Chicken pox - Highly infectious disease.

It is an acute, highly infectious disease caused by a Varicella-Zoster virus (V-Z virus). Chickenpox and Herpes Zoster are now considered as different host responses to the same virus. There is vesicular rash (fluid filled lesions) accompanied by fever. It usually occurs in children under 10 years of age. The disease will be severe if it occurs in adults. One attack gives durable immunity. Second attack is rare. The source of infection is usually a case of chickenpox. The virus is present in secretions from the mouth & lesions of skin and mucosa. Most of the patients are infected by person-to-person contact.

In majority of cases, the disease tends to be mild and typical. The clinical course of chickenpox may be divided in two stages.

First Stage

The disease starts suddenly with

1.Mild to moderate fever with or without Shivering
2.Body aches
3.Loss of appetite & Malaise

This stage may lasts for 24hrs.In adults this stage is more severe and may last 2 to 3 days before the appearance of rash.

Second stage:
In children the rashes are the first sign .It comes on the day the fever starts. The disease is communicable from 2 days prior to the onset of the rash till the time all skin lesions are crusted.

Distribution of rashes:
The rashes appear first on the trunk where it is abundant, and then face, arms & legs where it is less abundant .The lining of mouth is usually affected. Palms & soles of foot are not usually affected.

If you find vesicles filled with clear fluid (Dew Drop on rose petels) appearance surrounded by an area of redness it is a case of chickenpox. Scab formation begins 4 -7 days after the appearance of rash. The fever doesn’t run high but shows increase whenever fresh crops of rashes appear. Usually chickenpox is a mild, self-limiting disease.

Complications:
Majority of cases are resolved with time. However, chickenpox may be accompanied by severe complications particularly in aged, malnourished and immunocompromised patients. These include hemorrhages, infection may spread to lung or brain resulting in pneumonias and encephalitis respectively.

The women when they are infected during pregnancy the child inside the uterus may develop wasting, atrophied limbs, small head and have low birth weight.

Control:
1)Isolation of the cases for 6 days after the beginning of rash.
2)Disinfections of articles soiled by nose & throat discharges.

Vaccination:
Now vaccine is available in the market & routine immunization of all children is recommended routinely. Susceptible adults and immunucompromised persons should also vaccinated.

Treatment:
The treatment is mainly symptomatic. Proper care of skin involves daily bathing, close cutting of finger nails and use of soothing agents.

Oral antiviral drugs are also recommended. Other medications are used to treat fever and secondary infections.

With the consultation & Compilation with:
DR. Manoj Sethi
MBBS,DVD,DNB,MNAMS,AFIH

Chicken pox - Highly infectious disease.

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