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Chickenpox: Causes, Symptoms, Treatment
Two year old boy with chickenpox
In this article, we will describe 10 facts about chickenpox.
- Chickenpox (varicella) is a highly contagious viral illness caused by primary infection with the varicella-zoster virus (VZV), characterised by a pruritic (itchy) vesicular (blistering) rash.
2. Cause
- The varicella-zoster virus is transmitted via respiratory droplets or direct contact with rash fluid, with a secondary attack rate of up to 90% in susceptible household contacts.
3. Risk Factors
- High-risk groups include immunocompromised patients (e.g. HIV/AIDS, chemotherapy), pregnant women, newborns exposed perinatally, and adults, who are more likely to experience severe disease.
4. Symptoms
- The rash typically begins on the trunk (chest and back), and spreads to the face and rest of body.
- The rash evolves from macules to itchy, fluid-filled blisters that eventually crust and turn into scabs.
- It is often accompanied by fever, malaise, and headache.
- A person with chickenpox may have as many as 500 blisters.
5. Diagnosis
- Diagnosis is primarily clinical, based on the characteristic rash and exposure history; laboratory confirmation can be made with blood tests (e.g. PCR or serology) if needed.
6. Treatment
- Management is mainly supportive
- Antiviral therapy (e.g. acyclovir) considered for high-risk patients or severe cases; antihistamines and topical calamine can alleviate pruritus.
7. Complications
- Potential complications include secondary bacterial skin infections, pneumonia, encephalitis, and cerebellar ataxia; severe disease can occur in immunocompromised individuals.
8. Prognosis (outlook)
- Most immunocompetent individuals recover fully, but the virus remains latent in nerve ganglia and can reactivate as herpes zoster (shingles) later in life.
9. Prevention
- Vaccination is recommended for susceptible individuals, especially healthcare workers and household contacts of immunocompromised patients, to prevent infection and transmission.
10. Referral
- Refer patients to specialist care if they are immunocompromised, pregnant, or have severe symptoms or complications; early involvement of a dermatologist or infectious disease specialist may be warranted.
