varicella


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Related to varicella: chickenpox, varicella pneumonia

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.
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.)

var·i·cel·la

(var'i-sel'ă),
An acute contagious disease, usually occurring in children, caused by the Varicella-Zoster virus genus, Varicellovirus, a member of the family Herpesviridae, and marked by a sparse eruption of papules, which become vesicles and then pustules, like that of smallpox although less severe and varying in stages, usually with mild constitutional symptoms; incubation period is about 14-17 days.
See also: herpes zoster.
Synonym(s): chickenpox
[Mod. L. dim. of variola]

varicella

/var·i·cel·la/ (var″ĭ-sel´ah) [L.] chickenpox.

varicella

(văr′ĭ-sĕl′ə)
var′i·cel′loid′ (-sĕl′oid′) adj.

varicella

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

varicella

Chickenpox, see there.

var·i·cel·la

(var'i-sel'ă)
An acute contagious disease, usually occurring in children, caused by the varicella-zoster virus and marked by a sparse eruption of papules, which become vesicles and then pustules, usually with mild constitutional symptoms; incubation period is about 14-17 days.
Synonym(s): chickenpox.
[Mod. L. dim. of variola]

varicella

(var?i-sel'a) [L., a tiny spot]
Enlarge picture
VARICELLA (CHICKENPOX)
An acute infectious disease, usually seen in children under age 15, caused by varicella-zoster virus. Its hallmark is a rash, described clinically as having a “dewdrop on a rose petal” pattern, scattered in clusters (“crops”) over the trunk, face, scalp, upper extremities, and sometimes the thighs. It is transmitted mainly by respiratory droplets that contain infectious particles; direct contact with a lesion and contaminated equipment also can spread the virus. Reactivation of the virus in adults causes shingles. Synonym: chickenpox See: illustration; herpes zoster; varicella-zoster immune globulin

Symptoms

After an incubation period of 2 to 3 weeks (usually 13 to 17 days), patients develop fever, malaise, anorexia, and lymphadenopathy, followed by the appearance of an extremely pruritic (itchy) rash that starts flat and, over time, becomes a small blister on a red base, and then eventually forms crusted scabs. All three stages of the rash may be present on the body at one time. Varicella may be transmitted to others until all lesions are crusted over.

Occasionally, for example, when it occurs in adults or immunosuppressed children, chickenpox is complicated by superimposed bacterial pneumonia, encephalitis, or thrombocytopenia. Immunization with varicella vaccine provided during infancy is designed to prevent these complications.

Etiology

Chickenpox may strike individuals of any age who have not been previously been exposed to the virus. Epidemics are most frequent in winter and spring in temperate climates.

Differential Diagnosis

Impetigo, dermatitis herpetiformis, herpes zoster, and furunculosis may occasionally need to be distinguished from varicella, although usually the difference is obvious.

Complications

Secondary infections may occur, caused by scratching, which may result in abscess formation; at times, development of erysipelas or even septicemia may result. Occasionally, lesions in the vicinity of the larynx may cause edema of the glottis and threaten the life of the patient. Encephalitis is a rare complication. Varicella may be fatal in children with leukemia or children who are taking adrenocorticosteroids.

Prevention

Administration of varicella-zoster immune globulin (VZIg) within 72 hr of exposure will prevent clinical varicella in susceptible, healthy children. The following conditions should alert one to the possible need for use of VZIg: immunocompromised children; newborns of mothers who develop varicella in the period 5 days before to 48 hr after delivery; postnatal exposure of newborns (esp. those who are premature) to varicella; healthy adults who are susceptible to varicella and who have been exposed; pregnant women who have no history of having had varicella and who have had significant exposure. The use of VZIg in pregnant women will not prevent fetal infection or congenital varicella syndrome. Live attenuated vaccine is now available for general use.

CAUTION!

Because severe illness and death have resulted from varicella in children being treated with corticosteroids, these children should avoid exposure to varicella.

Treatment

Otherwise healthy affected children are treated with diphenhydramine or hydroxyzine to reduce itch and acetaminophen to reduce fever. Children at increased risk for complications and immunosuppressed adults are given varicella-zoster immune globulin as prophylaxis after exposure. If varicella infection develops in immunosuppressed persons or pregnant women in the third trimester, intravenous acyclovir is administered. Immunization with varicella vaccination is recommended for those children who have not had chickenpox and have not previously received the immunization.

varicella gangrenosa

Varicella in which necrosis occurs around the vesicles, resulting in gangrenous ulceration.

varicella

Chickenpo: a usually trivial infectious disease of childhood caused by the varicella-zoster virus which also causes SHINGLES in adults. There is a rash of tiny, flat, red spots which quickly become small blisters (vesicles), turn milky, dry to crusts and then scab off. Varicella in immunocompromised people can be serious, with as many as 1000 lesions, secondary infection, and severe general upset. It may occasionally be fatal in such cases. Varicella can be prevented by vaccination.

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.

varicella

chickenpox, causing marked vesicular eruptions of all skin areas, including feet

var·i·cel·la

(var'i-sel'ă)
Acute contagious disease, usually occurring in children, caused by the Varicella-Zoster virus genus, Varicellovirus; marked by a sparse eruption of papules, which become vesicles and then pustules, like that of smallpox although less severe and varying in stages, usually with mild constitutional symptoms; incubation period is about 14-17 days.
Synonym(s): chickenpox.
[Mod. L. dim. of variola]

varicella (ver´isel´ə),

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.
Enlarge picture
Varicella.

Patient discussion about varicella

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. take it easy Issac. chicken pox is a typical disease children have. me too i still live. the most important thing is that your child does not scratch his face because it can make skin damages. your 3 year old child has only now with 3 years a more or less correct working lymph system. perhaps this link-page can help you too:

before you would like to go on with any vaccination, you should check out this very long list of links:

http://www.aegis.ch/neu/links.html

at the bottom you will also find links in english. vaccinations in general are very disputable/dubious and it is probably time that we learn about it.

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. perhaps it will be then useful if the chicken pox would appear that you have then a separate room if necessary (quarantine).
i advice you also to inform yourself and build your own opinion with this link-page:

before you would like to go on with any vaccination, you should check out this very long list of links:

http://www.aegis.ch/neu/links.html

at the bottom you will also find links in english. vaccinations in general are very disputable/dubious and it is probably time that we learn about it.

More discussions about varicella
References in periodicals archive ?
Varicella seroprevalence in a random sample of the Turkish population.
History of varicella infection verified by a health care provider.
As for vaccination, a woman with no immunity to varicella should be vaccinated before conception or at the postpartum visit.
One of the committee members expressed concern about the outcomes in children who received Zostavax instead of the children's varicella vaccine.
The Company's varicella vaccine candidate is a live attenuated vaccine derived from a human cell line.
Varicella in an immunocompromised patient often presents as severe disease.
Medicare claims data from 1992 through 2010 were examined to evaluate trends in herpes zoster incidence in people older than age 65 and to determine any influence of the varicella vaccination program on these trends (Ann.
The varicella vaccine was licensed in the United States in 1995, and recommended soon after by the Advisory Committee on Immunization Practices for routine administration to children.
Alternatively, a prolonged length of time since primary varicella exposure may contribute to a heightened risk for HZ (3).
Association of reduced CD4 T cell responses specific to varicella zoster virus with high incidence of herpes zoster in patients with systemic lupus erythematosus.
Herpes zoster and meningitis resulting from reactivation of varicella vaccine virus in an immunocompetent child.