varicella /var·i·cel·la/ (var″ĭ-sel´ah) [L.] chickenpox.
Varicella
varicella.
chickenpox [chik´en-poks]
var·i·cel·la (v r  -s l  )n. See chickenpox. |
Varicella
Chickenpox; a disease caused by the Varicella zoster virus—human herpes virus 3—that can cause severe birth defects if transmitted to the fetus during the first 20 weeks of pregnancy and newborn complications if it is transmitted perinatally.
Mentioned in: Maternal to Fetal Infections
varicella.
See chickenpox.
Chickenpox
Acute human herpes virus-3 (HHV-3) infection, most common before age 10; 3.5 million cases & 50 children die/year of chickenpox—US; 9,000 are hospitalized
Complications Otitis, pneumonia, 2º bacterial rashes and infections, encephalitis—5–15% mortality, 15% with permanent neurologic sequelae— ataxia, palsies, Reye syndrome, a potentially fatal complication, viral pneumonia—1:400 require hospitalization—thrombocytopenia, purpura fulminans, myocarditis, glomerulonephritis, hepatitis, myositis; after resolution of clinical disease, HHV-3 becomes latent, integrating its DNA into the dorsal root ganglion cells
Management Acyclovir may shorten duration of disease
Complications Otitis, pneumonia, 2º bacterial rashes and infections, encephalitis—5–15% mortality, 15% with permanent neurologic sequelae— ataxia, palsies, Reye syndrome, a potentially fatal complication, viral pneumonia—1:400 require hospitalization—thrombocytopenia, purpura fulminans, myocarditis, glomerulonephritis, hepatitis, myositis; after resolution of clinical disease, HHV-3 becomes latent, integrating its DNA into the dorsal root ganglion cells
Management Acyclovir may shorten duration of disease
chickenpox [chik´en-poks]
an acute, highly contagious, viral disease, with mild constitutional symptoms and a maculopapular vesicular skin eruption; it is a common childhood disease and is rarely severe, but it can be accompanied by severe symptoms in infants and adults. It is usually spread by either contact with blisters or droplet infection, and the average incubation period is 10 to 16 days. The period of contagion lasts about two weeks, beginning two days before the rash appears. The causative virus is human herpesvirus 3 (formerly known as varicella-zoster virus). The same virus also causes herpes zoster (shingles), with the differences in the two diseases probably reflecting differences in the response to the virus. Called also varicella.
Symptoms. Chickenpox may begin with a slight fever, headache, backache, and loss of appetite. At the same time, or a day or two later, small red spots appear, usually on the back and chest first. Within a few hours the spots enlarge and a vesicle filled with a clear fluid appears in the center of each spot, surrounded by an area of reddened skin. After a day or two, the fluid turns yellow and a crust or scab forms. This crust peels off in from 5 to 20 days. During this period the patient experiences severe itching.
The vesicles do not appear all at once, but in crops, the number of crops depending on the severity of the case. Usually the eruptions are concentrated on the back and chest, with only a few appearing on the arms, legs, and face, but in severe cases they may cover almost all of the body.
The vesicles do not appear all at once, but in crops, the number of crops depending on the severity of the case. Usually the eruptions are concentrated on the back and chest, with only a few appearing on the arms, legs, and face, but in severe cases they may cover almost all of the body.
Chickenpox rash distribution. From McKinney et al., 2000.
Prevention and Treatment. Children should receive one dose of chickenpox vaccine between 12 and 18 months of age, or at any age after that if they have not had chickenpox. Individuals over age 13 who have not had chickenpox or received the vaccine should receive two doses, four to eight weeks apart. There are some contraindications to the use of the vaccine, such as women who are pregnant or are planning to conceive a child within a month.
Most cases of chickenpox are mild and require no special treatment except rest in bed and forcing fluids during the fever stage. For severe itching, emollient baths, calamine lotion, or other applications offer some relief. Since scratching the scabs may result in permanent scars and opens the way for other infections, the child's fingernails should be cut short and the hands washed often.
The Centers for Disease Control and Prevention recommends airborne and contact isolation. Other recommendations include after-exposure advisories. Varicella-zoster immune globulin (VZIG) should be used when appropriate, along with discharge of susceptible patients if possible. Exposed susceptible patients should be placed on airborne precautions beginning 10 days after exposure and continuing until 21 days after the last exposure (up to 28 days if VZIG has been given). Susceptible persons should not enter the room of patients on precautions if other immune caregivers are available. (See Atlas 2, part M.)
Most cases of chickenpox are mild and require no special treatment except rest in bed and forcing fluids during the fever stage. For severe itching, emollient baths, calamine lotion, or other applications offer some relief. Since scratching the scabs may result in permanent scars and opens the way for other infections, the child's fingernails should be cut short and the hands washed often.
The Centers for Disease Control and Prevention recommends airborne and contact isolation. Other recommendations include after-exposure advisories. Varicella-zoster immune globulin (VZIG) should be used when appropriate, along with discharge of susceptible patients if possible. Exposed susceptible patients should be placed on airborne precautions beginning 10 days after exposure and continuing until 21 days after the last exposure (up to 28 days if VZIG has been given). Susceptible persons should not enter the room of patients on precautions if other immune caregivers are available. (See Atlas 2, part M.)
varicella (ver´isel´
),n (chickenpox), an acute communicable disease with an incubation period of 2 or 3 weeks and caused by herpesvirus, usually found in children. Manifestations include coryza, fever, malaise, and headache, followed in 2 or 3 days by the eruption of macular vesicles.
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Varicella.
varicella
Chickenpox, see there
Patient discussion about varicella.
Q. Is chicken pox dangerous to my fetus? I am pregnant and have never had chicken pox before. My daughter is 2 years old and has not had chicken pox before and hasn't been vaccinated against it either. If she does catch chicken pox can this be dangerous to me or the fetus?
A. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth defects and she is at risk for more health complications than if she'd been infected when she wasn't pregnant. If she develops chickenpox just before or after the child is born, the newborn is at risk for serious health complications. Therefore, it is advised that you vaccinate your daughter against chicken pox so she will not catch it and then could not pass it on to you.
Q. How contagious is chicken pox? I just found out that a kid in my son's preschool has chicken pox. What are the chances my son got it too? He hasn't been vaccinated against it. He is 3 years old.
A. Chickenpox is very contagious — so there is a big chance your son caught it too. Most kids with a sibling who's been infected will get it as well, showing symptoms about 2 weeks after the first child does. Chickenpox causes a red, itchy rash on the skin that 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.
Some kids have a fever, abdominal pain, sore throat, headache, 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°–102° Fahrenheit (37.7°–38.8° Celsius), though in rare cases may be higher.
Read more or ask a question about varicellaSome kids have a fever, abdominal pain, sore throat, headache, 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°–102° Fahrenheit (37.7°–38.8° Celsius), though in rare cases may be higher.
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