CHICKEN POX – Symptoms, Prevention, Treatment

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Chicken pox is a very common viral infection occurring all over the world. It is caused by the varicella-zoster virus or HHV-3. This disease is highly contagious with 90% SAR ( Secondary Attack Rate). Chicken pox spread by skin to skin contact and droplet inhalation Like Seasonal influenza. It is also known by a varicella incubation period of this infectious disease is 10-20 days.

SIGNS AND SYMPTOMS

  • Fever
  • Malaise
  • Bodyache
  • Maculopapular Rash – Rash usually begins from face upper trunk and gradually spreads to the whole body. The rash becomes blister within a few hours and gives ” dew drops on a rose petal” appearance. Rashes are very pruritic, polymorphic and centrifugal. Blister gradually becomes crusts within 3-5 days. crusts usually go away with 1-2 weeks. Pitted scars are very common.
  • Loss of appetite

COMPLICATIONS OF CHICKEN POX

Chicken pox is usually a mild self-limiting disease but complications may occur rarely. Skin infections by bacteria like staphylococcus or streptococcus are common. Cellulitis, scarlet fever or impetigo may occur. Other secondary bacterial infections like septic arthritis, epiglottitis, osteomyelitis, meningitis can also develop. Respiratory problems as pneumonia occur often in smokers or pregnant women. Children with chicken pox may be complicated by neurological symptoms. Cerebellar ataxia is seen in the younger age group. Fulminant hepatitis is a very rare complication may occur in HIV infected people.

CHICKEN POX IN PREGNANCY

If chicken pox develops within 1st trimester of pregnancy, it has a small risk of developing congenital varicella syndrome of the fetus. Congenital varicella syndrome includes cataract, growth retardation, microphthalmia, deafness, chorioretinitis and limb abnormalities. If chicken pox occurs during delivery it causes fatal infection named as neonatal varicella.

CHICKEN POX DIAGNOSIS

Chicken pox is diagnosed by clinical presentation. Sometimes, PCR (Polymerase Chain Reaction) or immunofluorescence test is done.

CHICKEN POX TREATMENT

  • Symptomatic Treatment – Patients with varicella should be isolated until crusting. Fever should be treated by a high dose of acetaminophen. Itching is treated by oral antihistaminics like Lenocetrizine, Desloratidine etc and topical calamine lotion. In the case of secondary bacterial infection oral antibiotics are given. Aspirin is avoided for fever treatment. The patient should be informed to stop itching using nails due to the risk of infection.
  • Specific Antiviral TreatmentAcyclovir 20mg/kg (maximum 800 mg per dose) orally four times daily for 5 days, should be given as soon as possible. Acyclovir helps in quick healing. For pregnant women and immunocompromised patients intravenous acyclovir (30mg/kg/day) is given in three divided doses for 1 week.

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