Chickenpox is a highly contagious disease caused by varicella zoster virus (VZV).
It is an airborne disease, spread through respiratory droplets or direct contact with lesions. A patient may infect another person even three days prior to the onset of the rash as well as four to six days after the onset – until all the blisters have crusted over. Crusted lesions are not contagious.
Chickenpox is most common in kids under age 12, but anyone can get it. The incubation period lasts 14 to 16 days. The first symptoms of the disease are: fever, headache, sore throat, myalgia, itching, nausea, pain in both ears, feeling of pressure in head or swollen face, and malaise. In children, the first symptom is usually a characteristic, papular rash, which appears on the trunk and spreads to the face and limbs.
Chickenpox is rarely fatal, but it may lead to some serious complications – especially in adult males, non-immune pregnant women, and people with suppressed immune system. It is believed to be the cause of about 30 percent of stroke cases in children.
The most common late complication of chickenpox is shingles (herpes zoster), caused by the reactivation of VZV. After chickenpox, the virus can become latent in the neurons without causing any symptoms. Years or decades later, it may break out of nerve cells and cause viral infection of the skin in the region of the nerve. The rush is painful. About one in five patients develops postherpetic neuralgia – a condition difficult to manage. Other serious complications of shingles include partial facial paralysis (usually temporary), ear damage, or encephalitis.
Varicella treatment mainly consists of easing the symptoms. Patients are required to stay at home to avoid spreading the infection to other people. In order to minimize the risk of secondary infections, it is very important not to scratch the lesions. Staying in a cold surrounding as well as paying attention to personal hygiene help to ease the itching. Ointments or lotions with calamine or zinc oxide may also be used. Antiviral medications such as acyclovir should not be used in children younger than 12 years. Varicella treatment in children is aimed at symptoms whilst the immune system deals with the virus. In adults, antiviral treatment is generally advised and should be started within 24-48 hours from the rash onset. It is effective in reducing the severity of the condition and the likelihood of developing complications. Antihistamines may also be helpful – especially if the itching prevents sleep, because they have also sedative effect.
The best way to minimize the risk of chickenpox and its complications is varicella vaccination (two doses). It is not a part of the routine childhood vaccination schedule in Poland.
QUESTIONS (Choose TRUE or FALSE)
1. Varicella is most contagious between three days prior to the onset of the rash and six days after the onset.
2. Chickenpox may be fatal.
3. Shingles is the most common late complication of chickenpox and leads to permanent facial paralysis quite often.
4. Acyclovir is a first line agent in varicella treatment in children and adults.
5. One dose of varicella vaccine gives lifelong protection.
• chickenpox [ˈtʃɪkənpɒks] – ospa wietrzna
• varicella [værəˈsɛlə] – ospa wietrzna
• shingles [ˈʃɪŋgəlz] – półpasiec
• airborne [ˈɛərbɔrn] – przenoszona drogą kropelkową
• malaise [mæˈleɪz] – apatia, niepokój, złe samopoczucie
• papular [ˈpæpyulər] – grudkowaty
• herpes zoster [ˈhɜrpizˈzɒstər] – półpasiec
• fatal [ˈfeɪtl] – śmiertelny
• neuralgia [nʊˈrældʒə] – nerwoból
• encephalitis [ɛnsɛfəˈlaɪtɪs] – zapalenie mózgu
• calamine [ˈkæləmaɪn] – galman, kalamin
Correct answers: true, true, false, false, false
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