What is Chicken Pox – Symptoms, Treatment & Home Remedies (varicella)
This article containcs detailed information aboout “What is Chicken pox – Symptoms, Treatment & Home Remedies (varicella), Transmission, Diagnosis, Prevention and many others”. Chickenpox is a type of viral disease spread by the varicella zoster virus (VZV). This is a member of herpes zoster family. As chicken pox is highly contagious disease, a person becomes contagious 1 to 2 days before their blister appears. It usually starts from vesicular skin rash mainly on the body & head rather than at periphery and becomes itchy, raw pockmarks which mostly heal without scaring on certain examination are found at various stages of healing. Same virus also causes herpes zoster (Shingles) in adults. it is one of classical childhood disease, however it has become much less common since the introduction of chicken pox vaccine.
A person with chicken pox becomes contagious 1 to 2 days before their blisters appear. They remain contagious until all the blisters are crusted over so isolation is one of best step to avoid spread of chicken pox.
All viral diseases spread by various ways, some are spread by air droplet and some by water droplet chicken pox is one of them. When a person infected with chicken pox cough or sneeze become started, the droplet or his respiratory secretion containing virus contaminate environment and any other person who attended that infected person would get infected with VZV. There is cure of vzv but sometimes when get complicated or person is already under some other medical complications it could prove fatal.
Symptoms or clinical features of Chicken Pox
As chicken pox is highly contagious disease having a incubation period of 10 to 20 days after coming in contact with someone who had the disease. The average child develops 250 to 500 samll, itchy, fluid filled blisters over red spots on the the skin.
- The blister first seen on the face, middle of the body, or scalp.
- After a day or two, the blister become like a raised pink of red bumps (papules) which break after few days then these fluid filled vesicle becomes cloudy with in a day and finally scab, meanwhile new blisters forms in groups .Children with skin problems such as eczema may get thousand of blisters.
- At the blister stage intense itch is usually present.
- Blister may also occurs on palms, soles and mucous membrane.
- Shallow ulcer may appear in the mouth, top of throat and genital area.
- Some children who have had the vaccine will still develop a mild case of chicken pox. They usually recover much more quickly and have only a few pox marks (fewer than 30). These type of cases are mostly harder to diagnose. However these cases or children may spread the disease to other persons.
Patients suffering from chicken pox often have dehydration and beacuse of itch and dehydration they have severe headache.
- loss of appetite
- tiredness or weakness
- feeling of being unwell
Healthy childs are rare who get such disease.
Transmission of Chickenpox
Chicken pox is air borne disease that is why is highly contagious and spread by coughing, sneezing of infected individual or by direct contact with the secretion from the rash.
- Spread through the coughing sneezing
- Through the direct contact with the infected individual or his or her secretion from the rash
- A person with chicken pox is infectious before the rash appears
- They remain contagious until all lesions are crusted over
- Crusted lesions are not contagious
- Children whose mother have had chicken pox or have receive the vaccine are not likely to catch it before they are 1 year old, if they do catch it, they often have mild cases, this is all because of mothers blood antibodies that passed through placenta help to protect them whose mother have not had chicken pox or vaccine can get severe chicken pox (Children under 1 year of age)
- Also observed in primates like chimpanzees and gorillas
Diagnosis of Chicken Pox
For the confirmation of disease it is necessary to diagnose properly diagnoses helps to choose a proper treatment.
DIAGNOSIS of varicella is basically clinical with typical early prodromal symptoms. The characteristics of rash also helps for the diagnosis which can be sought via examination of the fluid with in the the rash or testing blood for evidence of an acute immunological response.
- Examination of rash or by the examination of fluid with in the vesicle of rash or examination for direct florescent antibody .
- Blood test for immunoglobulins IgM OR IgG. Blood test are required to identify a response to acute infection IgM or previous infection or subsequent immunity for IgG antibodies
- Tzanck smear test is used to examine the vesicular fluid
- Fluid can be cultured, where by the attempts are also made to grow virus from fluid sample.
- Prenatal diagnosis of fetal varicella infection can be diagnosed by ultrasonography though a delay of 5 weeks following primary maternal infection is advised
- A PCR (DNA) Test of the mother amniotic fluid can also be performed though the risk of abortion due to amniocentesis procedure is higher than the baby developing fetal varicella syndrome
Treatment Of Chickenpox
- Treatment mainly consist of easing of symptoms, patients are advised to stay at homes to avoid spread of infection.
- There is no actual cure of condition, some treatments are available for relieving the symptoms while the immune system clear the virus from the body.
- The condition usually resolved by with in couple of weeks but meanwhile patients must pay attentionto thier personal hygiene .
- The rash cause by varicella zoster virus may however last for upto one month, although the infectioud stage does not take longer than a week or two.
- Ask patients to cut their nails and wear gloves.
- Patients are advised to apply calamine lotion and a topical preparation containing zinc oxide. This is not actual cure the vesicle but it helps to control the rash and helps not to become hard and itchy.
- Maintain good hygiene and use aseptic techniques while attending that infected patients.
- Daily cleaning of skin with warm water to avoid secondary infection Is helpful either in hospital or at homes to protect from secondary infection. Scratching may also increase the risk of secondary infection there proper care is important.
- Paracetamol but not aspirin use to reduce fever.
- Paracetamol is painkiller that play a good role for patients relaxtion while aspirin can cause a syndrome in infected patients (REYE syndrome) a fatal disease if liver and brain.
- People at risk of developing severe complication who have had significant exposure to the virus may be given intra mascular immune globin (VZIG) a prepartion containing high titers of antibodies to varicella zoster virus, to ward of the disaes.
- Increase water intake to reduce dehydration.
- Antihistamines relive itches and may be used in cases where itches prevent sleep because they are sedatives.
- Hygienic measures are necessary to prevent the disease.
If oral acyclovir started with in 24 hours of rash onset it decreases symptoms by one day but has no effect on complication rates. Use of acyclovir therefore is not currently recommended for immune competent individuals (ex:otherwise healthy person without immunodeficiency or on comprehensiveness medicine).
“Children younger than 12 years old and older than one month are not meant to receive antiviral medication (<12 years >1 month ) if they are not suffering from another medical condition which would be put children at the risk of developing higher complication.”
Treatment of chicken pox in children basically focused on symptoms while the immune system deal with the virus. With a children who they are younger than 12 years cutting nails and keeping them clean at all the times is necessary to avoid the secondary infections or scratches because by scratching on blister blister becomes more deeper .
Adults especially healthy ones are tend to get more severe infection. treatment with antiviral drugs
are generally advised, as long as it is started with in 24 to 48 hours of rash onset. Adults are most often prescribed antiviral medication as its is effective in reducing the severity of the condition and likelihood of developing complication.
Antiviral medicine dont kill the virus but stop it from multiplying. Adults are also advised to increase the water intake to reduce the headaches.
Painkiller such as paracetamol (acetaminophen) are also recommended because its has good role to control the itching ,pain and fever. Anti histamines are used as sedatives for having good sleep and to reduce the itching. As with children, antiviral is considered more useful for those adults who are prone to develop complication. These include pregnant woman or people who have weekend or compromised immune system.
Home remedies of Chicken Pox
Chicken pox is highly contagious disease causing itching, pain, discomfort, headache, fatigue, fever, malaise because it is contagious airborne disease one should must follow the protective measures at home to avoid the spread.
- Family member have to maintain the distance from the infected person especially if they are old age, smoker, immuno compromised, or unvaccinated or those they have not had chicken pox in their life.
- Hygienic maintenance is necessary to avoid further spread of infection or for both family member or patient well being.
- Hand washing, use of gloves and use of face mask must be insure before going to the patients.
- Temperature maintenance in the environment is helpful.
- Noise free environment helps to improve patients discomfort.
- Monitoring of water intake is beneficial to decrease headaches , weakness.
- Regular cutting of nails and keeping them neat protect the patients from secondary infection in case of itching.
- Soft diet if pox develop in mouth.
- Check with your doctor to make sure that child may take safely antihistamines.
- Give him a cool bath adding baking soda in water, aluminium acetate , uncooked oatmeal or colloidal oatmeal and finally ground oat for soaking.
- Check your child for fever if fever lasts for four days or last up to 4 days or having a fever higher then 102 must call your doctor avoid to give tab aspirin in your child or as well as for adults because it can cause a severe syndrome known as Reye syndrome.
- Take a advise from your doctor before giving or administrating any (NSAIDS) non steroidal anti inflammatory drug e.g ibuprofen ( ADVIL , MOTRIN IB ,others) because some time these medication can cause tissue damage or skin infection in infected person.
When to see for a Doctor
If you noticed any type of symptoms and you think you must see for a doctor. Doctor may give you any medication to reduce the severity of your symptoms. Patient must avoid to sit in gathering to protect their other like in waiting room. You have to mention that you are noticing this symptoms from few days.
Your Doctor may check for:
1. You having fever or child having fever, is it high grade or low grade…
2. Rashes are spreads to eyes , feet, souls etc …
3. The rash hardness, tenderness or if warm its indicates secondary bacterial infection often…
4. Is there any family history of immunodeficient patients…
RISK FACTORS of Chicken Pox
Your risk to aquire varicella zoster virus is higher if you are immunodefecient, if you have not had chicken pox in life or not had. vaccines those person who use do job at schools and at where vaccine is given to those can aquire this virus immediately.
Some of them who have had already vaccine in their they life they may acquire infection but the chances are very rare about 1 percent and they get well early.
Who they are at High Risk?
- Infants and schools age child are at high risk
- Newborns who dont have vaccine
- Pregnant woman with supressed immune sysytem are at highest risk of serious complication
- It is generally more severe in adults males than in adult female and children
- Having chemotherapy which decreases the immunity and having disease like HIV or AIDS
- Cancer is also a risk factor
- People who they are taking steroids for other diseases like asthma
Complication or prognosis of varicella
It is rarely fatal, in adults, chickpox disease is more severe though the incidence is much less common. Infection in adults is greatly assosiated with morbidity and mortility due to following as given below:
- particularly up to 10 percent of pregnant woman develops pneumonia severity which increase with the onset later in gestation. In England and whales 75% deaths occurs due to chicken pox in adults
- Inflammation in brain or encephalitis can occured in immuno compromised individuals, although the risk is higher with herpes zoster
- Necrotizing fascities is also a rare complication
- It can be lethal to adults with impaired immunity
- Varicella is particular a problem in hospital, especially when they are patients with immune sysytems weekend by drugs (e.g high dose steroids or HIV).
Infection in pregnancy and neaonates
For pregnant woman, antibodies produced as a result of immunization or previous infection are transferred via the placenta and fetus. Women who are immune to chicken pox cannot get infected and have not need to concern about it for themselves or their infant during pregnancy.
Varicella infection in pregnant women could lead to viral transmission via the placenta and infection of the fetus. If the infection occour during the 1st 28 weeks of the gestation ,this can lead to fetal varicella syndrome (Also known as congenital varicella syndrome). Effects in fetus can be severe from underdevelop toes to malformation of anus and bladder.
Infection appear later in gestation or following after birth is named as neonatal varicella .
Maternal infection is associated with premature delivery. The risk of the babay is greatest following exposure to infection in the period 7 days prior to delivery and upto 7 days folloeing after birth.
The babay may also be exposed to virus via the infectious siblinges or other contacts, but this of less concern if the mother is immune. New borns who develop symptoms are at high risk of pneumonia and other serious complication of disease.
After chicken pox infection, the virus remains dominant in the body nerves tissues.immune system keeps the virus at bay, but later in life usually as an adult, it can be reactivated and can cause a different form of viral infection known as shingles (scientifically known as herpes zoster). ACIP united states advisory committee immunization practices suggests that any adult over 60 years can get herpes zoster vaccine as part of their normal routine checkup.
Many adults who had chicken pox in young are more tend to have shingles later age and have prosthetic neurolgia: a painful condition in which patient a have sleep difficulty. After the disappear of rash patient may feel a pin at the rash side at night.
Shingles affects one in five adults, infected with chicken pox as children, especially those who are immune suppressed, particularly infected with cancer HIV or other infection however stress can brings up the shingles as well although scientist are still researching the connection .
Those people get severe shingling infection who are under the age of 50 years and a have low immune system. Vaccine of shingles lesson the effect of symptoms, and side effects .
Chicken pox is relatively mild diseases in healthy children but may be life threatening in immuno- supressed patents, neonates and normal adults, especially smokers for whom the risk varicella is high. The epidemiology of chickens apperas to changing. There has been an unexplained up ward shift in the age distribution of cases over the last 20 years. In general practice this is reflected by increased concentration for the chicken pox. Due to chickenpox there are more deaths occurred in ENGLAND and WHALES. On the basis of the hospital admission for chicken pox in young adults, there is an evidence of similar trend in US. The epidemiological change has important consequences on future mortality rates and for risk of the infection in health care workers and pregnant women. The potential use of the varicella vaccine should be considered as measure to reduce the risk of vzv .
In temperate country vzv is primarily a disease of of children. The most cases occurring during the winter and the spring ,most likely due to school contact. It is one of the classical disease of the childhood, with the highest prevalence in the 4 to 10 year old group, it is uncommon in pre school and highly communicable with the infection rate of 90 % in close contacts. In tropics, often occurs in older people and may cause more serious disease. In adults the pock marks are darker and the scars more prominent than the children .
Prevention from Chickenpox
Child with chicken pox should not return to schools or play with other children until chicken pox sores have crusted over or dried scabs have fallen.Adults should follow the same rules when considering when to return to work or to be around other .
- Because it highly contagious and air borne it is difficult to avoid
- Spread of chicken pox can be prevent by isolating the infected individual
- Contagion is by exposure to respiratory droplet ,or direct contact with lesions,with in a period lasting from three days prior to the onset of rash.
- VZV is susceptible to disinfectant with chlorine bleach, sodium hydrocholride
- VZV is sensitive to heat,desiccation and detergents, therefore these viruses are easy to kill in the environment.
When to see for a Doctor?
You have to call your doctor or family doctor if you have noticed any sign or symptoms of chicken pox. Some points that may be helpful for preparing you for appointment .
Information you must know in advance
It is your duty to safe others from you by social distance. If your family members are infected from chickpox, stay safe at home to avoid spread of this infection to others. Ask for any type of restriction for you and your child which have to follow.
Pen down any symptoms you and your child having.
Recent exposure to any other infection
You must know and have to mention that you or your child have exposed to any other person who was having chicken pox.
Pen down any medicine you or your child have been taking from previous some months and also have to mention any medical problem if you and your child having.
Question if any you having in your mind
You may ask any question from your nurse and doctor related to your health issue. Relevant questions should be like this as under:
- What type of test you are going to recommend?
- What is cause of these sign and symptoms?
- How much time it will take to settle down?
- What treatment option are here for me?
- What type of treatment you like to recommend?
- Are there self care methods to relieve the symptoms or any home remedies?
- For how long? me and my child are contagious
- Who do we decrease the risk of infecting other healthy people
- Tell me the infected age?
Question from your Doctor side
- What type of sign and symptoms you have noticed?
- When did the appear at first time?
- Have come in contact with any person who was having symptoms like this?
- Are you and your have been taking any type of medication or treated with any disease? He may ask for prescription and over the counter drugs, vitamins and supplements .
- He may ask for any type of allergy from any group of medicine.
- What is your age and your child age? Is he going to school ?
- Are you smoker?
- Are you pregnant or at breast feeding stage?
Varicella vaccine initially developed by Michiaki Takahashi in 1974 derived from Oka strain. It has been available in US since 1995 to inoculate against the disease some country require vaccination before entering elementary schools protection from one dose is not life long second dose is necessary five years after the initial immunization which is currently part of routine immunization schedule in USA. It is not a part of routine childhood vaccination schedule in UK. Currently offered to people who are particularly vulnerable to chicken pox.
Children receive two doses of varicella vaccine first at age between 12 to 15 months and the second dose at age of 4 to 6 years .
Vaccine may be given in combination with measles, mumps, rubella but some children at the age od 12 to 23 months may get sever fever, seizures.
The unvaccinated child age group of 7 to 12 years who have not been vaccinated should receive two catch up doses of the varicella vaccine, given at least three months apart. Children age 13 or older who do not have been vaccinated should also receive two catch up doses of the vaccine, given at least four weeks apart.