Chickenpox

The symptoms caused by chickenpox infection appear 10 to 21 days after exposure to the virus and usually last about 5 to 10 days. The initial symptoms may resemble any other infection. At the beginning of chickenpox, a person may feel unwell, experience body aches and headaches, accompanied by loss of appetite. After one or two days, these are followed by the appearance of the classic rash of chickenpox. One is contagious to close contacts up to 48 hours before the skin rash starts to occur. The common non-rash symptoms of chickenpox are as follows:

• Fever: The most common symptom of chickenpox, usually lasting for 3-5 days and ranging from 101°–102°F (38.3°–38.8°C).
• Fatigue or malaise: A general feeling of being unwell.
• Loss of appetite.
• Headache.
• Muscle or joint pain.
• Flu-like symptoms: Such as cough or runny nose.

Once the chickenpox rash and blisters appear on the body, they go through the following three phases:

• Red or pink bumps (papules) are often first noted on the stomach, chest, back, or face, then spread throughout the body.
• The bumps eventually fill with fluid, forming blisters (vesicles) that begin to break open and leak.
• The blisters develop a crust, scab, and begin to heal.

All the blisters do not form at the same time. New blisters continue to develop throughout the infectious period, following the same phases as explained above. All symptoms are typically mild for young children. Those who have been vaccinated (including children and adults) can still get an infection, but symptoms will be milder and produce fewer blisters on the body.

In severe cases of chickenpox, rashes and blisters may spread throughout the body. Small lesions may even form on the throat, around the eyes, and in the mucous membranes of the urethra, vagina, or anus.

In some cases, rashes are accompanied by symptoms of disorientation, dizziness, shortness of breath, rapid heartbeat, worsening cough, poor muscle coordination, and stiff neck. These symptoms could indicate another possible medical condition or complication that may require prompt medical intervention.

Chickenpox is caused by the virus varicella zoster. It mostly spreads due to close contact with an infected person. The virus can spread through:

• Coughing or sneezing via respiratory droplets
• Kissing or sharing drinks or food through saliva
• Handshaking or hugging through contact with the blisters or the fluid on the skin
• Touching contaminated surfaces like door handles or tables

You may be at high risk of getting infected with the chickenpox virus if you have not contracted the infection in your life. The risk increases if you:

• Haven’t been vaccinated for the infection
• Have been in contact with an infected child or adult
• Are an adult living with an infected child
• Work in a school, childcare facility, or healthcare setting
• Have low or compromised immunity due to illness or use of medications

Chickenpox is usually easy to recognize and diagnose due to its classic skin rashes.

If required, a confirmatory test by polymerase chain reaction (PCR) testing can be conducted. For this, the blister fluid or scabs are tested for the presence of the virus.

Moreover, tests for antibodies may be performed to determine if immunity is present against chickenpox. These include:

• Varicella Zoster IgG test: Evaluates the level of IgG antibodies produced by the immune system to fight against the varicella zoster virus.
• Varicella Zoster IgM test: Performed to diagnose chickenpox and to distinguish between a recent, current, or old infection.

One of the simple and effective ways to prevent chickenpox is through vaccination. Although routine infant vaccination has substantially reduced transmission of wild-type varicella, chickenpox vaccination is not a part of the Indian Universal Immunisation Program. Hence, get vaccinated for chickenpox if you have not yet, as it can significantly lower the risk of suffering from an infection. Moreover, it is one of the safe and effective options to prevent chickenpox infection. Do consult your doctor for advice on vaccination.

As chickenpox is contagious in nature, it is recommended that if a person in a family is diagnosed with chickenpox, other family members must get vaccinated if they have not been vaccinated before.

Chickenpox usually runs its course in a week or 10 days. The treatment is mostly aimed at relieving the symptoms. Non-Aspirin products such as Paracetamol can be taken to reduce fever.

In adults and those with severe symptoms of chickenpox, doctors might prescribe antiviral medication as it can make the symptoms less severe and improve the condition. However, ensure to follow the course of the treatment and do not self-medicate. Some of the common antivirals used include:

• Acyclovir
• Famciclovir
• Ganciclovir
• Ribavirin
• Valacyclovir

Do’s and Don’ts

As a protective measure, those infected are usually required to stay at home while they are infectious.

It is advised not to use OTC medications such as aspirin for fever as it is associated with Reye’s syndrome in children. This is a severe disease that affects the brain and may even cause death.

Avoid the use of anti-inflammatory painkillers without consulting your doctor as they can increase the risk of severe skin infections.

Daily cleansing with warm water will help avoid secondary bacterial infections.

Keeping nails short and wearing gloves may prevent scratching and reduce the risk of secondary infections.

1. Do not scratch the itch
One of the key symptoms of chickenpox is itchy skin; therefore, it is advised to avoid scratching. This not only increases the risk of scars but also can lead to infection. As a safety measure, trim the fingernails of children to prevent skin infections caused by scratching. Tap or pat on the itchy skin but do not scratch.

2. Use cold compress
Chickenpox can cause fever, which may increase skin itching and scratching. Elevated body temperature can worsen the condition. It is advisable to use a cold compress, as it helps lower body temperature and soothes itchy skin. Apply a cool, damp compress over the itchy area as it serves as an effective remedy for chickenpox.

3. Eat healthy, home-cooked food
It is common to crave spicy and processed food when ill. However, it is best to avoid spicy, oily, or salty foods, as these can hinder digestion and increase heat in the body. Opt for home-cooked, preferably bland foods, to improve the healing process. Increase your intake of fruits rich in Vitamin C, such as oranges, apples, grapes, and lemons, to boost immunity.

4. Stay hydrated
Drink plenty of fluids to stay hydrated and prevent dehydration caused by high fever. This can also help flush viral toxins from the body and aid in quick recovery. Avoid sugary beverages and opt for fresh, plain water, especially if there are sores in the mouth. For children, sugar-free popsicles can help replenish fluid stores.

5. Wear gloves
This tip primarily applies to children, as they are more prone to scratching itchy skin. It is advisable to put gloves or socks over their hands to prevent scratching. This can help prevent direct contact of the nails with chickenpox blisters, lower the risk of infections, and limit scarring. Additionally, wear loose, cotton clothing to help the skin breathe and ease itching.

6. Avoid self-medication
Many people tend to take a pill for fever or a painkiller for body aches without a second thought when suffering from chickenpox. However, this is not advisable. Aspirin, commonly used to relieve fever, can cause a serious condition known as Reye’s syndrome in children under 16 years of age. Therefore, do not self-medicate; consult your doctor before taking any medications.

Chickenpox is usually a mild disease; however, complications can occur, especially in adults and individuals with weakened immune systems, such as:

• Infants
• Pregnant women
• Patients with conditions like HIV/AIDS, cancer, chemotherapy, steroid therapy, or transplants

Some serious complications of chickenpox include:

• Secondary bacterial infections
• Dehydration
• Pneumonia (infection of the lungs)
• Encephalitis (inflammation and swelling of the brain)
• Cerebellar ataxia (defective muscular coordination)
• Transverse myelitis (inflammation of the spinal cord)
• Bleeding
• Sepsis
• Toxic shock syndrome
• Reye's syndrome in children and teenagers who take aspirin during chickenpox
• Death

Chickenpox and Shingles

Although shingles and chickenpox are caused by the same virus, they are not the same illness. Chickenpox is typically a milder illness that affects children, while shingles results from the reactivation of the virus long after the chickenpox illness has resolved.

The chickenpox virus remains in the body even after recovery. Later in life, the virus can reactivate and cause shingles. If you have shingles, you can spread the varicella virus to individuals who have never had chickenpox or received the chickenpox vaccine. These individuals will develop chickenpox, not shingles. It takes from 10 to 21 days after exposure to chickenpox or shingles for someone to develop chickenpox.

In addition to antiviral medications, there are a few home remedies known to help relieve symptoms and reduce scars caused by scratching. However, consult your doctor before trying any of these chickenpox remedies.

• Oatmeal bath: Oatmeal bath is one of the most popular natural remedies to relieve itchy skin caused by chickenpox. Cook two cups of oatmeal in two liters of water for around 15 minutes. Let it cool, tie the cooked oatmeal in a cotton cloth, and allow it to float in a tub of warm water until the water becomes turbid. Splash this water all over the body to soothe itching.
• Baking soda: This is commonly used to relieve itching in people with chickenpox. Add 1/4 teaspoon of baking soda to a glass of water. Dip a soft cotton cloth in it and dab it on the skin, allowing the baking soda to dry on the skin. This can help prevent scratching of the blisters.
• Vitamin E oil: Rich in antioxidants, Vitamin E oil can help relieve itching as well as prevent scars from scratching chickenpox blisters. Gently apply Vitamin E oil all over the skin, as it exerts a calming and soothing effect, promoting healing. Regular application of this oil may also lighten scars and marks caused by chickenpox.

For the short time when a person has chickenpox, there’s little one can do other than make themselves as comfortable as possible. In most cases, once you have chickenpox, you will not have it again in your lifetime. Rarely, someone may get it more than once. Patients should:

• Take ample amounts of rest.
• Drink lots of water and other fluids to maintain hydration.
• Consider herbal teas such as cinnamon, chamomile, and basil to boost the immune system.
• Follow a simple and wholesome diet, avoiding fatty and spicy foods.
• Avoid foods high in saturated fat, as they can cause inflammation and slow healing.
• Trim fingernails to prevent scratching, which can lead to deep scars and wounds.
• Use antihistamine lotion and take cool baths to help calm the itching.

Along with self-care, it is very important to prevent chickenpox from spreading at home. Ensure your family:

• Washes their hands frequently, especially after eating and using the restroom.
• Avoids exposing unvaccinated family members, pregnant women, newborns, elderly individuals, or those with low resistance to infection.
• Stays isolated until all blisters have crusted or dried.