is the cause of chickenpox, which is highly contagious to people not immune to it. In locations where people are in close contact, such as schools, families and child care facilities in particular, the disease spreads quickly. The virus is transmitted by direct contact with the rash or by droplets dispersed into the air by sneezing or coughing.

Up to 48 hours before the telltale rash appears, the virus can be transmitted by a person who has chickenpox, and until all spots crust over, this person remains contagious. People who have had chickenpox in the past, as well as those who've been vaccinated against it are immune to the virus. Anyone who hasn’t been vaccinated or has never had the disease is at risk of contracting chickenpox.

Complications

Complications:

Though normally a mild disease, chickenpox can be serious and lead to complications in the following high-risk groups in particular:

  • People whose immune systems are impaired by medication such as chemotherapy, or another disease
  • Newborns and infants whose mothers never had chickenpox or the vaccine
  • Adults
  • Pregnant women
  • People with eczema
  • People who are taking steroid medications for another disease or condition, such as children with asthma
  • Teenagers


A bacterial infection of the skin is a common complication of chickenpox. Pneumonia, or in rare cases, an inflammation of the brain (encephalitis) may be caused by chickenpox; both of these conditions can be very serious.

Chickenpox and shingles:
There is a risk of shingles, a latent illness, in anyone who had chickenpox. As a matter of fact, shingles is experienced by one in 10 adults who've had chickenpox. As some of the varicella-zoster virus may remain in one's nerve cells after a chickenpox infection, the virus can reactivate and resurface as shingles, a painful band of short-lived blisters, many years later. In people with weakened immune systems and in older adults, the virus is more likely to reappear.
Postherpetic neuralgia, which can be severe, is shingles' own complication, in which the pain of shingles persists long after the blisters disappear.

Chickenpox and pregnancy:
Pregnant women can be affected by other complications of chickenpox. Having chickenpox early on in pregnancy can result in a variety of problems in a new born including low birth weight and birth defects, such as limb abnormalities. When the mother develops chickenpox in the week before birth, the risk for the baby is greater, as a serious, life-threatening infection in a newborn can be caused by this. A pregnant woman should talk to her doctor about the risks that she or her unborn child may be exposed to if she's not immune to chickenpox.

Treatments:

Generally, chickenpox requires no medical treatment in otherwise healthy children. The disease is allowed to run its course, though the patient may be prescribed an antihistamine to relieve itching.

To help reduce the risk of complications and to shorten the duration of the infection, medications may be prescribed for people who have a high risk of complications from chickenpox.

An antiviral drug such as acyclovir or another drug called immune globulin intravenous (IGIV) may be suggested in case an adult or a child falls into a high-risk group. When given within 24 hours after the rash first appears, these medications may lessen the severity of the disease. Some drugs have been approved for use only in adults though they may lessen the severity of the disease, these are antiviral drugs, such as famciclovir and valacyclovir. After exposure to the virus, getting the chickenpox vaccine may be recommended because it can lessen the severity of the disease or even prevent it.

The appropriate treatment may be determined if complications do occur. Encephalitis could be treated with antiviral drugs, skin infections and pneumonia can be treated with antibiotics, and hospitalization may be necessary.

A condition called Reye's syndrome occurs when anyone with chickenpox, child or adult, is given any medicine that contains aspirin, so this drug must be avoided in these patients.

Prognosis:

Not Available

Expert's opinion

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Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Samer Al-Jneidy

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Samir Moussa M.D.

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Dr. Faisal Dibsi

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