Chickenpox

Chickenpox is a highly contagious disease caused by primary infection with varicella

zoster virus (VZV).
Chickenpox is an airborne disease which spreads easily through coughing or
sneezing by ill individuals or through direct contact with secretions from the rash. A
person with chickenpox is infectious one to two days before the rash appears.
The origin of the term chicken pox, which is recorded as being used since 1684, is
not reliably known. It has been said to be derived from chickpeas, based on resemblance
of the vesicles to chickpeas, or to come from the rash resembling chicken pecks. Other
suggestions include the designation chicken for a child (i.e., literally 'child pox'), a
corruption of itching-pox, or the idea that the disease may have originated in chickens.
The early (prodromal) symptoms in adolescents and adults are nausea, loss of
appetite, aching muscles, and headache. This is followed by the characteristic rash or oral
sores, malaise, and a low-grade fever that signal the presence of the disease. In children
the illness is not usually preceded by prodromal symptoms, and the first sign is the rash
or the spots in the oral cavity. The rash begins as small red dots on the face, scalp, torso,
upper arms and legs; progressing over 1012 hours to small bumps, blisters and pustules;
followed by umbilication and the formation of scabs. Chickenpox is rarely fatal, although it
is generally more severe in adult men than in women or children. Non-immune pregnant
women and those with a suppressed immune system are at highest risk of serious
complications. Arterial ischemic stroke (AIS) associated with chickenpox in the previous
year accounts for nearly one third of childhood AIS. The most common late complication
of chickenpox is shingles (herpes zoster), caused by reactivation of the varicella zoster
virus decades after the initial, often childhood, chickenpox infection.
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 suppresses the virus in 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.[36] 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.[37]

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. It is
important to maintain good hygiene and daily cleaning of skin with warm water to avoid
secondary bacterial infection.[39] Scratching may also increase the risk of secondary
infection.
Acetaminophen (paracetamol) but not aspirin may be used to reduce fever. Aspirin
use by someone with chickenpox may cause the serious, sometimes fatal disease of the
liver and brain, Reye syndrome. People at risk of developing severe complications who
have had significant exposure to the virus may be given intra-muscular varicella zoster
immune globulin (VZIG), a preparation containing high titres of antibodies to varicella
zoster virus, to ward off the disease.

Treatment of chickenpox in children is aimed at symptoms while the immune system

deals with the virus. With children younger than 12 years cutting nails and keeping them
clean is an important part of treatment as they are more likely to scratch their blisters
more deeply than adults.
Infection in otherwise healthy adults tends to be more severe. Treatment with
antiviral drugs (e.g. acyclovir or valacyclovir) is generally advised, as long as it is started
within 2448 hours from rash onset. Remedies to ease the symptoms of chickenpox in
adults are basically the same as those used on children. Adults are more often prescribed
antiviral medication as it is effective in reducing the severity of the condition and the
likelihood of developing complications. Antiviral medicines do not kill the virus, but stop it
from multiplying.
Sorivudine, a nucleoside analogue has been reported to be effective in the
treatment of primary varicella in healthy adults (case reports only), but large-scale clinical
trials are still needed to demonstrate its efficacy.
After recovering from chickenpox, it is recommended by doctors that adults take
one injection of VZV immune globulin and one injection of varicella vaccine or herpes
zoster vaccine.