Chicken Pox

Chicken pox is a common childhood infection that usually causes mild disease. It is caused by a virus called Varicella zoster virus (or VZV for short).

The incubation period for chicken pox is usually 14 – 16 days but this might extend to between 10 – 21 days. Contacts are infectious from 48 hours before the development of the rash until all the lesions have scabbed over.

Typical features of infection before the rash appears includes fever, tiredness,sore throat and loss of appetite with the rash then developing within the next 24 hours. The rash is described as vesicular which means that there are small fluid filled lesions on the skin.

Most cases of chicken pox are mild and self limiting. Rarely there can be complications which affect the soft tissue, brain, lungs or liver. The disease can be a particular problem for patients with cancer, underlying immune deficiency, HIV , those who are on steroids or those who have had an organ transplant.

Treatment

Treatment is supportive ensuring adequate fluid intake and controlling the fever using paracetamol. Aspirin should NOT be used in children and ibuprofen is NOT recommended because of the risk of serious side effects.

Precautions

It is important that if infected, contact is avoided with newborn babies, pregnant women and those with a weak or defective immune system (including those on steroids).

Vaccine

There has been a chicken pox vaccine available since 1988 but it is not currently part of the United Kingdom vaccination programme. Unlike the UK, the United States has implemented the vaccine against chicken pox since 1995 with little in the way of negative effects.

There are however certain circumstances when vaccination is warranted:

To protect patients who have defective immune systems (such as those with HIV or who are receiving chemotherapy). In this situation, individuals who come into contact with these patients but who are not chicken pox immune can be vaccinated.

Healthcare workers who have not had chicken pox should be vaccinated.

Chicken pox during pregnancy can cause complications in the newborn infant and therefore treatment may be indicated to reduce the risks. The following link from the Royal college of obstetricians and gynaecologists explains when intervention is needed;

Pregnancy & chicken pox

Authored by: Dr Tim Ubhi

Published: 8th March 2019

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