Chickenpox
What is chickenpox?
Chickenpox (varicella) is an extremely contagious childhood disease caused by the varicella-zoster virus. Winter and spring are the most common times of the year for chickenpox to occur.
Persons whose immune systems have been weakened from disease or medication should contact their doctor immediately if they are exposed to or develop chickenpox. If you are pregnant and are either exposed to or develop chickenpox, you should immediately discuss prevention and treatment options with your doctor.
Symptoms of chickenpox
Symptoms tend to appear 14 to 16 days after the initial exposure but can occur any time from 10 days up to 21 days after contact with the virus. These symptoms generally include one to two days of mild fever up to 102 degrees F, general weakness, and a red, raised rash that progresses to blisters that eventually burst and crust over. Rarely, a person may have the disease without the rash. This process usually starts on the scalp, then the trunk (its area of greatest concentration), and finally the arms and legs. Any area of skin that is irritated (by diaper rash, poison ivy, eczema, sunburn, etc.) is likely to be hard hit by the rash. The rash is typically very itchy.
Patients are contagious from one to five days before, and five days after, the date that their rash appears. When the sores have crusted over, the person is usually no longer contagious.
Because scratching the blisters can cause them to become infected, keep fingernails trimmed short. Calamine lotion and Aveeno® (oatmeal) baths may help relieve some of the itching. Do not use aspirin or aspirin-containing products to relieve fever, especially in children. The use of aspirin in children with chickenpox has been associated with development of Reye’s syndrome (a severe disease affecting all organs, but most seriously affecting the liver and brain, that may cause death).
How chickenpox is spread
It is easily passed between members of families and school classmates through airborne particles, droplets in exhaled air and fluid from the blisters or sores. It also can be transmitted indirectly by contact with articles of clothing and other items exposed to fresh drainage from open sores. Most people contract chickenpox by age 15, the majority between ages 5 and 9, but all ages can contract it. Chickenpox is usually more severe in adults and very young infants than in older children.
Complications from chickenpox
Complications can and do occur from chickenpox. Infection of the open pox sore by bacteria can injure the skin, sometimes causing scarring, especially if the patient scratches the inflamed area. Bacterial skin infection is, in fact, the most common complication of chickenpox in children. The next most common complications in children affect the central nervous system and include wobbliness, dizziness, tremor, and altered speech; encephalitis (inflammation of the brain with headaches, seizures, and decreased consciousness); damaged nerves (nerve palsies); and Reye's syndrome, a potentially fatal combination of liver and brain disease that can be associated with aspirin (children with fever should NOT take aspirin).
Especially serious complications can occur in patients with AIDS, lupus, leukemia, and cancer. Complications also occur in people taking immune-suppressing drugs, such as cortisone-related medications. Newborn infants whose mothers have chickenpox in the last trimester of pregnancy are at increased risk from the disease. If the mother develops the disease from five days before to two days after delivery, the fatality rate for the baby is up to 30%.
