Introduction

Chicken pox is a highly contagious disease caused by the Varicella virus, a member of the herpes virus family. It can occur at any age group, more common in children but often more severe in adults. It is spread by direct contact, or by droplets from an infected person or indirectly through articles freshly soiled by droplets or fluid from the blisters of an infected person.

A person who has chickenpox can transmit the virus for up to 48 hours before the rash appears and remains contagious until all spots crust over. It can, at a later stage, cause shingles.

Signs and Symptoms

An infected person usually has fever with red spots which turn into small liquid-filled blisters that break open and crust over. The rashes normally involve the face, scalp, chest, back and may spread across the entire body. The chickenpox rash usually appears less than two weeks after exposure to the virus. New spots continue to appear for several days and may number in the hundreds. Itching may range from mild to intense and may leave scar when scratched. Other symptoms may include abdominal pain or loss of appetite, mild headache, general feeling of unease and discomfort (malaise) or irritability. The infected person has mild cough and runny nose the first two days of illness before the rash appears.

Complication

Chickenpox usually lasts about two weeks and rarely causes complications. The disease can be serious, even in healthy children and can lead to complications and even death especially in these high-risk groups:

• Newborns and infants whose mothers never had chickenpox or the vaccine

• In pregnant women, it can cause low birth weight and birth defects, such as limb abnormalities. If the mother develops chickenpox in the week before birth, it can cause a serious, life-threatening infection to a newborn.

• People whose immune systems are impaired by another disease or condition such as HIV, leukaemia and cancer patient on chemotherapy
• People who are taking steroid medications for another disease or condition, such as children with asthma and Nephrotic Syndrome
• People with the skin inflammation like eczema

Complications of chicken pox include:-

• Skin infection with red, swollen, or tender sores
• Dehydration due to frequent vomiting or refusal to drink. The person will pass urine less often, experience dry mouth and lips, and feels very thirsty.
• Brain damage from encephalitis, which may present with severe headache, confusion, irritability, stiff neck and back or excessive drowsiness
• Arthritis characterised by joint pain, stiffness and swelling.
• Pneumonia (lung infection) characterised by coughing, wheezing, breathing difficulty and chest pain
• Post herpetic neurolfia, defined as any pain remaining after full intranous hearing

Treatment

What is the treatment for Chicken pox?

Anti-viral medications such as Acyclovir or intravenous immune globulin can be used to treat chickenpox which are usually most effective when taken within the first 24 hours of developing the illness. They reduce the severity and duration of chickenpox, as well as reduce the likelihood of complications. Most adults would benefit from them if taken early enough, especially those who have impaired immunity as they are more susceptible to severe chickenpox.

If complications develop, appropriate treatment will be given. Antibiotic is needed for skin infection and pneumonia. Hospitalization is necessary for those with encephalitis and antiviral is usually given.

• Apply calamine lotion
• Antihistamine to relieve itching
• Acetaminophen for the fever

Prevention

Vaccination provides life-long immunity and should be given between 12 to 18 months. For those below the age of 13 years should receive only 1 dose of the chicken pox vaccine. Those who are 13 years and above need 2 doses, 4-8 weeks apart.

Chicken pox infection may confer life long immunity .However it is still possible to get chicken pox more than once although this not common

Rehabilitation

Severe post herpetic neurolfia can be debilitating.This condition can be treated /controlled.