CHICKENPOX...

Chickenpox or chicken pox is a highly contagious illness caused by primary infection with varicella zoster virus (VZV).[1] It usually starts with vesicular skin rash mainly on the body and head rather than at the periphery and become itchy, raw pockmarks, which mostly heal without scarring.


Chicken pox is spread easily through coughs or sneezes of ill individuals or through direct contact with secretions from the rash. Following primary infection there is usually lifelong protective immunity from further episodes of chickenpox.

Chickenpox is rarely fatal, although it is generally more severe in adult males than in adult females or children. Pregnant women and those with a suppressed immune system are at highest risk of serious complications. Chicken pox is now believed to be the cause of one third of stroke cases in children.[2] The most common late complication of chicken pox is shingles, caused by reactivation of the varicella zoster virus decades after the initial episode of chickenpox.

Chickenpox has been observed in other primates, including chimpanzees[3] and gorillas.[4]


Signs and symptoms

Chickenpox is a highly infectious disease that spreads from person to person by direct contact or by air from an infected person's coughing or sneezing. Touching the fluid blister can also spread the disease. A person with chickenpox is infectious from one to five days before the rash appears.[5] The contagious period continues until all blisters have formed scabs, which may take 5 to 6 days at which point they are no longer contagious.[6] It takes from 10 to 21 days after contact with an infected person for someone to develop chickenpox. Chickenpox (varicella) is often heralded by a prodrome of anorexia, myalgia, nausea, fever, headache, sore throat, pain in both ears, complaints of pressure in head or swollen face, and malaise in adolescents and adults, while in children the first symptom is usually the development of a papular rash, followed by development of malaise, fever (a body temperature of 38 °C (100 °F), but may be as high as 42 °C (108 °F) in rare cases), and anorexia. Rarely cough, rhinitis, abdominal pain, and gastrointestinal distress has been reported in patients with varicella. Typically, the disease is more severe in adults.[7]



A single blister, typical during the early stages of the rash

The back of a 30-year-old male, taken on day 5 of the rash



Treatment



This section requires expansion.


Although there have been no formal clinical studies evaluating the effectiveness of topical application of calamine lotion, a topical barrier preparation containing zinc oxide and one of the most commonly used interventions, it has an excellent safety profile.[20] It is important to maintain good hygiene and daily cleaning of skin with warm water to avoid secondary bacterial infection.[21] Scratching may also increase the risk of secondary infection.[22] Addition of a small quantity of vinegar to the water is sometimes advocated. Painkillers could be taken to prevent feeling itchy [23]

To relieve the symptoms of chicken pox, people commonly use anti-itching creams and lotions. These lotions are not to be used on the face or close to the eyes. An oatmeal bath also might help ease discomfort.[24]

Varicella treatment mainly consists of easing the symptoms as there is no actual cure of the condition. Some treatments are however available for relieving the symptoms while the immune system clears the virus from the body. As a protective measure, patients are usually required to stay at home while they are infectious to avoid spreading the disease to others. Also, sufferers are frequently asked to cut their nails short or to wear gloves to prevent scratching and to minimize the risk of secondary infections.

The condition resolves by itself within a couple of weeks but meanwhile patients must pay attention to their personal hygiene.[25] The rash caused by varicella zoster virus may however last for up to one month, although the infectious stage does not take longer than a week or two.[26] Also, staying in a cold surrounding can help in easing the itching as heat and sweat makes it worse. Calamine lotion may be tried as it may relieve the symptoms because of its soothing, cooling effect on the skin.

Natural chicken pox remedies include pea water, baking soda, vitamin E oil, honey, herbal tea or carrot and coriander. It is believed that the irritation of the skin can be relieved to some extent with water in which fresh peas have been cooked.[27] A lotion made of baking soda with water can be sponged onto the skin of the patients to ease the itching. Also, rubbing vitamin E oil or honey on the skin is thought to have a healing effect on the marks that could remain after the infection has been cured. Some people claim that the mild sedative effect of green tea is effective in relieving the symptoms. It is not however known to what extent these home remedies can actually help the patients cope better with their symptoms.

A varicella vaccine is available for people who have been exposed to the virus, but have not experienced symptoms. The vaccine is more effective if administered within three days and up to five days after exposure. It has been shown that the chicken pox vaccine may prevent or reduce the symptoms in 90% of cases, if given within three days after exposure. People who have been exposed to the virus but who are contraindicated to receive the vaccine, there is a medication available, called varicella zoster immunoglobulin or VZIG which may prevent or reduce the symptoms after exposure. VZIG is primarily administered to individuals who are at risk of developing complications due to its high costs and temporary protection. This type of treatment is only recommended in newborns whose mothers have had chicken pox few days prior or after delivery, children with leukemia or lymphoma, people with a poor immune system or pregnant women. VZIG is recommended to be administered no later than 96 hours after exposure to the virus.