| ||||
Chickenpox(Varicella)
by
Rick Alan DefinitionChickenpox is a viral infection. It is highly contagious. It creates a widespread, itchy rash. The infection can also cause serious complications in some people. Chickenpox is more dangerous for adults and newborns. It is also a danger for people with suppressed immune systems.
CausesChickenpox is caused by the varicella-zoster virus (VZV). It spreads from person to person via:
It is contagious 1-2 days before the rash erupts. It remains contagious until all of the blisters have crusted. This takes five days. It is most contagious just after the rash has broken out. A pregnant mother can transmit the virus to a fetus. Risk Factors TOPFactors that increase your chance of getting chickenpox include:
Symptoms TOPSymptoms break out about 10-21 days after contact. They are more severe in adults than they are in children. Initial symptoms include:
The rash appears within 1-2 days after the first symptoms. The rash will:
Diagnosis TOPThe doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis is usually based on the rash and your age. Blood and lab tests to identify the virus are rarely needed. Treatment TOPChickenpox is mild in most people. It will naturally run its course. In these cases, treatment focuses on relieving the symptoms. To Reduce Itching
AntibioticsAntibiotics cannot cure infections caused by a virus. They may be given if the rash becomes infected with bacteria. Antiviral MedicationThe course, severity, and duration of the infection may be reduced by antiviral medications, such as:
They are often used in:
Special NeedsVaricella-zoster immune globulin is often given immediately after exposure. It is reserved for newborns and people with weak immune systems. Prevention TOPAvoid contact with anyone who has chickenpox. This is very important if you have not been vaccinated against the infection. Vaccination in ChildrenThe varicella vaccine, or a combination vaccine called MMRV, is recommended for most children. MMRV protects against measles, mumps, rubella, and varicella. There is a “catch-up” schedule if your child has missed the routine injections. Vaccination in AdultsAdults who have never had chickenpox or received the varicella vaccine should be vaccinated. Vaccination After ExposureIf you or your child has not been vaccinated, but are exposed to chickenpox, a vaccine given right away may help lessen the severity of the infection, or prevent the infection. RESOURCES:American Academy of Family Physicians http://www.aafp.org/ American Academy of Pediatrics http://www.aap.org CANADIAN RESOURCES:AboutKidsHealth http://www.aboutkidshealth.ca/ College of Family Physicians of Canada http://www.cfpc.ca/ References:
Baker CJ, Pickerling LK, et al. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011.
Ann Intern Med.
2011;154(3):168-173.
Berkow R.
The Merck Manual of Medical Information.
17th
ed. Newy York, NY:Simon and Schuster, Inc; 2000.
Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2011.
MMWR.
2011;60(5).
Gales SA, Sweet A, et al. The safety profile of varicella vaccine: a 10-year review. J Infect Dis. 2008;197(Suppl2):S165-9). Marin M, Meissner HC, et al. Varicella prevention in the United States: a review of successes and challenges. Pediatrics. 2008;122: e744-51. A New Product (VariZIG) for Postexposure Prophylaxis of Varicalla Available under an Investigational New Drug Application Expanded Access Protocol. MMWR. 2006;55: 209-210.
Skull SA, Wang EE. Varicella vaccination: a critical review of the evidence.
Arch Dis Child.
2001;85:83-90.
Vaccine and Immunizations.
Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/vpd-vac/varicella/default.htm.
Accessed July 11, 2008.
Varicella (chickenpox). National Centers for Infectious Diseases website. Available at:
http://www.cdc.gov/chickenpox/about/overview.html.
Accessed July 11, 2008.
Vazquez M, LaRussa PS, et al. Effectiveness over time of varicella vaccine.
JAMA.
2004;291:851-855.
1/31/2008 DynaMed's Systematic Literature Surveillance. Available at:
http://dynamed.ebscohost.com/about/about-us: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm.
Updated January 10, 2008. Accessed January 28, 2008.
10/14/2008 DynaMed's Systematic Literature Surveillance. Available at:
http://dynamed.ebscohost.com/about/about-us: Macartney K, McIntryre P. Vaccines for post-exposure prophylaxis against varicella (chickenpox) in children and adults.
Cochrane Database Syst Rev.
2008;(3):CD001833.
Last reviewed October 2012 by Michael Woods, MD Last Updated: 10/11/2012 | ||||
| ||||