Varicella Zoster Virus (Chickenpox)

Varicella-zoster virus (VZV) causes Chickenpox which is a very contagious disease. VZV is a neurotropic human herpes virus which is transmitted via respiratory secretions. The VZV develops a latent infection in the sensory ganglia cells in individuals with primary infection. When the latent virus (VZV) is reactivated Herpes Zoster occurs. However, Herpes Zoster is rare in children because it is the reactivation of latent (VZV) varicella zoster virus.  Nevertheless, children who are immune compromised are susceptible to herpes zoster. 

The VZV spreads easily from a person infected with chickenpox to others. Any individuals who have never had chickenpox infection or received the chickenpox vaccine can contract the disease. The virus can also be spread by touching or breathing in the virus particles that come from chickenpox blisters.

The illness begins 14-16 days after the exposure, but the incubation period ranges from 10 to 21 days. The typical symptoms that may begin to appear 1-2 days before rash are high fever, tiredness, headache, loss of appetite and mild abdominal pain. The classic symptom of chickenpox is rash. The rashes are pruritic consisting of papules, vesicles, pustules, and crushed lesions in crops in various stages. It usually takes about one week for all the blisters to become scabs. The rash may first show up on the face, chest, and back then spread to the rest of the body, including inside the mouth, eyelids, or genital area.

Diagnosis is made clinically and no laboratory tests are necessary. The treatment plan is usually symptomatic. Nevertheless, quite a few things can be done at home to help ease the symptoms and prevent skin infections. Itching may be relieved by using Calamine lotion and colloidal oatmeal baths. The skin infections that might occur by scratching blisters can be prevented by keeping the fingernails trimmed short. However, in high risk cases Acyclovir and Varicella zoster immune globulin may be helpful.

The complications that can arise from chicken pox are scarring caused by secondary infection with group A streptococci and S. aureus. Chickenpox can be worse, especially in neonates, adolescents and people with weakened immune systems. Pneumonia is a complication in 15-20 % of adults and the immune-compromised. Neurological sequence includes Guillian- Barre encephalitis, and cerebellar ataxia. It may cause congenital infection and neonatal transmission.

The best way to prevent chickenpox is by getting the chickenpox vaccine. The vaccine is very safe and effective at preventing the disease. Most people who have been vaccinated will not get chickenpox, however if a vaccinated person gets chickenpox, it is usually mild with fewer blisters and mild or no fever. The chickenpox vaccine prevents almost all cases of severe disease.