CHICKENPOX(Varicella) |
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CHICKENPOX (Varicella)
DESCRIPTIONChickenpox is a very contagious, mild disease caused by the herpes zoster virus. The skin and mucous membranes are involved.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications, if complications arise.
SIGNS & SYMPTOMS
The following are usually mild in children, severe in adults:
Fever.
Abdominal pain or a general ill feeling that lasts 1 or 2 days.
Skin eruptions that appear almost anywhere on the body, including the scalp and penis, and inside the mouth, nose, throat, or vagina. They may be scattered over large areas, and they occur least on the arms and legs. Blisters collapse within 24 hours and form scabs. New crops of blisters erupt every 3 to 4 days. (Adults have additional symptoms that resemble influenza.)
CAUSES
Infection with the herpes zoster virus. Incubation after exposure is 7 to 21 days.
A newborn is protected for several months from chickenpox if the mother had the disease prior to or during pregnancy. The immunity diminishes in 10 to 12 months.
RISK FACTORS
Use of immunosuppressive drugs.
PREVENTING COMPLICATIONS OR RECURRENCECannot be prevented at present. An experimental vaccine is available for high-risk persons, such as those who take anti-cancer or immunosuppressive drugs.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
POSSIBLE COMPLICATIONS
Secondary bacterial infection of chickenpox blisters.
Encephalitis (rare).
Shingles many years later in adulthood (possibly).
Scarring (rare). This is more common if blisters become infected.
PROBABLE OUTCOME
Spontaneous recovery. Children usually recover in 7 to 10 days. (Adults take longer and are more likely to develop complications.) After recovery, a person usually has lifelong immunity against a recurrence of chickenpox.
After chickenpox runs its course, the virus remains dormant in the body (probably in the roots of nerves near the spinal cord). The same virus may later cause shingles.
TREATMENT
HOME CARE
Use cool-water soaks or cool-water compresses to reduce your child's itching.
Keep the patient as quiet and cool as possible. Heat and sweat trigger itching.
Keep the child's nails short to discourage scratching, which can lead to secondary infection.
MEDICATION
The following non-prescription medicines may decrease your child's itching:
-- Steroid lotion, ointment, or cream. This reduces inflammation and relieves itching in 24 to 48 hours.
-- Topical anesthetics and topical antihistamines, which provide quick, short-term relief. Preparations containing lidocaine and pramoxine are least likely to cause allergic skin reactions.
-- Lotions that contain phenol, menthol, and camphor (such as calamine lotion). These are soothing, but use with care. Large amounts may be absorbed through the skin into the bloodstream, and they can be toxic.
If you must reduce fever, use acetaminophen instead of aspirin. Aspirin may contribute to the development of Reye's syndrome, a form of encephalitis, when given to children during a viral illness.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Bed rest is not necessary. Allow quiet activity in a cool environment. Your child may play outdoors in the shade during nice weather. Keep an ill child away from others until all blisters have crusted.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?The child can return when lesions have all scabbed over, temperature is normal, and sense of well-being has returned.
CALL YOUR DOCTOR IF
Your child has symptoms of chickenpox.
Lethargy, headache, or sensitivity to bright light develop.
Fever rises over 103F (39.4C).
Chickenpox lesions contain pus or otherwise appear infected.
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