Causative agent
Chickenpox is a disease that is highly contagious, and its causative agent is varicella zoster virus (Wood).
Historical information
The history of the term chicken pox that is documented as being used from 1684 is not dependably known. There have been speculations that it was derived from chickpeas, on the basis of their resemblance of vesicles to chickpeas (Belshe).
Transmission
It begins with vesicular skin rash on the head and body. It is transmitted through the air and it easily spreads via sneezing or coughing by affected persons or via direct contact with the rash’s secretions. The patient is infectious one to two days prior to the rash appearance and remains contagious until crusting over of all lesions since crusted lesions are not transmissible (Atkinson, Wolfe and J.). Patients who are immune-suppressed can pass the disease in the entire period since they experience reappearance of new lesions.
Diagnosis
The varicella diagnosis is basically clinical, with characteristic early prodromal signs, followed by typical sores in the oral-cavity and rash. Diagnosis verification may be assayed through either checkup of the vesicular fluid, or through a blood test for response of acute immunology evidence. Examination of vesicular fluid can be done using a Tzanck smear, or through direct fluorescent antibody testing. The vesicular fluid can as well be cultured, where efforts are made to ensure growth of the virus from a fluid sample. Tests of blood can be employed in identifying a reaction to acute infection, as well as subsequent immunity (Pincus, McPherson and Henry). Prenatal varicella infection diagnosis of a fetus can be carried out using ultrasound, but 5 weeks delay after primary maternal infection is recommended. The mother’s amniotic fluid’s DNA test can as well be done, but the miscarriage risk because of the process is more than the risk of development of the fetal varicella syndrome by the baby.
Prognosis
The visible blistering duration caused by varicella zoster virus is varied in children normally between 4 and 7 days, and the new blisters appearance starts to subside following the 5th day. Infection is milder in young children, and medication with antihistamine or bathing with sodium bicarbonate may relieve itching. New infants should be kept away from sick persons for the first six months of their life (Somekh, Dalal and Shohat).
The disease is more severe in grownups although there are fewer occurrences. Infection in grownups is linked to greater mortality and morbidity because of pneumonia (Mohsen and McKendrick), encephalitis (Abro, Ustadi and Das), as well as hepatitis (Anderson, Schwartz and Hunter). Particularly, about 10% of pregnant women suffering from chickenpox develop pneumonia whose severity rises with onset later in gestation. Brain inflammation may occur in immune-suppressed persons, even though there is a higher risk with herpes zoster.
There are more hemorrhagic complications in the immunosuppressed or immunocompromised populations, even though adults and healthy children have been affected. There has been a description of five major clinical syndromes, which include malignant chickenpox with purpura, febrile purpura, post infectious purpura, anaphylactoid purpura, and purpura fulminans. These syndromes have varying courses, and febrile purpura is the most benign with an unproblematic effect. Contrary to this, malignant chickenpox with purpura is a severe clinical condition with a rate of mortality that is over 70%. The causes of these hemorrhagic chickenpox syndromes are unknown.
Treatment
Primarily, chickenpox treatment comprises of relieving the symptoms since there is no real remedy of the disease. Nonetheless, there are several treatments available for alleviating the symptoms as the there is suppression of the virus by the body’s immune system. As a prophylactic measure, persons suffering from the condition are normally needed to remain at home as they are infectious in order to prevent the spread of the infection to healthy individuals. The patients are also often required to keep their nails short or to put on gloves to avoid scratching so that to reduce the secondary infections risk.
Chickenpox heals by itself in a few weeks, in the meantime, the sufferers have to observe personal hygiene. The rash may, nevertheless, take one month, even though the stage that is infectious does not stay more than one or two weeks. Even though there have not been formal clinical research studies assessing the efficacy of calamine lotion topical application, a preparation of topical barrier comprising of zinc oxide has an outstanding profile of safety (Tebruegge, Kuruvilla and Margarson). It is essential to keep good hygiene, as well as daily skin cleaning using warm water to prevent secondary infection by bacteria (Domino). Scratching may, as well raise increase the secondary infection risk.
Paracetamol or cetaminophen can be used for reduction of fever. Aspirin should not be used since it may result in the serious and at times fatal brain and liver disease called Reye syndrome. Individuals at jeopardy of getting grave complications who have previously been significantly exposed to the causative organism can be administered intra-muscular varicella zoster immune globulin in order to avert the disease (Parmet, Lynm and Glass). Antivirals are also used sometimes (Gnann and John).
Works Cited
Abro, Ali Hassan, et al. "Chickenpox: presentation and complications in adults." Journal of Pakistan Medical Association 59 .12 (2009): 828–831.
Anderson, D. R., et al. "Varicella Hepatitis: A Fatal Case in a Previously Healthy, Immunocompetent Adult." Archives of Internal Medicine (JAMA) 154.18 (1994): 2101–2106.
Atkinson, W, S. Wolfe and J. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th. Washington DC: Public Health Foundation, 2012.
Belshe, Robert B. Textbook of human virology. 2nd. Littleton MA: PSG, 1984.
Domino, Frank J. The 5-Minute Clinical Consult. Lippincott Williams & Wilkins, 2007.
Gnann, Jr. and W. John. Human herpesviruses : biology, therapy, and immunoprophylaxis. Cambridge: Cambridge University Press, 2007.
Mohsen, A. H. and M. McKendrick. "Varicella pneumonia in adults." Eur. Respir. J. 21.5 (2003): 886–91.
Parmet, S., C. Lynm and R. M. Glass. "JAMA patient page. Chickenpox." JAMA 291.7 (2004): 906.
Pincus, Matthew R., Richard, A. McPherson and John Bernard Henry. Henry's clinical diagnosis and management by laboratory methods. 21st. Saunders Elsevier, 2007.
Somekh, E., et al. "The burden of uncomplicated cases of chickenpox in Israel." J. Infect 45 .1 (2002): 54–7.
Tebruegge, M., M. Kuruvilla and I. Margarson. "Does the use of calamine or antihistamine provide symptomatic relief from pruritus in children with varicella zoster infection?" Arch. Dis. Child 91 .12 (2006): 1035–6.
Wood, M. J. "History of Varicella Zoster Virus." Herpes 7.3 (2000): 60–65.
