Blood tests can confirm immunity to chickenpox in people who are unsure if they have had the disease. What are the symptoms of chickenpox? Symptoms may include: Fatigue and irritability one to two days before the rash begins Itchy rash on the trunk, face, scalp, under the armpits, on the upper arms and legs, and inside the mouth. The rash appears in several crops. It starts as flat red spots and progresses to raised red bumps that then become blisters. Feeling ill Decreased appetite The initial symptoms of chickenpox may resemble other infections.
How is chickenpox diagnosed? How is chickenpox treated? Specific treatment for chickenpox will be determined by your healthcare provider based on: Your overall health and medical history Extent of the condition Your tolerance for specific medicines, procedures, or therapies Expectations for the course of the condition Your opinion or preference Treatment for chickenpox may include: Acetaminophen to reduce fever. Skin lotion to relieve itchiness Antiviral drugs for severe cases Bed rest Drinking plenty of fluids to prevent dehydration Cool baths with baking soda to relieve itching Children should not scratch the blisters because it could lead to secondary bacterial infections.
What are the complications of chickenpox? Complications may include: Secondary bacterial infections Pneumonia lung infections Encephalitis inflammation of the brain Cerebellar ataxia defective muscular coordination Transverse myelitis inflammation along the spinal cord Reye syndrome. This is a serious condition marked by a group of symptoms that may affect all major systems or organs.
Do not give aspirin to children with chickenpox. It increases the risk for Reye syndrome. Death When should I call my healthcare provider? It is easily spread to others. There is a vaccine available to prevent chickenpox. They may be life-threatening to adults and people of any age with weak immune systems.
New lesions may continue to develop for more than 7 days, may appear on the palms and soles, and may be hemorrhagic. Children with HIV infection tend to have atypical rash with new crops of lesions presenting for weeks or months. The lesions may initially be typical maculopapular vesicular but can later develop into non-healing ulcers that become necrotic, crusted, and hyperkeratotic.
The rate of complications may also be lower in HIV-infected children on antiretroviral therapy or HIV-infected people with higher CD4 counts at the time of varicella infection. Retinitis can occur among HIV-infected children and adolescents. As a result, varicella is relatively uncommon among HIV-infected adults. Pregnant women who get varicella are at risk for serious complications, primarily pneumonia, and in some cases, may die as a result of varicella. Some studies have suggested that both the frequency and severity of VZV pneumonia are higher when varicella is acquired during the third trimester, although other studies have not supported this observation.
If a pregnant woman gets varicella in her first or early second trimester, her baby has a small risk 0. The baby may have scarring on the skin; abnormalities in limbs, brain, and eyes, and low birth weight. If a woman develops varicella rash from 5 days before to 2 days after delivery, the newborn will be at risk for neonatal varicella. The vaccine is contraindicated for pregnant women. Top of Page. Varicella-Zoster Immune Globulin For people exposed to varicella or herpes zoster who cannot receive varicella vaccine, varicella-zoster immune globulin can prevent varicella from developing or lessen the severity of the disease.
Varicella-zoster immune globulin is recommended for people who cannot receive the vaccine and 1 who lack evidence of immunity to varicella, 2 whose exposure is likely to result in infection, and 3 are at high risk for severe varicella. VariZIG is commercially available from a broad network of specialty distributors in the United States list available at www. Acyclovir Treatment The American Academy of Pediatrics AAP recommends that certain groups at increased risk for moderate to severe varicella be considered for oral acyclovir or valacyclovir treatment.
These high risk groups include:. Some healthcare providers may elect to use oral acyclovir or valacyclovir for secondary cases within a household. For maximum benefit, oral acyclovir or valacyclovir therapy should be given within the first 24 hours after the varicella rash starts. Oral acyclovir or valacyclovir therapy is not recommended by AAP for use in otherwise healthy children experiencing typical varicella without complications.
Acyclovir is a category B drug based on the U. Some experts recommend oral acyclovir or valacyclovir for pregnant women with varicella, especially during the second and third trimesters. Intravenous acyclovir is recommended for the pregnant patient with serious, viral-mediated complications of varicella, such as pneumonia. Intravenous acyclovir therapy is recommended for severe disease e. Vaccination provides effective prevention in immunocompetent patients.
Chickenpox is caused by the varicella-zoster virus human herpesvirus type 3 ; chickenpox is the acute invasive phase of the infection, and herpes zoster Herpes Zoster Herpes zoster is infection that results when varicella-zoster virus reactivates from its latent state in a posterior dorsal root ganglion. Symptoms usually begin with pain along the affected Mucosal usually nasopharyngeal inoculation via infected airborne droplets or aerosolized particles. Chickenpox is most communicable during the prodrome and early stages of the eruption.
It is communicable from 48 hours before the first skin lesions appear until the final lesions have crusted. Indirect transmission by carriers who are immune does not occur. Prior to the advent of the varicella vaccine Varicella Vaccine Varicella vaccination provides effective protection against varicella chickenpox.
It is not known how long protection against varicella lasts. But, live-virus vaccines, like the varicella After initial infection, all herpesviruses remain latent within specific host cells and may subsequently In immunocompetent children, chickenpox is rarely severe.
In adults and immunocompromised children, infection can often be serious. Mild headache, moderate fever, and malaise may occur 7 to 21 days after exposure, about 24 to 36 hours before lesions appear. The initial rash, a macular eruption, may be accompanied by an evanescent flush. Within a few hours, lesions progress to papules and then characteristic, sometimes pathognomonic teardrop vesicles, often intensely itchy, on red bases.
The lesions become pustular and then crust. Lesions evolve from macules to papules and vesicles, which then crust. A hallmark of chickenpox is that lesions develop in crops so that they are in various stages of development in any affected region.
The eruption may be generalized in severe cases involving the trunk, extremities, and face, or more limited but almost always involves the upper trunk. Ulcerated lesions may develop on the mucous membranes, including the oropharynx and upper respiratory tract, palpebral conjunctiva, and rectal and vaginal mucosa.
In the mouth, vesicles rupture immediately, are indistinguishable from those of herpetic gingivostomatitis, and often cause pain during swallowing. New lesions usually cease to appear by the 5th day, and the majority are crusted by the 6th day; most crusts disappear 20 days after onset. Sometimes vaccinated children develop varicella called breakthrough varicella ; in these cases, the rash is typically milder, fever is less common, and the illness is shorter; the lesions are contagious.
Secondary bacterial infection typically streptococcal or staphylococcal of the vesicles may occur, causing cellulitis or rarely necrotizing fasciitis or streptococcal toxic shock. Pneumonia may complicate severe chickenpox in adults, neonates, and immunocompromised patients of all ages but usually not in immunocompetent young children.
Transverse myelitis Acute Transverse Myelitis Acute transverse myelitis is acute inflammation of gray and white matter in one or more adjacent spinal cord segments, usually thoracic. Causes include multiple sclerosis, neuromyelitis optica Reye syndrome Reye Syndrome Reye syndrome is a rare form of acute encephalopathy and fatty infiltration of the liver that tends to occur after some acute viral infections, particularly when salicylates are used.
A person with chickenpox is considered contagious beginning 1 to 2 days before rash onset until all the chickenpox lesions have crusted scabbed. Vaccinated people who get chickenpox may develop lesions that do not crust. These people are considered contagious until no new lesions have appeared for 24 hours. CDC strongly recommends against hosting or participating in these events.
Chickenpox can be serious and can lead to severe complications and death, even in healthy children. So it is not worth taking the chance of exposing your child to someone with the disease.
The best way to protect infants and children against chickenpox is to get them vaccinated. The varicella-zoster virus also causes shingles.
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