Please...let it not be chicken pox...

Varicella (Chicken Pox)

Chicken pox (Varicella) is a highly communicable viral disease that occurs most often during the winter and spring. Once you have had chicken pox, you are usually immune to it. However, if you have never had the disease, you can get it at any age.

SYMPTOMS
If you have chicken pox, you may have a slight fever and cold-like symptoms. However, you may not realize that you have the disease until you notice a red rash on your face, trunk, scalp, or in your mouth. Later, you may find lesions on your arms and legs. Your rash will go through three stages: initially, it will be a red spot, next a blister (vesicle), and finally a scab. You may have "old" spots that are healing and "new" spots that are just beginning to blister. Your rash will probably itch. In fact, it may begin to itch before you notice the rash. Scratching your lesions can lead to infection and the development of crater-like scars. After your lesions have healed, you may notice "red spots." These spots are not scars and will fade within a few weeks.

HOW IS CHICKEN POX SPREAD?
Chicken pox can be spread by direct person-to-person contact droplet or airborne spread of vesicle fluid or secretions of the respiratory tract, such as coughing and sneezing. It is contagious from 1-2 days before the onset of the rash and may be spread until all lesions have dried up and become scabs. After you are exposed to the disease, it may take from 10 days to three weeks before you notice a rash. These two facts may make it hard for you to identify when and where you were exposed to the illness.

HOW CAN THIS DISEASE BE PREVENTED?
For those individuals who do not have a known history of varicella, a blood titer is recommended, followed by the live varicella vaccine if the titer is negative. The chicken pox virus can be spread through contact with fluid from your blisters. It can also live for long periods of time on inanimate objects. Therefore, to reduce your chance of spreading this disease, use the following guidelines:

To avoid spreading the illness, stay in your room or apartment until all your lesions have dried up (approx. 5-7 days). Do not use public transportation, attend classes or social events. You may have visitors who have had chicken pox in the past. Avoid friends who have not had the disease.

Do not share eating utensils, food, smoking materials or allow others to drink after you. Use plastic utensils and paper plates. Place all paper products that you handle (including tissues) in a plastic bag for disposal. You should also keep your own supply of toilet items (including soap) that are stored away from the items used by others.

Your used bedsheets are another potential source of infection. Place these linens in a plastic bag. At the washer, you or a friend (preferably one who has had chicken pox) can dump the sheets from the bag without touching them. Be sure to use hot water, a strong detergent and a hot dryer setting. After the sheets are washed, they no longer carry the disease.


Non-immune students who are exposed to chicken pox and are pregnant or have some form of immunosuppression may consider receiving varicella zoster immune globulin (VZIG). The expense of this vaccine limits its use to cases at "special risk." VZIG is most effective if given within three days of exposure.

WHAT ARE THE COMPLICATIONS OF CHICKEN POX?
Chicken pox can lead to fetal death if the disease is acquired by a pregnant woman within four days before the baby's birth. Although young adults are less susceptible to varicella than children, their chance of experiencing serious complications is much higher.


Therefore, YOU SHOULD REPORT THE FOLLOWING SYMPTOMS TO YOUR PHYSICIAN IMMEDIATELY: severe chest pain, difficult or labored breathing, blood when you cough, sudden onset of severe headache, unexplained drowsiness (some medications, including decongestants and medications to relieve itching, can cause drowsiness) or severe vomiting.

WHAT SHOULD I DO IF I HAVE CHICKEN POX?
For older adolescents and adults, many physicians recommend starting on oral acyclovir within 24 hours of development of rash; so contact your physician right away to see if you are a candidate. Acyclovir may decrease the total number of lesions, the time to cessation of newly-formed lesions, and the need for pain relievers and fever reducers. It may also reduce the possibility of serious complications. The following measures may help you feel more comfortable:

Cool compresses and cool to tepid baths with baking soda and calamine lotion can help soothe itching.

DO NOT SCRATCH YOUR LESIONS.

Using a humidifier, sleeping with your head elevated, and taking decongestants can help relieve your stuffy nose.

Acetaminophen (Tylenol, Panadol, Datril) can help relieve body aches and fevers. AVOID ASPIRIN PRODUCTS.

Cool juice, popsicles and cool liquids can soothe your throat. Avoid spicy foods, citrus drinks, chocolate and hot sauces.

Clean cotton sheets can increase your comfort. Wear cotton T-shirts or gowns. Polyester can be too warm and other fabrics can irritate your lesions.

ADDITIONALLY:

Stay confined to your room until the lesions are all scabbed over. Keep any follow-up appointment before returning to class.

Make sure any visitor is aware you have chicken pox and allow only visitors that have had chicken pox or are know to be immune.

Do not allow any visitor who may be pregnant or have an immunosuppressed illness, such as cancer, AIDS, Lupus, organ transplants.

You need to make food service arrangements. Do not go to the dining area.

When showering, use the community bathroom when there are the least number of other people present.

Wear a mask when going to and from the bathroom – leave unless you are showering or brushing your teeth. A mask is not necessary when you are confined to your room.

Notify your instructors that you will be confined for 7-10 days.

Do not leave your residence room unless there is a fire. You should not go to public places such as movie theaters, restaurants, or use buses or other public transportation.

Follow any instructions given to you by your provider as to medication, showering, diet and return visits.

When you have been cleared by a provider, wash all bed linens and personal clothing items in a washer with hot, soapy water. Keep all items separate from other laundry.

I think I have chickenpox...

Chickenpox is a common disease caused by the varicella-zoster virus (VZV), which is part of the herpesvirus family. Although many people associate the word herpes with genital herpes, the herpesvirus family is made up of nearly 100 kinds of viruses, eight of which cause disease in humans. Examples of different herpesviruses are herpes simplex virus (which causes cold sores and genital herpes infections), Epstein-Barr virus (which causes infectious mononucleosis), and varicella-zoster virus (which causes chickenpox and shingles). Varicella-zoster virus spreads in the air through coughs or sneezes or through contact with fluid from inside the chickenpox blisters.

Chickenpox, which occurs most often in the late winter and early spring, is very contagious - if exposed to an infected family member, about 80% to 90% of those in a household who haven't had chickenpox will get it. However, immunization of children with the chickenpox vaccine that's now available is expected to decrease cases of the disease dramatically over the next few years.

Although it's more common in kids under the age of 15, anyone can get chickenpox. A person usually has only one episode of chickenpox in his or her lifetime. But the virus that causes chickenpox can lie dormant within the body and can cause a different type of skin eruption later in life called shingles, also referred to as herpes-zoster.


Signs and Symptoms
Chickenpox is a viral infection that causes a red, itchy rash on the skin. The chickenpox rash usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body, including the scalp, mouth, nose, ears, and genitals.

The rash begins as multiple small, red bumps that look like pimples or insect bites. They develop into thin-walled blisters filled with clear fluid, which then becomes cloudy. The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs. One of the most characteristic features of the chickenpox rash is that all stages of the lesions can be present at the same time.

Chickenpox blisters are about a quarter to half an inch wide, have a reddish base, and appear in bouts over 2 to 4 days. Some children have only a few blisters, whereas others have several hundred. The rash may be more extensive or severe in kids who have skin disorders such as eczema.

Some children have a fever, abdominal pain, or a vague sick feeling a day or 2 before the rash appears. These symptoms may last for a few days, and fever stays in the range of 100 to 102 degrees Fahrenheit (37.7 to 38.8 degrees Celsius), although it may occasionally be higher. Younger children often have milder symptoms and fewer blisters than older children or adults.

Normally, chickenpox is a mild illness, but certain groups of people are more likely to have a more severe illness that could lead to complications. These include infants, adolescents, adults, and people with weak immune systems from either illnesses or from medications such as long-term steroid use. The most common complication of severe chickenpox illness in these groups of people is a bacterial infection that can involve many sites of the body including the skin around the blisters, bones, lungs, joints, and the blood. Other serious complications are due to the virus itself infecting the organs and include viral pneumonia, bleeding problems, and inflammation of the brain (encephalitis).

Anyone who has had chickenpox as a child is at risk for a complication later in life called shingles. After an infection, some of the varicella-zoster virus may remain inactive in nerve cells near the spinal cord. Many years later, the virus can reactivate and resurface as shingles. When it reactivates, it affects the nerve to the skin. Symptoms, such as a tingling feeling, itching, or pain followed by a rash with red bumps and blisters appear only in the area of the skin that the nerve goes to.


Contagiousness
The contagious period for chickenpox begins about 2 days before the rash appears and lasts until all the blisters are crusted over. A child with chickenpox should be kept out of school until all of the blisters have dried, which is usually about 1 week, but you don't have to wait until all the scabs fall off to let your child get back to a normal schedule.

Pregnant women, as well as people with diseases or problems with their immune system, should not be near a person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially before 20 weeks), the fetus is at risk for birth defects. If she develops chickenpox 5 days before to 2 days after delivery, the newborn is at risk for life-threatening varicella (the mother has transferred the virus to the baby, but she hasn't had time to produce and transfer antibodies, which fight off infection, to the baby before it's born).

If the mother had chickenpox in the past (before the pregnancy or any time more than a week before delivery), then the fetus receives antibodies through the placenta. That means the mom's immunity gets passed on to the baby through the placenta and breast milk, so it would be unlikely for the infant to get sick. But antibodies are not fail-safe; there is no 100% guarantee that a baby won't get the infection - it's just less likely. Or, the infant might have the disease, but it won't be as severe. It's also important for pregnant women to realize that they're at increased risk of chickenpox complications if they catch it for the first time while pregnant.

People who haven't had chickenpox can also catch it from someone with shingles, but they cannot catch shingles itself. Why can't a person catch shingles from someone else? It's because shingles can only develop from a reactivation of the varicella-zoster virus in a person who has previously had chickenpox.

Incubation
The incubation period for chickenpox is 10 to 21 days after exposure; most cases appear in 14 to 17 days. For example, if one child in a family breaks out with chickenpox picked up at school, siblings probably will show symptoms about 2 weeks later.

Duration
Chickenpox usually lasts 7 to 10 days in children, but typically lasts longer in adults.

Professional Treatment
A virus causes chickenpox, so your child's doctor won't prescribe antibiotics (which are for bacterial infections). However, your child may require antibiotics if the sores become infected by bacteria, a common complication.

An antiviral medicine known as acyclovir may be prescribed for anyone over the age of 12, people with weakened immune systems (from diseases or medications), and those with long-term lung or skin diseases. The drug, which can make the chickenpox less severe, must be given within the first 24 hours after the rash appears. Acyclovir is not prescribed for children younger than 12 because the drug can have side effects. Your child's doctor can tell you if the medication is right for your child.