Varicella

What is Varicella?

Varicella, commonly known as chickenpox, is a highly contagious viral infection caused by the varicella-zoster virus (VZV). It primarily affects children, but individuals of all ages can be susceptible. Varicella is characterized by a rash of itchy, fluid-filled blisters that eventually crust over. Most cases of varicella resolve on their own within a few weeks without complications, but it can cause more severe symptoms and complications in certain populations.

Who's at risk for Varicella?

Anyone who has not previously had chickenpox or received the varicella vaccine is at risk of contracting varicella. The risk is higher for individuals who:

• Have not been vaccinated: People who have not received the varicella vaccine are more susceptible to varicella.
• Have not had chickenpox before: Those who have never had varicella or have not been previously vaccinated are at risk of contracting the virus.
• Have weakened immune systems: Individuals with weakened immune systems, such as those with HIV/AIDS, undergoing chemotherapy, or taking immunosuppressive medications, have an increased risk of severe varicella.
• Are pregnant: Pregnant women who have not had chickenpox are at risk, and varicella during pregnancy can lead to complications for both the mother and the baby.
• Newborns: Infants born to mothers who develop varicella near the time of delivery are at risk of developing severe varicella soon after birth.

What causes Varicella?

Varicella is caused by the varicella-zoster virus (VZV), which is highly contagious and spreads from person to person through respiratory droplets or direct contact with fluid from the blisters of an infected individual. The virus can also be transmitted through airborne particles when an infected person coughs or sneezes. Once a person is infected with VZV, the virus remains dormant in nerve cells and can reactivate later in life, causing a different condition known as herpes zoster or shingles.

How does Varicella start?

Varicella usually starts with a prodromal phase, which can last for a day or two before the characteristic rash appears. During this phase, individuals may experience flu-like symptoms such as fever, headache, fatigue, and loss of appetite. After the prodromal phase, a red, itchy rash appears on the skin. The rash progresses through different stages, including raised bumps, fluid-filled blisters, and crusted sores, over a period of about 7 to 10 days.

What are the symptoms of Varicella?

The symptoms of varicella typically include:

• Rash: The hallmark symptom of varicella is a rash that starts as red, itchy bumps and quickly progresses to fluid-filled blisters. The rash usually begins on the face, chest, and back, then spreads to other parts of the body.
• Itching: The rash is often accompanied by intense itching, which can be relieved with appropriate measures.
• Fever: Many individuals with varicella develop a low-grade fever, generally ranging from 100°F to 102°F (37.8°C to 38.9°C).
• Fatigue: Varicella can cause fatigue and general malaise.
• Headache: Some individuals may experience headaches, especially during the early stage of the illness.
• Loss of appetite: Decreased appetite is a common symptom of varicella.

How is Varicella diagnosed?

In most cases, a clinical diagnosis of varicella can be made based on the characteristic rash and symptoms. Laboratory tests are generally not required unless the diagnosis is uncertain or the patient is at increased risk of complications. In such cases, a healthcare professional may collect a sample from the rash or conduct a blood test to detect the presence of VZV antibodies.

How can Varicella be treated?

Treatment for varicella aims to relieve symptoms and prevent complications. It usually includes:

• Home care: Managing symptoms at home involves rest, staying hydrated, and maintaining good hygiene to prevent secondary infections by keeping the blisters clean and avoiding scratching.
• Medications: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate fever, discomfort, and pain associated with varicella. However, aspirin should not be given to children or adolescents due to the risk of Reye's syndrome.
• Antiviral medications: In certain cases, antiviral medications may be prescribed to individuals at high risk of severe varicella or those with complications. Antivirals can help shorten the duration of the illness and reduce the severity of symptoms.

What complications may occur with Varicella?

Most cases of varicella resolve without complications, but some individuals may experience complications, particularly those at higher risk. Complications of varicella can include:

• Secondary bacterial infections: Scratching the blisters can lead to bacterial infections, such as cellulitis or impetigo.
• Pneumonia: In rare cases, varicella can cause viral pneumonia, especially in adults, pregnant women, or individuals with weakened immune systems.
• Encephalitis: Although very rare, varicella can lead to inflammation of the brain, resulting in encephalitis.
• Reye's syndrome: The use of aspirin during varicella infection in children or adolescents can increase the risk of Reye's syndrome, a rare but potentially life-threatening condition affecting the liver and brain.
• Complications in pregnant women: Varicella during pregnancy can lead to severe illness in the mother and pose risks to the unborn baby, including congenital varicella syndrome.

How can I prevent Varicella?

The varicella vaccine is highly effective in preventing varicella infection or reducing the severity of the illness. It is recommended as part of routine childhood vaccinations and is typically administered in two doses, the first around 12 to 15 months of age and the second dose between 4 to 6 years of age. The vaccine is also recommended for susceptible adults who have never had varicella.

Other preventive measures include:

• Avoiding close contact with infected individuals, especially those with active varicella infection.
• Practicing good hand hygiene by washing hands frequently with soap and water.
• Covering the mouth and nose when coughing or sneezing to prevent the spread of respiratory droplets.
• Avoiding scratching the blisters to reduce the risk of bacterial infection.

Where can I go for more information on Varicella?

For more information on varicella, reliable sources such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the Mayo Clinic, or other reputable healthcare institutions can provide valuable information and resources. These sources offer comprehensive information on varicella, including vaccination guidelines, prevention strategies, and treatment options. Consulting with a healthcare professional, such as a pediatrician or primary care physician, can also provide personalized information and guidance specific to an individual's situation.