CHECKEN POX

Chicken pox:

A viral disease due to varicella zoster virus infection mostly transmitted by respiratory route . It may also spread by contact with ruptured lesion or with herpes zoster.

Incubation period is from 10 to 20 days. Herpes zoster is caused by the same virus .Onset is associated with fever and malaise.




















Chicken pox is more rash changes to vesicles within few hours and is more severe in adults than in children. About 90% of adults develop pneumonia.

In children there may be acute cerebellar ataxia developing 3 to 21 days after the rash appears. The recovery is usual. In innunosuppressed patients the disease may be fatal. Congenital malformations in the fetus may result if the disease occurs during first and second trimester of pregnancy.

Zoster immune globulin (ZIG) is effective in preventing the disease in exposed persons when given within 72 hoursa of exposure.

Varicella live attenuated vaccine is now available. It should be given to-
(a)    All children above 12 months
(b)    Susceptible adults
(c)    Household contacts and health workers as they run high risk of fatality even though the disease is rare.


Treatment:

1.    Patient should be isolated till the crusts have disappeared.
2.    Antiseptic baths to reduce secondary bacterial infection.
3.    Antihistaminics in adequate doses for pruritus.
4.    If there us secondary infection use appropriate antibiotics orally.
5.    Bacitracin-neomycin ointment may be used locally.
6.    Corticosteriods may be used for.
7.    Adenine arabinoside or acyciovir when administered during the first 6 days of the disease, may be effective.