"Chickenpox: Transmission, Symptoms, Home Treatments, Complications, and Prevention"

I. What is Chickenpox and how is it transmitted?

chicken pox is a highly contagious disease caused by the varicella-zoster virus (VZV). The virus spreads easily from people with chickenpox to others who have never had the disease or never been vaccinated. If a person has chickenpox, up to 90% of people close to that person who are not immune will also become infected. The virus is mainly spread through close contact with someone who has chickenpox.

A person with chickenpox is considered contagious from 1 to 2 days before the onset of the rash until all chickenpox lesions have formed (crusted). Vaccinated people who get chickenpox may develop lesions that do not crust over. These people are considered contagious until no new lesions have appeared for 24 hours.

The varicella-zoster virus also causes Zona Zoster. After chicken pox, the virus remains in the body (latent). People develop shingles when VZV reactivates in their body after they’ve already had chickenpox. People with shingles can spread VZV to people who have never had chickenpox or who have never received the chickenpox vaccine. This can happen through direct contact with the fluid from the shingles blisters. If they get infected, they will develop chicken pox, not shingles.

It takes approx 2 weeks (from 10 to 21 days) after exposure to someone with chickenpox or shingles for someone to develop chickenpox. If a vaccinated person gets the disease, they can spread it to others. For most people, getting chickenpox once provides lifelong immunity. It is possible to get chickenpox more than once, but this is not common.

II. Signs and symptoms

Chickenpox can often start without the classic rash, with fever in the range of 38.3°–38.8°C headache, sore throat or stomach, loss of appetite, fatigue. These symptoms may last for several days.

The classic eruption red, itchy rash usually starts on the belly or back and face. It then spreads almost everywhere on the body, including the scalp, mouth, arms, legs and genitals.

The rash starts as many small red bumps that look like pimples or bug bites. They appear in waves for 2 to 4 days, then develop into thin-walled, fluid-filled blisters. The walls of the blisters break, leaving open sores and eventually brown, dry crusts will form. It usually takes about a week for all the blisters to crust over.

III. Home treatments for people with chicken pox:

III.1 How can I help my child feel better?

There are several things you can do at home to help relieve the symptoms of chicken pox and prevent skin infections. Calamine lotion and a warm bath with baking soda can help relieve itching (baths do not spread the rash). Dry the body (do not rub). Try to keep nails trimmed short and minimize scratching to prevent spreading the virus to others and help prevent skin infections. If you accidentally scratch a blister, wash your hands with soap and water for at least 20 seconds.

Do not use aspirin or products containing aspirin to relieve chicken pox fever. Aspirin use in children with chickenpox has been associated with Reye’s syndrome, a severe disease that affects the liver and brain and can cause death. Instead, use non-aspirin medications such as acetaminophen (eg Panadol) to relieve chicken pox fever. The American Academy of Pediatrics recommends avoiding treatment with ibuprofen after blistering (eg, Algin, Nurofen syrup) if possible, as it has been associated with life-threatening bacterial skin infections.

If your child has blisters in the mouth give cold, soft and bland foods as they can make it difficult to swallow or eat. Avoid anything acidic or salty, such as orange juice or pretzels.

IV. Complications:

IV.1 When should I call the doctor?

Most chickenpox infections do not require special medical treatment. But sometimes problems can arise. Call the doctor if your child:

– has a fever that lasts more than 4 days, higher than 38.8°C

– has a worsening cough or difficulty breathing

-has an area of rash that oozes pus (thick, yellowish liquid) or becomes red, warm, swollen, tender or painful.

-he has a severe headache. This could be a sign that the skin is infected with bacteria.

-has a stiff (stiff) neck

-is very sleepy or wakes up with difficulty

– fast heartbeats

-loss of ability to use muscles

– the rash spreads to one or both eyes

-bears the light with difficulty

– he has walking disorders

– he seems confused and disoriented

– looks very sick, lies down or vomits

V. How to prevent VZV infection:

In Romania it exists 2 types of vaccine which can prevent infection with varicella virus.

VARILRIX is indicated for active immunization against varicella in healthy subjects (from 9 months of age). Vaccination of healthy people who come into close contact with subjects at high risk of developing severe forms of chickenpox is recommended to reduce the risk of transmission of wild-type virus.

Two doses of Varilrix vaccine are recommended, at least 6 weeks apart, but not earlier than 4 weeks apart.

VARIVAX may be administered to persons 12 months of age or older. It can be administered starting from the age of 9 months in special circumstances (discuss with the family doctor or pediatrician).

9-12 months: 2 doses given at least 3 months apart

12 months-12 years: 2 doses administered at an interval of at least one month between the administration of the first and the second dose.

13 years and over: 2 doses administered at an interval of 4-8 weeks.

It can also be given to people at risk of exposure to chicken pox. Vaccination within 3 days of exposure can prevent a clinically manifest infection or can modify the course of the infection. In addition, there are limited data indicating that vaccination up to 5 days after discharge may alter the course of infection.

Signature,

Dr. Raluca STĂNESCU

Pediatric specialist

PROCTOVEN CLINIC

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