Varicella Zoster (Chicken Pox)

The varicella zoster virus, known as chicken pox, is highly contagious and most often occurs during childhood usually before age 10 years. Transmission occurs through direct skin-to-skin contact and by airborne droplets containing the active virus. Outbreaks occur throughout the year, but an increased incidence is seen during March, April, and May. The virus can be much more serious in adults and may be complicated by pneumonia or encephalitis. Once a person has developed chicken pox, the varicella zoster virus can be reactivated later in life in the form of herpes zoster (shingles). Vaccines are now available for chicken pox and for shingles.

Physical exam

The lesions of chicken pox are itchy and can involve all parts of the body. Usually starting as small bumps, the lesions grow in groups and progress into clear vesicles that ooze and crust. Lesions in all stages (papules, blisters/vesicles and crusts) are seen at once. The skin lesions can be accompanied by fever, abdominal pain, headache, or a dry cough.

Treatment

  • Prevention by avoiding contact with infected individuals is important
  • Antihistamines and topical agents help reduce itching
  • Aveeno baths for cleansing and anti-inflammatory actions
  • Oral antiviral medications (acyclovir, valacyclivir, famciclovir) may decrease severity and may be especially useful in immunosuppressed persons
  • Vaccine immunizations
  • Antibiotics to treat secondary skin infections
  • Never give anyone with chickenpox any medicine containing aspirin because this combination has been associated with a severe condition called Reye's syndrome
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