Chickenpox or varicella is a common childhood disease. This viral disease is mostly transmitted by droplet infection. The most typical symptoms are the noticeable skin rash.
What is chickenpox?
Chickenpox is a childhood disease transmitted by droplet infection and is caused by the varicella zoster virus. Chickenpox, also called wet pox or sheep pox, is a viral infection known as a typical childhood disease with a high risk of infection. Sufferers usually have a fever and an itchy rash characteristic of the disease. Most sufferers are immune to chickenpox for the rest of their lives after a single outbreak. In children, the disease is usually free of complications and is over after three to five days. In adults, chickenpox is predominantly more severe and lasts significantly longer. In addition, more serious complications such as pneumonia or meningitis may occur. Particularly in pregnant women, infection with chickenpox should be avoided because of the increased risk to mother and child.
Causes
The cause of chickenpox disease is the varicella zoester virus, which is why the disease is also known as varicella. The virus, which belongs to the herpes virus family, is transmitted exclusively from person to person. In addition to direct contact, with the varicella blisters that appear during the course of the disease (the “chicken pox”), transmission is also possible through expiratory droplets or even through the air, since the pathogens can survive outside the human body for a short time. Chickenpox is contagious two days before the rash appears and remains so for about a week after the first appearance of skin irritations. The risk of infection is as high as 90% for people who spend more than an hour in the presence of people with chickenpox.
Symptoms, complaints, and signs
When a person becomes ill with chickenpox, only nonspecific signs are initially evident. General symptoms of the disease occur, such as fever and fatigue. Subsequently, characteristic symptoms develop. A typical skin rash appears, which is visible all over the body. Numerous red spots form, from which blisters develop. These contain a clear fluid. There is a strong, unpleasant itching. After one or two days, the blisters crust over. Over a period of about five days, new papules may appear again and again. New and already encrusted vesicles mix over the entire skin. These usually appear first on the face and trunk. The rash then spreads to the arms and legs. Even the genitals, oral mucosa and scalp are affected. The number of vesicles can vary significantly among sufferers. Symptoms for chickenpox can be more severe in adults than in children. In severe cases, additional symptoms such as stiff neck, unsteady gait, or shortness of breath may be experienced by the sufferer in a complicated course. In addition, a pregnant patient suffering from chickenpox may develop malformations of the unborn child. Scarring may occur in the blister area after the disease subsides if the blisters have been scratched open by itching.
Course of the disease
Because the disease is much more severe in adults, parents often try to infect their children with the virus at a young age in so-called chickenpox parties. After infection, ten to 21 days may pass before chickenpox breaks out. In most cases, the disease begins in children with a mild fever, sometimes with headache and pain in the limbs. Within 24 hours, small red itchy pustules then form in the chest and head area, where watery vesicles often form. The mucous membranes are rarely affected by this pustule formation. When the vesicles burst, a brown crust forms that soon falls off without scarring, provided care is taken not to scratch the children too much. Adults show more chickenpox in the majority of cases, which can also affect the limbs and genital area. Repeatedly appearing pustules are often accompanied by high fever. In pregnant women, chickenpox infection can also lead to miscarriage.
Complications
Chickenpox is a disease that usually occurs in children and usually heals without complications. Only in very rare cases can serious courses of the disease occur. This is especially true for newborns, people with a weakened immune system or pregnant women. Occasionally, however, complicated courses of the disease also occur in otherwise healthy children. These are then caused by a superinfection with bacteria. If the affected person constantly scratches the itchy blisters, there is a risk of an additional bacterial infection at these sites. This risk can be reduced by staying in cool environments as well as by administering itch-relieving medications. In newborns and immunocompromised people, however, the actual chickenpox pathogen (varicella zoster virus) can spread more widely in the body and attack various organs. Among other things, this leads to life-threatening pneumonia caused by varicella-zoster. Varicella can also affect the nervous system with the formation of encephalitis. The heart, kidneys, cornea or joints are sometimes also affected. Furthermore, there is a so-called fetal varicella syndrome in unborn children. This can develop if the mother contracts chickenpox during the first six weeks of pregnancy. Fetal varicella syndrome is characterized by malformations of the skeleton and nervous system, eye damage, and skin changes. If the mother becomes ill with chickenpox around her due date, the baby may become infected, developing a very severe neonatal varicella infection.
When should you go to the doctor?
Chickenpox is a disease with which a doctor should be consulted in any case. Since the disease is in childhood before low risk, an appointment can be made for affected children. Immediate treatment is recommended for the child because of the accompanying symptoms, but it is not vital. In contrast, the situation is different for adult patients and adolescents. Affected persons should contact a doctor immediately, as chickenpox can even become life-threatening in this age group. It makes sense to contact a doctor at early signs. As soon as the first rashes or a feverish feeling appear, patients should seek medical clarification. It is particularly important that patients who believe they have chickenpox call the doctor’s office in advance. Since the disease is highly contagious, the respective practice needs time to take measures to prevent other patients from also becoming infected. It is also advisable for affected children to arrange their visit with their pediatrician in advance.
Treatment and therapy
Because chickenpox is a viral disease, only the symptoms are treated if possible. Itching can be relieved by cool moist compresses or drying emulsions. To reduce the risk of further infection and scarring, children should have their fingernails trimmed to prevent them from scratching the pustules. Existing fever can be controlled with antipyretics. Aspirin should not be given, however, because it increases the risk of severe Reye’s syndrome in the case of chickenpox. Immunocompromised persons should be given the virus-inhibiting agents aciclovir or vidarabine. Furthermore, especially in adults suffering from chickenpox, attention should be paid to symptoms of meningitis (pain when nodding and lowering the head), pneumonia (difficulty breathing or sputum), or gastrointestinal complications (severe abdominal pain, bloating). Chickenpox usually progresses without complications and does not require immediate follow-up. The fluid-filled blisters dry up and crust over. It is important not to scratch the crust, otherwise bacterial skin infections may occur. After 3-5 days, the crust falls off without scarring. Once you have survived chickenpox, you have lifelong immunity. In rare cases, if the first disease had occurred in early childhood or only weakly, a second disease may occur.
Follow-up
For long-term follow-up, it is important to remember that varicella zoster viruses remain in the body throughout life. They persist in an inactive state in nerve fibers. After years or decades, the viruses can be reactivated and overcome the body’s defenses.As a result, shingles (herpes zoster) is triggered as a secondary disease. Every fifth person who has experienced a chickenpox infection will later get shingles at least once. People with weakened immune systems are particularly affected. This includes older people, as the function of the immune defense decreases with increasing age. Therefore, primarily these risk groups must pay attention to the appearance of typical symptoms of shingles (skin rashes, nerve pain). At the first suspicion of disease, antiviral drugs should be administered. Vaccination is also available to prevent shingles. Vaccines are approved for persons 50 years of age and older.
What you can do yourself
The disease is highly contagious. Those affected should therefore stay at home until all the blisters have crusted over. Chickenpox is no longer transmissible until then. As a rule, this lasts for about a week. Adult relatives who have already contracted chickenpox in childhood are in most cases immune to a new infection. Therefore, they do not need to take any special measures. However, since the disease can be quite aggressive in adults, it is recommended to keep relatives out for the duration of the infection if they did not have chickenpox as a child. This is particularly advisable for elderly people, pregnant women and relatives with immune deficiency. Children living in the household do not need to be separated. The disease is usually mild in them. Nevertheless, direct contact with the affected person should be avoided. An important self-help measure is to refrain from scratching the blisters. Otherwise, infections with bacteria can occur. Ideally, sufferers should wear light cotton clothing, as this does not further irritate the skin. The itching can be relieved by washing the whole body with apple cider vinegar water. In addition, the intake of folic acid and iron supplements is recommended.
