The Road to Better Health

Varicella or chicken pox and Zoster

Varicella or chicken pox and Zoster are viral infections caused by a virus, herpesvirus varicellae . Varicella or Chickenpox represents primary infection with this agent, whereas Zoster is due to reactivation of this virus from its dormant state in the nerve, dorsal root ganglia.

Primary infection with this virus manifests itself after a 10-21 day incubation period or within that time after you were exposed to that virus. Symptoms begin with a nonspecific viral prodrome or flu like symptoms followed by the appearance of the diagnostic rash and later with vesicular (small water filled) lesions. Individual lesions evolve from maculopapular to maculovesicular before bursting and scabbing over. Diagnosis is usually made when the patient has lesions in all stages of evolution. Pruritis or itchiness is intense, and scratching frequently leads to secondary bacterial infection.

Complications of this viral infection include pneumonia, hepatitis, Reye syndrome, and post infectious encephalitis. Certain groups are at high risk for more severe systemic disease especially the newborns, the elderly, and immune suppressed patients.

The virus is transmitted by aerosolized respiratory secretions through coughing, sneezing or by direct contact with vesicular fluid. Patients are contagious from the prodrome (flu like symptoms) until all of the lesions have scabbed over, typically a period of 7-10 days. Affected students and workers in groups should isolate themselves at home until all lesions are dry which is about one to two weeks.

Diagnosis is usually made by doctors on clinical grounds and on seeing the characteristic lesions.. In atypical, the diagnosis may be supported by specific immune fluorescent staining of the vesicular fluid.

Treatment is supportive, using fluids and non-salicylate-containing antipyretics. Pruritis or itchiness may be treated with antihistamines or oatmeal baths. Antibiotics may be given for infected lesions

Active immunization of patient at risk for severe infection with the live attenuated virus vaccine is controversial but should be considered. When high risk patients are inadvertently exposed, they should be passively immunized with varicella-zoster immune globulin (VCIG) within 72 hour of exposure. If a high risk patient becomes symptomatic, please visit your doctors, who can prescribe him high dose of acyclovir therapy as early as possible.

In areas where this infection is common, prevent this infection by staying away from infected person, avoid direct contact and avoid droplet or respiratory transmission of virus. Children are given two doses of anti varicella vaccine starting at one year of age as primary dose and later as booster dose of vaccination./TE