What is chickenpox ?
Chickenpox is a highly contagious infection caused by the varicella-zoster virus. It is especially infectious for those who never have the disease or never received a vaccine for it. At present, there are vaccines to protect children from chickenpox. According to the Centers for Disease and Prevention (CDC), routine vaccination is highly recommended to prevent chickenpox. The chickenpox vaccine is a safe and effective method for the prevention of chickenpox and its complications.
Symptoms
The signs and symptoms of chickenpox will start with an itchy rash that will appear 10-21 days after the patient is exposed to the virus. The blistering rash will appear for about five to 10 days. Other symptoms that will appear before the rash are:
- Fever
- Appetite loss
- Headache
- Feeling tired and malaise
There are three phrases of chickenpox after it has appeared:
- Pink or red papules that are starting to breakout for many days.
- Small blisters that are filled with fluid will start forming for one day and then starts to break and begin leaking.
- There will be crusts and scabs that will cover blisters that have broken, and these crusts will take many more days to recover.
After that, new red bumps will start to appear for days after, and eventually, the patient will face the different stages of rashes including bumps, blisters, and then eventually scabs. The patient will begin to spread the virus to others 48 hours before starting the rash and the infection will remain highly contagious until all blisters have covered crusts.
The disease tends to appear mild for healthy children. However, for severe cases, the rash can spread to the entire body and lesions could start occurring in the throat, eyes through the mucous area in the urethra, anus, and vagina of the patient.
When to see a doctor
Consult the doctor if you think you or the child may have the symptoms of chickenpox. The doctor usually can perform a diagnosis by performing a physical examination of the rash-like chickenpox and looking at other symptoms. The doctor may prescribe medicines to help manage the chickenpox as well as manage other complications. It is advised to call in advance for an appointment and mention to the hospital that you think you could be infected with chickenpox; this will help avoid spreading the virus to others.
The patient should also inform the doctor if there is a rash that has spread from one eye to both eyes. If rash becomes redder, warmer, or softer, it could mean other skin infection from bacteria. Or if the rash symptoms come with other symptoms such as feeling dizzy, fast heartbeat, shortness of breath, shaking, muscle coordination loss, a cough that gets worsens, vomit, stiff neck, or high fever that is higher than 38.9 Celsius.
Causes
The cause of a chicken pox infection is the virus that can spread to others through direct contact with the rash. If the infected patient cough or sneezes, it can also spray droplets into the air and infected those that inhale the droplets.
Risk factors
The patient would have a higher risk of being infected with chickenpox if they never had chickenpox before or never received the chickenpox vaccine. Chickenpox vaccination is vital for those who work in childcare or school. Most people who have previously had chickenpox or received the chicken pox vaccine have immunity for chickenpox. For those that get the vaccine but still develop the chickenpox, the symptoms will appear to be milder, fewer blisters, and mild fever. However, it is rare for people to get chickenpox more than once in a lifetime.
Complications
Chickenpox, although often mild, can also be severe and cause several complications, which are:
- Infections on the skin, tissues, bones, joints, or bloodstreams caused by bacteria
- Dehydration
- Pneumonia
- Encephalitis
- Toxic shock syndrome
- Reye’s syndrome which will occur in children and teenager that took aspirin during chickenpox infections
- Fatality
Risk groups
- Newborns and infants that their mothers have never had chickenpox or received chickenpox vaccines
- Teenagers and adults
- Women during pregnancy who have never had chickenpox
- Smokers
- Those with weakened immune systems, such as those who undergo chemotherapy or from conditions such as cancer or HIV
- Those who need to take steroid medications for the treatment of other conditions such as asthma
The effects of chickenpox on pregnancy
Babies born with mothers infected with chickenpox during the early-stage pregnancy tend to have low birth weight and abnormalities with their limbs. The baby will also have an increased risk of developing severe and life-threatening chickenpox if the mother has been infected during the week before birth or after birth.
Consult with the doctor about the risks that may happen to you and your unborn baby if you are currently pregnant and unimmune to chickenpox.
Shingles
Those who previously had chickenpox also will have a high risk of developing shingles. Shingle is a complication caused when the varicella-zoster virus remains in the nerve cells even after those skin infections have cured. The virus can reoccur several years later as shingles. Shingle is a cluster of painful blisters, but blisters do not last long. However, the pain could last longer even after blisters are gone. This condition is known as postherpetic neuralgia. It is a severe complication that tends to reappear in seniors or those with low immunity.
There are shingles vaccine available for adults that have chickenpox. Shingrix is an approved vaccine for people 50 or older and have received Zostavax. The doctor often prefers using Shingrix over Zostavax.
Prevention
The best way to prevent chickenpox is through chickenpox vaccination. According to the Centers for Disease Control and Prevention, the vaccine can help fully protect chickenpox and relieve symptoms of chickenpox.
Who should get the chickenpox vaccine?
Young children – The vaccine can be given in combination with other vaccines such as measles, mumps, and rubella. The combinations may cause fever and seizure risk in children ages between 12 and 23 months.
Older children who haven't been vaccinated – Older children between the ages of 7 to 12 years who are unvaccinated should also get two doses of the chickenpox vaccine; each dosage should be three months apart. As for unvaccinated children aged 13 or older, they should receive two doses of vaccines; each dose should be four weeks apart.
Adults who haven't been vaccinated – This group will have a higher risk of being exposed to chickenpox, these groups are for example, healthcare workers, those who work in school, childcare, military, or those who travel abroad consistently. Adults who live with young children and women capable of birthing a child should also get the vaccine.
Adults that have never had chickenpox – These groups should get two doses of vaccine; each dosage should be four to eight weeks apart. Discuss with the doctor if you are unsure if you have ever had the chickenpox infection or receive the vaccine, as the doctor will perform a blood test that can help determine the patient's immune system.
Which group should not receive chickenpox vaccine?
- Those who are pregnant
- Those who have weakened immune systems, such as HIV patients
- Those who need to take immune-suppressing medications
- Those who have allergies to gelatin or the antibiotic neomycin
Discuss with the doctor to find out if you need to be vaccinated. If you are planning on getting pregnant, it is essential to discuss vaccinations with the doctor before getting pregnant.
- Vaccines are a safe and effective method to prevent chickenpox. There are some side effects, but they are mild and are as follow:
- Red skin
- Feeling sore
- Small bumps at the shot spot, but this rarely happens
Diagnosis
The doctor will be able to diagnose chickenpox from examining rash as well as other tests, including:
- Blood tests
- Culture for samples of lesions
Treatment
Chickenpox usually requires no treatment, especially for healthy children. The doctor will, however, prescribe an antihistamine to help lessen itching symptoms.
For those with a higher risk of having complications from chickenpox, the doctor will prescribe medicine to help lessen the infection length and help lower the complication risks.
Suppose the doctor suspects that you or your child have an increased risk of having complications. In that case, the doctor may prescribe an antiviral drug to help lessen chickenpox's severe complications. It will be given within 24 hours after the rash appeared. Some other antiviral medicine could also help relieve the disease complications. The doctor will also suggest the patient get vaccination after the virus's exposure to help with disease prevention and reduce the chance of severe complications.
The treatment for the complications
Depending on the complications, the doctor will find the treatment that is suitable for the patient. The doctor may give an antibiotic prescription for infections on the skin as well as pneumonia. Antiviral drugs will also be given to treat encephalitis. In some cases, the patient may require staying at the hospital for treatment.
These self-care tips could help lessen the symptoms of chickenpox, as follow:
Do not scratch – Scratching can cause a scar and result in the wounds healing slowly, and the risk of becoming infected can increase.
Also, contact the doctor if the fever lasts longer than four days and the fever is higher than 38.9 Celsius. Do not give aspirin to children or adolescents who have chickenpox as it could cause severe Reye’s syndrome.
It is essential to discuss with the doctor before giving any NSAID drugs to a chickenpox patient. According to some research, this medicine could cause skin infections or damage to the tissues.
Preparing for the doctor appointment
These steps can help you prepare yourself for the appointment.
- Ask the doctor if there are any restrictions either you or the child should strictly follow, such as isolate yourself from others to prevent the spread of infections.
- Note down any symptoms that you and your child encounter, including when it starts and how long it has been going on.
- Try to remember if you or your child has received any chickenpox exposure recently.
- List any health problems you or your child have and any medications that both of you are currently taking.
- Note down the questions you want to ask the doctor.
Some of the questions the patient can ask the doctor:
- What are the possible causes of these signs and symptoms?
- Are there any other causes that could result in these symptoms?
- What are treatment options?
- How long does it take for these symptoms to improve?
- Will these symptoms become contagious to others, and for how long?
- How can we reduce any risk of spreading the infections to others?
What to expect from the doctor
Some of the questions the doctor may ask are as follow:
- What are the first signs or symptoms that you noticed?
- Did you know or come across anyone with similar symptoms of chickenpox in these past few weeks?
- Have you had or has your child received the chickenpox vaccine, and how many doses?
- Are you or your child being treated for any other medical conditions?
- Are you or your child currently taking any other medicines, including prescribed drugs, vitamins, or supplements?
- Is your child now in school or childcare?
- Are you currently pregnant, or are you breastfeeding?
