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Chickenpox (varicella virus)

Chickenpox (varicella virus) – is a highly contagious disease caused by the herpes virus type 3, which is also known as varicella-zoster or herpes zoster. It is very common throughout the world, according to some data, each person is 100% susceptible to primary infection.

The name “chicken pox” is connected to the wrong assumption, common in the Middle Ages and modern times which said that this disease was a type of smallpox – and in the Middle English language (12th-15th centuries) the word “Icchen” had meaning, “to itch.” So it seems possible that “Chicken Pox” may simply be a bastardized version of Icchen/Itching/Chicken + “Pox.”

Nowadays there is no need for differential diagnosis with smallpox because, firstly, the latter disease is not practically encountered in developed countries, and secondly, there were identified some unique symptoms characteristic only to chickenpox, thirdly, in some rare doubtful cases, laboratory blood tests and the contents of the bubbles give an accurate answer.

Content
  1. What happens in the body under the influence of the virus?
  2. How can one get infected
  3. Diagnosis and Symptoms
  4. Pictures of chickenpox
  5. Treatment
  6. How to cure skin irritation
  7. Prophylaxis
  8. Complications
  9. Video

1What happens in the organism under the influence of the virus?

Varicella Zoster virus belongs to the herpes viruses, and its effect on the body is sufficiently similar to other forms of herpes development. The behavior of varicella-zoster is caused by two of its qualities : dermotropic and neurotropic, which means “love” to the skin cells and nerve cells, respectively.

Chickenpox has several stages, and among some of them the time gap may be tens of years.

Both a child and an adult who has never suffered from this disease can catch primary infection, what’s more adults usually suffer from this disease much harder than children.

The most common age of catching this disease is when a person is 4-7 years old.

Infants also suffer hard, and only in very rare cases:

  • with intrauterine infection (mother falls ill during the last week of pregnancy);
  • in the absence of breastfeeding and respectively without mother’s protective antibodies;
  • in strong immunodeficient states (including cancers and AIDS).

There is a risk of contamination of a healthy baby who is being breastfeeded ,it appears if his mother has no specific immunity (when she has never had chickenpox and has not ever been vaccinated).

  • Contamination and the incubation period

    The virus gets into an organism through the air and is fixed on the mucous membrane of the upper respiratory tract, where it accumulates and multiplies – without any of chickenpox symptoms being observed. On average, this stage lasts for about 2 weeks, the patient is not contagious.

  • The first symptoms

    Gradually, the chickenpox virus begins to penetrate into the blood and, when its quantity becomes sufficient , the body’s immune system reacts to a foreign presence. The patient may have a fever, weakness may appear together with headache, pain in the back, but there still won’t be rash. This period lasts for 1-2 days, and the patient may infect others.

  • Primary acute phase

    With the current of blood virus reaches its goals – skin and nerve cells. There is still no damage to nerve cells. , Varicella Zoster is only being fixed in the roots of a spinal cord, but specific symptoms appear on the skin – such as rash, which occurs in fits during the next 4-7 days. Rash – is a reaction to the chickenpox virus activity which is concentrated in the skin, in rare cases, hardly noticeable, making it difficult to diagnose. The patient remains contagious.

  • Recovery

    If the patient has a healthy immune system, then after 4-7 days the rash is terminated, the general condition improves, the acute phase is over. The patient is no longer contagious, but the virus is firmly fixed in the nerve cells and it will remain there for a whole life.

  • Secondary acute stage

    With the weakening of immunity or stimulation of the nervous system (as a result of frequent stresses for example) chickenpox virus finds itself again. This time the places where rash is going to appear depend on what kind of nerve is more affected- most often it is the underarm area or abdomen, causing a secondary appearance of Varicella Zoster-encircling shingles (zoster (lat.) – encircle).There may not even be any skin staining at this stage, because the symptoms are limited to pain along the nerve, which is especially common with the elderly people. In periods of skin rash the patient, as well as with chickenpox, is contagious, also for children.

At present, there is no way to complete destruction of the herpes virus type 3 in the body.Having fixed itself in the nerve endings, Varicella Zoster gets less susceptible to the antiviral drugs and immune agents – their action is directed basically to the treatment of worsening of different kind,it is effective for the localization of the virus in the skin cells in these periods . Therefore, chickenpox can only be described as the first phase of a chronic disease – herpes virus type 3.

However, after the first contamination a strong immunity against varicella zoster is formed in a human body – that is why people never suffer from chickenpox (i.e, the first acute stage) again, all the following symptoms are the result of the activities of virus which is already present in the body.

Taking into consideration such a nature of the immune response, in many countries, including, partially in Russia, it is considered appropriate to be vaccinated, rather than infect children at pre-school age on purpose, which is also very common nowadays.

2How can one get chickenpox?

As it was already mentioned, the virus is transmitted by airborne droplets from an infected person during the period between the first and the last day of rash, as well as for 1-2 days before the appearance of pustules.

This is one of the causes of spreading of chickenpox all over the world – premonitory period is almost impossible to detect. In addition, very high sensitivity of people to the herpes virus type 3 is noted, because every single person who has been in a contact is infected by it.

Chickenpox is transmitted only from human to human, it will not survive in the environment or, for example, in the organisms of domestic animals. The source of the initial infection and the patient can be herpes zoster in the acute stage. In rare cases, contamination may occur because of contact with the contents of pustules.

3Diagnosis and symptoms of of chickenpox

Specific symptoms of chickenpox is rash, which appears only in the second or the third week after contamination, and on the second or the third day, after the person becomes contagious.

The first distinctive feature is widespread localization of the rash – it is found even on the hairy part of a head, the mucous membranes, conjunctiva. A characteristic feature of rash is itching – from mild to severe.

Secondly, the rash of chickenpox is rather inhomogeneous by appearance, as it appears in fits during 1-7 days. On the patient’s body there are fresh formations – such as small pink spots; and papules and vesicles with purulent contents, both with scarring scabs.

Diagnosis of chickenpox except for infrequent cases of complications, is not complicated and is made on the basis of survey, but there are laboratory tests that detect the Herpes Zoster virus in the blood and rashes during acute condition.

4Pictures of chickenpox

That is what chickenpox looks

5The treatment of chickenpox in children and adults

The treatment of chickenpox both in children and adults requires the prescription of special medications to facilitate the course of disease. The appointment of antihistamines to get rid of the itching, fever-reducing drugs and antiseptics (usually aniline dyes) is considered to be a usual therapy in most countries.

A solution of brilliant green (Viridis nitentis spirituosa) is used for chickenpox as a standard antiseptic for disinfection. However, this approach has been abandoned long ago in medical practice all over the world because antihistamines and antiallergic drugs exert strong systemic effects on the body of a child or an adult and have a number of side effects, and brilliant green or iodine are not always acceptable from an aesthetic point of view.

Since chickenpox is caused by virus, using antibiotics to cure it is ineffective, including cases of complications by chickenpox pneumonia. Furthermore, in the normal course no specific treatment is required at all – the immune system recognizes and destroys the virus in the blood and skin cells within several days. But the virus Herpes Zoster, which has invaded into the nerve cells usually cannot be cured neither with the immune system nor with medications.

Therapeutic treatment of chickenpox in children has several directions:

Relief of symptoms, including itching. For this purpose some antihistamine drugs of systemic effects, are used, however they are becoming less popular today, since inhibition of the immune response, as it is thought, can lead to complications. When common symptoms of inflammation are observed, it is recommended to facilitate the patient’s condition – to relieve pain and temperature paracetamol or ibuprofen are commonly used.

Reduction of the acute period, especially in cases with high risk of complications. For this purpose, antiviral drugs which inhibit viral replication and stimulate the immune system are used.

Prevention of complications, including secondary infections. For this rash is treated with antiseptic elements, confinement to bed is administered.

During the time of rash it is necessary to limit contacts with the patient, in addition, individuals who have never been ill with chickenpox but who had communication with the patient for 1-2 days before the rash appeared are subject to quarantine.

Prevention of chickenpox

The question of prevention of chickenpox is very controversial. Some experts still do not consider it necessary, despite the possible side effects, including time delay. Due to the fact that preschoolers tend to suffer with chickenpox lighter than other age groups, sometimes parents and doctors seek to infect children on purpose, to let them overcome the disease in a less vulnerable age.

Meanwhile, since the 70-ies of the last century in civilized countries a very effective vaccine against chickenpox has been successfully used. This vaccine gives a strong immunity for decades, according to the research of blood of the adults who were vaccinated as well as children.

This vaccine, including its modified versions is particularly recommended for people at high risk of complications – women planning pregnancy, cancer patients, HIV-infected, and so on. Remember that it is difficult to predict the course of disease even in a healthy child that’s why you should better consult several specialists before you decide to take some measures to prevent chickenpox.

9Video

Author: Grifeli Daria Artemovna