27/01/2015
CHICKEN POX INFECTION
Chicken pox is a highly contagious viral illness that usually occurs in epidemics and mostly during hot weather conditions. Humans are the only source of infection. Person-to-person transmission occurs by direct contact with vesicular fluid from patients with the disease or by airborne spread from respiratory tract secretions. There is a risk of infection up to 21 days after contact with a person with chicken pox.
Complications include bacterial super-infection of skin lesions, pneumonia, central nervous system involvement (acute cerebellar ataxia, encephalitis), thrombocytopenia, and other rare complications such as glomerulonephritis, arthritis, and hepatitis. Chicken pox tends to be more severe in adolescents and adults than in young children and also in immunosuppressed patients e.g. patients on steroids. Exposure to varicella-zoster virus (VZV) in utero during the second 20 weeks of pregnancy can result in an apparent varicella infection in early life without having had extra uterine chicken pox. Varicella infection can be fatal for an infant if the mother develops varicella from 5 days before to 2 days after delivery.
CAUSE • Varicella-zoster virus
SIGNS/ SYMPTOMS
• Extensive Skin rash - lesions are groups of macules, papules and vesicles and crusting.
• Intense itching
• Mild headache
• Fever and malaise
TREATMENT
Non-pharmacological treatment
• Avoid scratching in adults and children if possible
• Keep hands clean and nails clipped short in children • Regular bathing with soap and water
Pharmacological treatment (Evidence rating: C)
• Calamine lotion, topical, Adults and children apply liberally to the skin
• Paracetamol, oral,
Give antibiotics if lesions are super infected.
• Flucloxacillin, oral, 250-500 mg 6 hourly for 5-7 days
Or In the case of penicillin sensitivity,
• Erythromycin, oral, 500 mg 6 hourly for 5-7 days and Antihistamines in severe cases of itching
• Cetirizine, oral, 10 mg daily,
Note; Avoid Aspirin in children less than 16 years of age because of risk of Reye's syndrome.
• Apply Calamine lotion 8-12 hourly to the skin
• Chlorpheniramine, oral, to relieve itching.