Chicken Pox Disease

Chicken Pox Disease

General Considerations

It is a common contagious disease of child and spread by inhalation of ineffective droplets or local contact. The incubation is 10-20 days.

Clinical Manifestations 

Onset is generally with fever. Maculopapules that soon change to vesicles appear on the trunk, face, scalp and to lesser extent on the extremities. These then become pustular and then dry up and crusts form. New vesicles continue to appear for 4-5 days, so that all stages of rash maculopapules, vesicles, pustules, scabs are present in the same patient. The scabs are cast off in 1-2 weeks, leaving superficial pitted scars.

Vesicles may involve the mucous membrane of the mouth and conjunctiva also.

Laboratory Diagnosis

• Leucopenia
• Multinucleated giant cells in Tzanck smear from scrapings from underneath the vesicles.
• Virus isolation 
• Viral antigen detection in vesicle fluid using immunofluorescent antibody.

Complications 

1. Secondary bacterial infection.
2. Varicella pneumonia 
3. Encephalitis
4. Reyes syndrome (hepatic encephalopathy). This is specially likely to develop if aspirin to these patients.
5. Varicella affecting the mother during the first two trimeters of pregnancy may be associated with fetal malformations.

Prevention 

• Varicella zoster immunoglobulin to exposed high risk 
• (immune deficient status) persons.
• Live attenuated vaccine is available for active immunization.

Treatment 

• Isolate till crusts have dried up.
• Bed rest. Control fever if high.
• Itching may be helped with calamine lotions and antihistamines.
• Antibiotics local or systemic if secondary infection develops.
• Acyclovir can reduce the severity and duration of the illness.
• Do not use Aspirin or salicylates.