(varicella) is a viral infection that causes an itchy, blister-like rash. Chickenpox is highly contagious to people who haven’t had the disease nor been vaccinated against it. Before routine chickenpox vaccination, virtually all people had been infected by the time they reached adulthood, sometimes with serious complications. Today, the number of cases and hospitalizations is down dramatically.
For most people, chickenpox is a mild disease. Still, it’s better to get vaccinated. The chickenpox vaccine is a safe, effective way to prevent chickenpox and its possible complications.
Chickenpox infection usually lasts about five to 10 days. The rash is the telltale indication of chickenpox. Other signs and symptoms, which may appear one to two days before the rash, include:
Loss of appetite
Tiredness and a general feeling of being unwell (malaise)
Once the chickenpox rash appears, it goes through three phases:
Raised pink or red bumps (papules), which break out over several days
Fluid-filled blisters (vesicles), forming from the raised bumps over about one day before breaking and leaking
Crusts and scabs, which cover the broken blisters and take several more days to heal
New bumps continue to appear for several days. As a result, you may have all three stages of the rash — bumps, blisters and scabbed lesions — at the same time on the second day of the rash. Once infected, you can spread the virus for up to 48 hours before the rash appears, and you remain contagious until all spots crust over.
The disease is generally mild in healthy children. In severe cases, the rash can spread to cover the entire body, and lesions may form in the throat, eyes and mucous membranes of the urethra, anus and vagina. New spots continue to appear for several days.
Chickenpox, which is caused by the varicella-zoster virus, is highly contagious, and it can spread quickly. The virus is transmitted by direct contact with the rash or by droplets dispersed into the air by coughing or sneezing.
Your risk of catching chickenpox is higher if you:
Haven’t had chickenpox
Haven’t been vaccinated for chickenpox
Work in or attend a school or child care facility
Live with children
Most people who’ve been vaccinated against chickenpox or who’ve had chickenpox are immune to the virus.
Chickenpox is normally a mild disease. But it can be serious and can lead to complications, especially in high-risk people. Complications include:
Bacterial infections of the skin, soft tissues, bones, joints or bloodstream (Sepsis)
Inflammation of the brain (Encephalitis)
Toxic shock syndrome
Reye’s syndrome for people who take aspirin during chickenpox
Who’s at risk?
Those at high risk of having complications from chickenpox include:
Newborns and infants whose mothers never had chickenpox or the vaccine
Pregnant women who haven’t had chickenpox
People whose immune systems are impaired by medication, such as chemotherapy, or another disease, such as Cancer or HIV
People who are taking steroid medications for another disease or condition, such as children with Asthma
People taking drugs that suppress their immune systems
TREATMENTS AND DRUGS
In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course.
If you’re at high risk of complications
For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications.
If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (IGIV). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but they have been approved for use only in adults. In some cases, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity.
Don’t give anyone with chickenpox — child or adult — any medicine containing aspirin because this combination has been associated with a condition called Reye’s syndrome.
If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and Pneumonia may be with antibiotics. Treatment for Encephalitis is usually with antiviral drugs. Hospitalization may be necessary.
LIFESTYLE AND HOME REMEDIES
The chickenpox (varicella) vaccine is the best way to prevent chickenpox. Experts from the Centers for Disease Control and Prevention (CDC) estimate that the vaccine provides complete protection from the virus for nearly 90 percent of young children who receive it. When the vaccine doesn’t provide complete protection, it significantly lessens the severity of the disease.
The chickenpox vaccine (Varivax) is recommended for:
In the United States, children receive two doses of the varicella vaccine — the first between ages 12 and 15 months and the second between ages 4 and 6 years — as part of the routine childhood immunization schedule. The vaccine can be combined with the Measles, Mumps and Rubella vaccine, but the combination may increase the risk of Fever and seizure from the vaccine. Discuss the pros and cons of combining the vaccines with your child’s doctor.
Unvaccinated older children.
Children ages 7 to 12 years who haven’t been vaccinated should receive two catch-up doses of the varicella vaccine, given at least three months apart. Children age 13 or older who haven’t been vaccinated should also receive two catch-up doses of the vaccine, given at least four weeks apart.
Unvaccinated adults who’ve never had chickenpox but are at high risk of exposure. This includes health care workers, teachers, child care employees, international travelers, military personnel, adults who live with young children and all women of childbearing age. Adults who’ve never had chickenpox or been vaccinated usually receive two doses of the vaccine, four to eight weeks apart. If you don’t remember whether you’ve had chickenpox or the vaccine, a blood test can determine your immunity.
If you’ve had chickenpox, you don’t need the chickenpox vaccine. A case of the chickenpox usually makes a person immune to the virus for life. It’s possible to get chickenpox more than once, but this isn’t common. However, if you’re older than 60, talk to your doctor about the Shingles vaccine.
The chickenpox vaccine isn’t approved for:
People with weakened immunity, such as those with HIV or people taking immune-suppressing medications
People who are allergic to gelatin or the antibiotic neomycin
Talk to your doctor if you’re unsure about your need for the vaccine. If you’re planning on becoming pregnant, consult with your doctor to make sure you’re up to date on your vaccinations before conceiving a child.
Is it safe and effective?
Parents typically wonder whether vaccines are safe. Since the chickenpox vaccine became available, studies have consistently found it safe and effective. Side effects are generally mild and include redness, soreness, swelling and, rarely, small bumps at the site of the shot.
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