What are the other Names for this Condition? (Also known as/Synonyms)

• Varicella Infection
• Varicella Zoster Infection
• VZV Infection

What is Chickenpox Infection? (Definition/Background Information)

• Chickenpox Infection (or Varicella) is an airborne, highly contagious infection caused by the varicella-zoster virus (VZV, a member of the herpes virus family)
• This infection, which mostly affects young children, causes the development of itchy and sometimes painful blisters all over the body
• Chickenpox Infection is a self-limiting infection; hence, a symptomatic treatment is often provided such as medications for fever, pain, and to reduce the itching sensations
• The prognosis of Chickenpox in normally healthy individuals is excellent. However, in immunocompromised individuals, pregnant women, and very young infants, the infection can be severe with complications
• Chickenpox is seen worldwide and vaccination is an effective way to prevent the infection. Also, it gives a life-long immunity to a majority of the vaccinated individuals

Who gets Chickenpox Infection? (Age and Sex Distribution)

• Individuals of any age and sex may be affected by Chickenpox Infection
• Young children (less than 10 years of age) are most likely to be affected
• No racial or ethnic group preference is observed and the infection is observed around the world

What are the Risk Factors for Chickenpox Infection? (Predisposing Factors)

The risk factors associated with Chickenpox Infection include:

• Individuals, who have not had Chickenpox earlier
• Individuals, who have not been vaccinated

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Chickenpox Infection? (Etiology)

Chickenpox Infection is caused by the varicella-zoster virus (human herpes virus 3). It can spread from one affected individual to another in the following manner:

• Through air: When an infected person sneezes or coughs, the virus circulates in the air spreading the infection. The infected droplets transmit infection to another person, when they inhale the infected airborne droplets
• By direct contact with the fluids discharged from Chickenpox blisters
• Through direct contact with an individual, who has already contracted the disease

Typically, the infectious phase of the disease is the period shortly before the blisters appear, which continues till after the blisters break and heal.

What are the Signs and Symptoms of Chickenpox Infection?

Chickenpox Infections are generally mild in children, but severe in older children and adults. It can also be very severe in individuals with certain underlying conditions such as weak immune systems, in pregnant women, and infants below 1 year of age.

The common signs and symptoms before the skin rashes appear are:

• Myalgia or muscle pain
• Nausea
• Malaise; feeling of uneasiness
• Fever (37.7-38.8 deg. C), lasting for 1-2 days
• Headache
• Sore throat
• Itching
• Diarrhea
• Pain in both ears
• Pressure and pain in the head
• Swollen face
• Stomach ache
• Severe back pain
• Loss of appetite
• Oral sores

The skin rashes start appearing on the face, chest, back, and even the scalp, about 10-21 days after exposure to the virus. About 250-500 itchy blisters develop all over the body. After 1-2 days, they ripen, burst, and become open sores, which then slowly start drying. Usually, these blisters do not leave any scars after they heal.

How is Chickenpox Infection Diagnosed?

The diagnostic procedure to confirm the presence of Chickenpox Infection (Varicella) may include:

• Physical examination with medical history evaluation: Normally, a physician may diagnose the infection based on the characteristic signs and symptoms, especially the skin rashes
• A blood test for varicella zoster virus may be performed to confirm the infection, if required

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Chickenpox Infection?

The possible complications associated with Chickenpox Infection include:

• Encephalitis: Inflammation and swelling of the brain
• Reye’s syndrome: A fatal disease causing severe liver and brain damage in children with Chicken Pox, who have been given aspirin
• Myocarditis - inflammation of the heart muscle
• Pneumonia - inflammation/infection of the lungs
• Arthritis - inflammation of the joints
• Cerebellar ataxia: Impaired or uncoordinated muscle movements, due to injury to the cerebellum (a part of the brain) resulting in walking, vision, and speech difficulties

How is Chickenpox Infection Treated?

Chickenpox Infection is a self- limiting disease, and generally, a supportive treatment is provided. These include:

• Acetaminophen can help with fever and body aches. The correct dose of acetaminophen (Tylenol) needs to be administered according to the child’s body weight
• Aspirin or any other medication containing aspirin should be avoided, especially in children. Treatment with aspirin in Chickenpox patients can result in Reye’s syndrome
• Frequent oatmeal baths can be helpful in reducing itching
• Calamine lotions can be applied on the blisters to soothe them and help them dry
• Antihistamines may be used to reduce severe itching sensations
• Chickenpox affected individuals should trim their nails short, in order to avoid scratching, which may result in superimposed bacterial skin infections
• Acyclovir anti-viral drug can be used for treating the infection. Anti-viral drugs are particularly beneficial in children with other skin conditions, such as eczema
• Cool and light bedclothes have to be used; the use of rough clothing should be avoided
• In tropical countries, neem tree (Azadirachta indica) leaves made into a paste form can be applied on the blisters, to give a cooling effect

How can Chickenpox Infection be Prevented?

Chickenpox is a viral infection that can be prevented through vaccination. Vaccination to prevent Chickenpox Infection is normally part of a child’s immunization schedule. The schedule of doses is as follows:

• For children, the first dose is between ages 12 -15 months
• The second dose is between the ages 4-6 years
• For individuals who are over 13 years, but have not yet received the vaccine and not had had Chicken Pox, the vaccine should be administered in two doses with a 4-8 weeks gap between the 2 doses
• Individuals over the age of 13 years, who have previously received the vaccine, but not had had Chicken Pox, are advised to go for another dose for safety reasons
• Vaccinations should not be administered to those individuals who are allergic to gelatine and neomycin, including to pregnant women
• Individuals, who receive the vaccination, may get shingles later in their lives (as adults), when their immunity is weakened, or during times of acute stress. It has to be noted that there is a 10% chance for such an occurrence

Chickenpox patients are advised to remain at home, till the blisters break, dry, and heal; a stage when they are completely cured. This can prevent spread of the infection to others either at schools or at work places.

What is the Prognosis of Chickenpox Infection? (Outcomes/Resolutions)

• Children or adults who are healthy, can make a complete recovery from Chickenpox Infection without the development of any complications. The blisters usually remain for 4-7 days and starts subsiding after the 5^th day. Chickenpox is generally a self-limiting condition in a majority of cases
• Adults and older children who have not received the vaccination, may get severe forms of  the infection
• Serious complications may develop in those with certain underlying conditions, individuals with weak immune systems, pregnant women, and in infants below a year old
• Pregnant women, who have been vaccinated, may pass on the antibodies (against the infection) to their offspring. Generally, such babies are affected only by milder forms of the infection
• Even children, who have been previously vaccinated, may be mildly infected by the varicella-zoster virus (VZV). But, generally following an infection, most individuals have lifelong immunity to the disease

Additional and Relevant Useful Information for Chickenpox Infection:

Chickenpox and shingles test maybe performed to detect and diagnose a current or past chickenpox and/or shingles (herpes zoster) infection.

The following article link will help you understand chickenpox and shingles test:

http://www.dovemed.com/common-procedures/procedures-laboratory/chickenpox-and-shingles-test/