Healthy Line: What is Chickenpox

 

Chickenpox: A Comprehensive Guide

 

Introduction

The contagious viral infection, chickenpox, which is also called varicella, is caused by the varicella zoster virus (VZV). It mainly targets children but can also affect adults that have not been vaccinated or infected. The disease presents with an itchy blister-like rash, fever and fatigue. Although chickenpox is generally mild in healthy children, it may develop serious complications in infants, adults, pregnant women, and those with weakened immune systems.

In this article, we give an extensive overview of chicken pox; its causes, symptoms, mode of transmission, diagnosis, treatment, prevention and possible complications.

Causes of Chickenpox

Chickenpox is created by varicella-zoster virus (VZV) belonging to the herpesvirus family. The virus stays dormant in the body once a person is infected and can later be reactivated resulting in shingles (herpes zoster) in adulthood.

How the Virus Spreads

The virus spreads through:

·        Physical contact with the fluid in chickenpox blisters.

·        Droplets from coughing or sneezing into the air.

·        Airborne transmission if a person with infection lets out virus particles.

 

An infected person with chicken pox is contagious from 1-2 days before the rash appears to all blisters have developed a crust (usually about 5-7 days after the rash begins).

 

Symptoms of Chickenpox

The symptoms of the chickenpox disease develop 10 to 21 days after the exposure (incubation period) and develop in stages

Early Symptoms (Prodromal Phase – 1-2 Days Before Rash)

·        Fever (usually 101°F–102°F or 38°C–39°C)

·        Fatigue and malaise

·        Loss of appetite

·        Headache

·        Mild cough or runny nose

 

Rash Development

The chickenpox rash has 3 stages:

1.     Macules – flat red spots on the skin (first on the face, chest, back, then all over the body).

2.     Papules and Vesicles – The nodes rise and are filled with fluid, and it causes itching of blisters.

3.     Crusts and scabs – blisters burst, dry up and crust over, and then fall off.

 

There may be new waves of blisters for 3-7 days, meaning a person can have lesions in different stages at the same time.

 

Other Possible Symptoms

·        Itching (can be severe)

·        Sore throat

·        Swollen lymph nodes

·        Dehydration (caused by fever and lack of fluids in the body)

 

Diagnosis of Chickenpox

Diagnosis of most cases of chickenpox is based on:

1.     Clinical Examination – Generally a doctor can diagnose chickenpox by the characteristic rash.

2.     Medical History – Exposure to an infected person is indicative of the diagnosis.

Lab tests may be used in ambiguous cases:

·        PCR (Polymerase Chain Reaction) Test – VZV DNA is identified from blister fluid or blood.

·        Blood Tests – Test for antibodies against VZV.

·        Tzanck Smear – Microscopic inspection of blister fluid (not so common nowadays).

 

Treatment of Chickenpox

Most healthy children recover without special treatment, but the management is symptomatic relief and prevention of complications.

1. Home Care and Symptom Relief

·        Hydration – To avoid dehydration drink plenty of water.

·        Fever Control – For fever and pain use acetaminophen (Tylenol). (Skip aspirin because of the risk of Reye’s syndrome).

·        Itch Relief –

o   Calamine lotion

o   Oatmeal baths

o   Antihistamines (e.g., diphenhydramine)

·        Nail Care – Short nail to avoid scratching and secondary infections.

2. Antiviral Medications

Antivirals (e.g. acyclovir, valacyclovir) can be prescribed for:

·        High risk patients (adults, pregnant women, immunocompromised).

·        Severe cases.

·        Should be started within 24-48 hours of rash onset for best effect.

3. Hospitalization (For Severe Cases)

Required if complications like:

·        Pneumonia

·        Encephalitis (brain inflammation)

·        Severe bacterial skin infections

 

Complications of Chickenpox

Although most of the cases are mild, complications may develop particularly in high-risk groups:

1. Bacterial Infections

·        Cellulitis (skin infection)

·        Staphylococcal / streptococcal infections (is a cause of sepsis)

2. Neurological Complications

·        Encephalitis (brain inflammation)

·        Cerebellar ataxia (loss of coordination)

3. Respiratory Complications

·        Pneumonia (common among adults and smokers)

4. Other Severe Complications

·        Reye’s syndrome (if a child is given aspirin)

·        Hepatitis (liver inflammation)

·        Blood clotting disorders

5. Risks in Pregnant Women

·        Congenital varicella syndrome (infection in early pregnancy – can cause birth defects).

·        Severe chicken pox in mother (high risk of pneumonia).

·        Infantile chickenpox (if the mother develops the disease close to the time of delivery).

 

Prevention of Chickenpox

1. Vaccination (Most Effective Prevention)

The vaccine against varicella is very effective:

·        Given in two doses:

o   First dose at 12-15 months

o   Second dose at 4-6 years

·        Effectiveness: Approximately 90% after one dose, approximately 98 % after two doses.

·        Side Effects: Mild fever, soreness at injection site, occasional rash.

2. Post-Exposure Prophylaxis

·        Vaccine within 3-5 days of exposure can cure or mitigate.

·        Varicella-zoster immune globulin (Vari ZIG) for high-risk patients (newborns, pregnant women, immunocompromised).

3. General Preventive Measures

·        Keep individuals infected isolated until all blisters crust.

·        Practice good hygiene (hand washing covering mouth when coughing).

·        Practice good hygiene (hand washing covering mouth when coughing).

 

Chickenpox vs. Shingles

Following chickenpox, the virus remains dormant in nerve tissues and in later life may reactivate, causing shingles (herpes zoster), a painful, blistering rash.

Key Differences:

Feature	Chickenpox	Shingles
Cause	First VZV infection	Reactivation of dormant VZV
Rash Location	Widespread	Localized (one side of the body)
Pain Level	Itchy, mild discomfort	Often severe, burning pain
Contagious?	Yes (spreads chickenpox)	Yes (spreads chickenpox)

 

Adults aged 50 and over are advised to use a shingles vaccine (Shangri) to avoid reactivation.

 

Conclusion

The chickenpox is a common childhood disease, although generally mild, it has the potential for causing severe complications in specific groups of individuals. Its incidence has been dramatically reduced by vaccination; hence it is preventable. Quick diagnosis of symptoms, correct home care and medical treatment where needed can prevent the infection from getting out of control.

 

Among the unvaccinated or the previously infected, the knowledge of transmission risks and preventive measures is extremely important. If you suspect the presence of chickenpox, seek health care provider to be diagnosed and treated, especially if you or your child belong to high-risk group.

 

Staying aware and taking precautionary steps, we can minimize the effects of chickenpox, and prevent vulnerable individuals from the complications of the same.

 

References

·        Centers for Disease Control and Prevention (CDC). Chickenpox (Varicella).

·        World Health Organization (WHO). Varicella and Herpes Zoster Vaccines.

·        Mayo Clinic. Chickenpox: Symptoms and Causes.