Chickenpox is a viral infection of the skin that most individuals have had before the age of 10. The rash consists of small, fluid-filled blisters with red surrounding skin. It often starts on the face and scalp and later spreads to the upper body, arms, and legs. Some individuals may have only a few dozen blisters, while others may have up to 500. It can also cause mucous membrane changes in the mouth and genital area. The diagnosis is based on the classic presentation. There are also virus and antibody tests that can confirm the diagnosis, but they are rarely necessary. The child is usually in overall good condition. Some children may experience fever, headache, mild abdominal pain, and diarrhea. In very rare cases, the chickenpox virus can cause other severe infections in the body, such as pneumonia and encephalitis.
Chickenpox is caused by the Varicella zoster herpes virus. The virus spreads rapidly through airborne transmission (droplet spread)or direct skin contact. The highest infectious period is from 1-2 days before the rash appears to 3-4 days after. It takes about two weeks after exposure fora person to become sick. Prior to the rash, the child may have mild cold symptoms for a couple of days. The viral infection provides lifelong immunity, and therefore, chickenpox typically occurs only once. By adulthood, 90-95% of the population has experienced chickenpox. However, like all herpes viruses, the virus remains latent in the body for the rest of life. The virus is "asleep" in the body's nervous system and can be reactivated many years later, presenting as herpes zoster (shingles).
Chickenpox does not require treatment in healthy children. The immune system handles the infection, and the skin heals on its own (without scarring). Typically, the small blisters dry up and form brownish scabs, which later fall off over a two-week period. The child is contagious as long as new blisters are appearing and until the last ones have dried up. However, chickenpox can increase the risk of other infections, such as bacterial skin infections. Impetigo, caused by bacteria, is one of the infections that can occur concurrently with or following chickenpox. Treatment and measures are therefore aimed at preventing/treating these "secondary" infections.Bacterial infections in chickenpox increase the risk of scarring. Bacterialinfections can be prevented by keeping nails short, practicing good hand hygiene/showering, and applying antiseptic wash. Additionally, itch-relieving measures such as antihistamines (allergy tablets) and cold compresses can be tried. Vaccines against chickenpox are available. They are widely used in some countries, while in some countries reserved for patients with weakened immune systems and a few other patient groups.
