Monday, January 14, 2008

India Child Health Care

Varicella (Chicken Pox)

Chickenpox is caused by the varicella-zoster virus. It is characterised by fever and an itchy and blistered rash. It is a highly contagious disease. Although chickenpox-related complications are relatively rare among healthy children, the disease could be more dangerous among infants and the older age groups.

In most cases, chickenpox in childhood is not life threatening. However, it can cause considerable suffering and discomfort to the patient and inconvenience to the parents. Children who suffer can miss valuable time at school, especially during exams and parents can lose working time, spent in looking after their sick children. Medical costs are also involved. Moreover, if an adolescent or adult becomes infected, the problems pertaining to lost working time and medical costs could be even greater.

What is chickenpox?

It is a viral disease caused by first exposure to the varicella-zoster virus (VZV). The disease is identified with fever and typical blistered rash all over the body. The virus then remains latent or dormant in the body and can later be reactivated and cause shingles (herpes zoster).

What are the symptoms of chickenpox?

Common symptoms are fever, chills, nausea and vomiting. The most obvious and the most well-known is the blistered and highly itchy rash. Most children have 200-300 lesions which later form a crust or scab.

Is chickenpox contagious?

Yes, it is. Chickenpox is most contagious a couple of days before the rash appears and until scabs have formed on all the lesions i.e. till they dry up, which usually occurs in a weeks time after the onset of the rash.

How can you contract chickenpox?

The virus commonly spreads from person-to-person by air-borne droplets. This occurs when an infected person coughs or sneezes and releases secretions in the surrounding air. It can also spread by direct contact with chickenpox or herpes, since the wet lesions contain infectious fluid. In few cases, it can also occur from an infected pregnant mother to her unborn or newly born child.

Who is most susceptible to this virus ?

Chickenpox can occur in both children and adults, males and females. Most people contract chickenpox sometime or the other during childhood or adolescence, but adults who have not been infected before are susceptible to infection and can develop chickenpox in adulthood if and when they come in contact with a case. As chickenpox usually affects young children, those who spend a lot of time with children, like susceptible teachers and persons running the day-care centres have more chances of contracting the infection. In addition, healthcare providers (doctors, nurses and hospital personnel) are at added risk of developing the infection since they may come in contact with a case during the course of their duty. Chickenpox is usually more severe in older individuals who missed getting it when they were children.

Does chickenpox cause complications in children?

Although for many children chickenpox does not produce major health problems, complications can develop in some cases. Secondary bacterial infection affecting the skin lesions is the commonest complication that one encounters, especially when hygiene is poor and when bathing is not regular. Rarely, in a few children, the virus could prove more aggressive and cause infection in lungs leading to pneumonia and may affect the brain leading to swelling and infection (encephalitis). These could prove fatal. Other complications have been described, but these usually have a self-limited course. Rarely, residual scarring may be unsightly, leading to cosmetic concerns later in life.

Is chicken pox in adults different from that in children ?

Chickenpox is more severe in adolescents and adults than in children. The fever is higher and continues for a longer time. The rash is usually heavier with deeper and more lesions. The likelihood of complications is greater too. Adults are more likely to suffer from pneumonia. The chances of complications and risk to life tend to be higher when chickenpox is contracted later in life.

Some viral infections are dangerous in pregnancy. What about chickenpox? The interaction between chicken pox and pregnancy would depend on the timing of contracting the infection during pregnancy. If chickenpox is contracted by the pregnant lady during the first three months of pregnancy, there is a risk of congenital foetal malformations, or chances of abortion. Infection later in pregnancy but not too close to delivery allows maternal antibodies to be passed on to the fetus thus offering protection. Maternal chickenpox within 5 days prior to delivery or 2 days after is dangerous as this can result in transmission of the virus without antibodies to the child. Such chickenpox in the newborn can be life threatening as the baby's immune response is poorly developed at this time.

What is the relation between shingles and chickenpox?

Both these conditions are caused by the same virus i.e., varicella zoster virus.
First exposure to the varicella zoster virus results in chickenpox; that is followed by immunity against the infection, which usually lasts a lifetime. The virus, however, hides in certain nerve roots and remains dormant. The virus may get reactivated many years later, leading to shingles (herpes zoster). Shingles usually afflicts adults, especially old people, as the efficiency of the immune system declines with age.

What is the social impact of chickenpox?

The full impact of chickenpox on patients and their families is often not appreciated. Physically, chickenpox is very uncomfortable for patients because they have to endure discomfort from symptoms such as rash and the associated itching, fever, chills, nausea and vomiting. Patients often need to be isolated and kept at home. Thus, a school-going child may miss school for a few days to a month. Where both parents are working, it might require one of them to keep the child company and miss work. In adolescents and adults chickenpox can be more serious and severe leading sometimes to complications. In some cases there could be residual scarring. Chickenpox infection can thus lead to loss of man hours in the form of missing school, college or working time.

How can chickenpox be prevented?

Isolating infected individuals by keeping them away from school or work will help reduce transmission of the virus. Vaccination is an effective way of preventing suffering from chickenpox.

What are the advantages of chickenpox vaccination?

Where chickenpox is more prevalent among older age groups _ in whom complications are more likely _ it represents a major health threat. It follows that some means of controlling the situation is vital, and pro-active measures like vaccination in children would be most effective. Vaccination of children and susceptible adults and adolescents can reduce the disease burden and transmission of chickenpox. This would also result in avoiding the social impact of the disease and reducing healthcare costs. Vaccination can be offered to individuals more than one year of age, who have not suffered previously from chickenpox.

What are the chances of suffering with chickenpox after vaccination?

Clinical studies of currently available varicella vaccines show they are close to 100% effective and well-tolerated. However, long-term follow-up of vaccines has shown the incidence of a mild breakthrough like syndrome in 1-4% of vaccine recipients.

Thanks to modern science you or your children don't have to suffer with chickenpox in the first place.

Chickenpox is now preventable through vaccination. Consult your doctor.


GavEv3 said...

Herpes Zoster what is the cure??
do they have any Vaccination for it?? and where do i buy these vaccinations from?? i am based in Kuwait at the moment. Can you please help us.
my Husband is infected with Shingles 2 weeks now. but the sores are gettin dried up.
please do let me know the closest place where i can buy these vaccinations from.

Thank You

Urgent Health Care Services in Florida said...

Health Care is more focussed to child as they personally can't take of themselves. so this is really a big issue for them and nice article on "India Child Health Care".