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6

Chickenpox is a highly contagious

disease, caused by a virus which
belongs to the herpes family. This
virus is known as varicella-zoster
virus and also as the Herpes
Zoster virus. Not only chickenpox
is produced by it but shingles is
too.
Shingles occurs most commonly in
older patients, and occurs because
of a reactivation of the Varicella
virus.
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ÿ f an infected person coughs or
sneezes, the virus will be spread in
the air and will be caught by other
healthy persons while breathing.
The virus is known to be present in
the body long before the skin rash
appears; this is the reason why
there are so many cases of
contamination.

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ÿ
fter the virus got into your body it

generally needs two weeks to
develop and only then the rash will
appear. But this does not mean
that you are not contagious within
these two weeks.

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 ‰isk Factors
ÿ sually it is a self limiting disease but
complications can occur in those with the
following risk factors
± mmunocompromised
± Older age
± Long-term steroid use
± Malignancy
ÿ t tends to be milder in younger children
than in older children and if contracted in
adulthood it is significantly more
unpleasant.
ÿ t is dangerous in neonates and to the fetus
if contracted in pregnancy.
ÿ The infection tends to be severe in
pregnancy - a high risk of pneumonia as
well as risks to the fetus as described below
ÿ Complications may occur in as many as 1 in
50 cases
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§The characteristic chickenpox vesicle,

surrounded by an erythematous halo, is
described as a dewdrop on a rose petal
§Chickenpox is clinically characterized by
the presence of active and healing lesions,
in all stages of development, within
affected locations. Lesions characteristically
heal without scarring, though excoriation or
secondary bacterial superinfection
predispose to scar formation.
§
dults may experience a more widespread
rash; prolonged fever; and an increased
likelihood of complications, the most
common being varicella pneumonia.
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§ n children the first symptom is
usually the development of a
papular rash

§ Followed by development of
malaise, fever (a body temperature
of 38 ÚC (100 ÚF), but may be as
high as 42 ÚC (108 ÚF) in rare
cases), and anorexia.

§Typically, the disease is more

severe in adults.

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§Chickenpox is usually diagnosed clinically on the
basis of the characteristic rash and successive
crops of lesions. Lesions may be found in all stages
of development and healing in affected sites.

history of exposure to an infected contact within
the incubation period of 10-21 days is also an
important clue in the diagnosis. Consider the
following:

§Chickenpox in adults and adolescents may be

preceded by a prodrome of nausea, myalgia,
anorexia, and headache.

§The typical patient is infectious for 1-2 days prior

to the development of rash and for 4-5 days
afterwards, which is usually the time at which the
last crop of vesicles has crusted over.

§The triad of rash, malaise, and low-grade fever

signals |the onset  






of chickenpox.
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ÿ Small, erythematous macules appear on the

scalp, the face, the trunk, and the proximal
limbs, with rapid sequential progression
over 12-14 hours to papules, clear vesicles,
and pustules, with subsequent central
umbilication and crust formation.

ÿ New crops of lesions form, which

subsequently progress to vesicles with
crusting.
ÿ Vesicles may appear on the palms and the
soles and on the mucous membranes, with
painful, shallow, oropharyngeal or
urogenital ulcers.

ÿ ntense pruritus commonly accompanies

the vesicular stage of the rash.
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single blister, typical during the early
stages of the rash
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§ n children the first symptom is
usually the development of a
papular rash

§ Followed by development of
malaise, fever (a body temperature
of 38 ÚC (100 ÚF), but may be as
high as 42 ÚC (108 ÚF) in rare
cases), and anorexia.

§Typically, the disease is more

severe in adults.

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§Minimize scratching
§
void sharing of things such as clothes
& utensils
§Prevent spread of infection
§Provide adequate rest period
§Promote good hygiene
§
dvice regarding adequate fluid intake
§Symptomatic treatment
§
ciclovir
§Practice universal precautions
§ solate the patient

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