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Chickenpox

By Sasha de Beausset Aparicio, MSc

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Chickenpox

What Is Chickenpox

Chickenpox represents a disease that is viewed as highly contagious and begins with a vesicular skin rash that appears on the body and the head and not at the periphery. It is airborne which means that it spreads from one person to the other through sneezing, coughing or direct contact with the secretions that come from the rash. An individual that suffers from this disease is generally infections one to two days prior its manifestation. Additionally, this disease has been observed in other primates such as gorillas or chimpanzees.

From a historical point of view, this disease was noticed by people from ancient Babylonia. It was stated that “There was a description of an affliction similar to chicken pox more than 2,000 years ago in ancient Babylonia. In the late 800’s/early 900?s AD, Muhammad ibn Zakariya Razi, also known as Razi, recorded some of the first known information on chicken pox and noted the differences between measles and small pox. Later in the 1500?s Giovanni Filippo was able to give a more detailed description of chicken pox.” However, the name “chickenpox” was given by Richard Morton to something he initially considered a milder form of smallpox. Only in 1700, William Heberder proved that chickenpox systematically differs from smallpox. Furthermore, in 1909, Von Bokay proposed the idea that shingles and chickenpox were related infections. It was confirmed ten years later because “children inoculated with fluid from zoster vesicles were shown to contract chickenpox.”

Shingles is the reactivation of the virus that determined the initial chickenpox. This virus is kept at bay by the immune system, but can reactivate after 60 years old. Most of the adults who suffered from chickenpox in their childhood are susceptible to shingles who affects one in five adults. This is why it is usually recommended to get the shingles vaccine after the age of 50.
This disease occurs in countries all over the world. According to certain statistics, it caused somewhere around 6,800 deaths in 2010 as compared to 11,200 in 1990. While in temperate regions it appears during childhood, in the tropics, older people are more likely to suffer from a more serious form of chickenpox.

Causes

The cause behind the development of this disease is a virus named varicella-zoster. As it was previously mentioned, it can be easily spread through coughing and sneezing from an infected to a healthy person. A characteristic that should be taken into account is the fact that it can infect two or three days before the apparition of the rash. It can only affect individuals who have never suffered from this infection and didn’t have a vaccine against it. It is often viewed as a childhood disease and a person can only suffer from it once in a lifetime. On the other hand, the virus remains in the organism after its manifestation and can reappear in another form called shingles after the age of 60.

Shingles is often a result of a malfunctioning immune system due to other diseases like HIV or Lupus. In order to decrease the chances of its development, one should consider taking the vaccine at a proper time.

Signs & Symptoms

The first sign of chickenpox are usually represented by headache, sore throat, and fever. When it comes to children, they may present as tired, sick and with a lack of appetite. The rash appears one or two days after the initial symptoms. However, there are some situations in which children don’t have fever or headaches and the rash seems to be out of the blue.

The actual manifestation of the disease is fourteen to sixteen days after being around an individual that has it. This duration is called the incubation period. After the apparition of the first chickenpox red spot, it takes one to two days for it to get through all stages. These are blistering, bursting, drying, and finally crusting over. Unfortunately, new spots will appear for up to five-seven days counted after the first one.

One can go back to the job, school or other daily chores once all blisters have crusted over. This generally happens ten days after the first symptom has occurred. Considering the fact that other medical conditions come with similar symptoms as chickenpox, one should think twice before viewing it as a viable option, particularly if no contact with an infected person occurred in the past two weeks.

Diagnosis Chickenpox

When the above-presented symptoms are experienced and there was a contact with an infected individual in the past two weeks, the person should consider visiting a personal doctor in order to diagnose this disease. The first step in the process is asking information about the patient in order to find out if there was any type of contact with the infection.

It is generally suggested to avoid the visit to a healthcare provider if chickenpox occurs in children that were previously healthy and didn’t suffer from any type of medical complication. Instead, the parents can call a doctor and describe the symptoms. By doing this, further spreading is avoided because there will be no contact with other healthy people.

When it comes to teenagers, pregnant women, adults, or people with health problems, the story goes on a different way. They are advised to immediately consult the doctor so potential complications are prevented. For instance, in pregnant women, chickenpox can determine birth defects if it’s not treated in any way. In addition, those that possess low immunity levels can also be negatively affected and may be more susceptible to more serious complications. Those with health issues usually require more treatment that can include antiviral medicine or immunoglobulin treatment or IG. The visit to the doctor can also be made immediately after the exposure to an infected person in order to make the patient feel better throughout its manifestation.

Treatment for Chickenpox

Before thinking about ways to treat chickenpox, one should consider preventing it because it can be done way more easily. The most common way of prevention is vaccination. Doctors suggest two doses for healthy children that are more than twelve months of age and haven’t previously had it. The same dose goes for older children and adults who weren’t exposed to the virus in their childhood. There are also some cases in which individuals who got the vaccine still develop chickenpox as there are cases in which people get it again even though they had it during their childhood. However, the manifestation is mild in those situations and there are fewer symptoms and symptoms. This second occurrence goes by the name of breakthrough infection.

The vaccine that has been administrated to children throughout time has been found effective by researchers from Kaiser Permanente in Northern California. The research was done on a 14-year old period and included seven thousand five hundred eighty five children that received the vaccine between June and November in the year 1995. They were between twelve and twenty three months of age. These children were checked every six months for the time being and the telephone interviewers asked if the vaccinated children developed either chickenpox or shingles in this period. Furthermore, parents received a number that was free to call if their child developed this disease. Throughout the entire study, there were one thousand and five hundred cases of “breakthrough” varicella reported in children that have been immunized. This represents the equivalent of sixteen cases per one thousand people in a year. For unvaccinated children, the rate situates at one hundred forty cases per one thousand in a year.

It was observed that the incidence of breakthrough situations declined during the study, most likely because of an increase in herd immunity. This means that the vaccine’s protection didn’t wear off over time. After the second dose of vaccine, none of the children developed chickenpox. As a conclusion, Dr. Randy Bergen from the Kaiser Permanente’s Walnut Creek Medical Center concluded in the following statement: “Clearly, the vaccine is a very effective tool in preventing or limiting the severity of chicken pox in young people.” This means that parents should definitely consider vaccinating their kid before deciding to try any other approach for preventing chickenpox.

Another feature on which doctor emphasize is represented by the intentional exposure to people that suffer from chickenpox. While there is a wide array of parents that do it, it is not viewed as a good idea due to the weak immune system of children that can develop serious complications while having this disease.

As far as the actual treatment goes, people should try to avoid rubbing or scratching the itchy areas, apply a moisturizes after bathing in order to cool and soften the skin, don’t expose for longer periods to excessive humidity or heat, wear light bedclothes that doesn’t include wool, try over-the-counter hydrocortisone cream on infected areas, and try over-the-counter oral antihistamine like diphenhydramine. For more troublesome cases, there is also medication for fighting the chickenpox made available through prescription. This should be taken within the first twenty-four hours of the rash for optimal results.

After the visit to a specialized doctor, he or she can decide to prescribe medication, depending on the severity of chickenpox and potential risks the patient is exposed to. For instance, people that suffer from other health problems, teenagers with weak immunity system or pregnant women are among the individuals that beneficiate from another type of treatment as compared to healthy children. The type of medication that is generally prescribed is antiviral medication.

While the opinion of a specialized healthcare provider is important, those who prefer to skip it should keep in mind that aspirin or ibuprofen administration is very dangerous because it has been linked to a serious condition named Reyes syndrome. Moreover, ibuprofen is associated with other severe secondary infections and taking it can be a matter of life and death.
For people that decide to try the natural supplementation approach, ingredients like chamomile, kiwi, lemon, berries and Vitamin C should be targeted. Proper hydration and a good sleeping schedule will also have a positive influence on the patient’s recovery.

References

chickenpox.emedtv.com
webmd.com
health.nytimes.com
“Principles and practice of clinical virology” (3d edition) Wiley p.37
“Chickenpox clinical presentation” in Medscape Reference, Retrieved on 4th of August 2012
“Chickenpox in pregnancy” March of Dimes, April 2007
“Symptoms of chickenpox” NHS Choices