Throw away your myths on Chickenpox!

Dr. Amali Ruwanchinthani and Dr. Arosha Senanayake

In the Sri Lankan context, Chickenpox is an infection which has lead to lots of myths. It is considered as a disease given by god and there are so many traditional beliefs and myths regarding the diseases. The disease is caused by a virus called varicella zoster, a member of the herpes virus family. It is a common illness among kids, with the highest prevalence in the 4-10 year old age group. Chickenpox is highly contagious (capable of transmitting infection), with an infection rate of 90% in close contacts. Most people become infected before adulthood but 10% of young adults remain susceptible.
Chickenpox is spread easily through coughs or sneezes of ill individuals or through direct contact with secretions from the rash. Following primary infection there is usually lifelong protective immunity from further episodes of chickenpox.

Infected

When someone becomes infected, the pox usually appears 10 to 21 days later. Chickenpox is contagious from about 2 days before the rash appears until all the blisters (a blister is a bump on your skin that fills up with fluid) are crusted over. So you could be spreading around chickenpox without even knowing it! A child with the disease should be kept out of school until all blisters have dried, usually about 1 week.
Chickenpox causes a red, itchy skin rash that usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body, including the scalp, mouth, nose, ears, and genitals. The rash may be more extensive or severe in kids who have skin disorders such as eczema.
At first, the rash looks like pinkish dots that quickly develop a small blister on top. These blisters are usually less than one centimeter wide and have a reddish base. After about 24 to 48 hours, the fluid in the blisters gets cloudy and the blisters begin to crust over which finally become dry, brown scabs. Meanwhile, new crops of blisters spring up in groups. New chickenpox clusters usually stop appearing by the seventh day, though they may stop as early as the third day. It usually takes 10-14 days for all the blisters to be scabbed over and then you are no longer contagious.
Most pox will not leave scars unless they become infected with bacteria from scratching. If your fever gets high and an area of your skin gets really red, warm, and painful, you’ll need to see a doctor because you could have a skin infection. In adults the pock marks are darker and the scars more prominent than in children.
Most children with chickenpox act sick, with symptoms such as a fever, headache, stomachache, or loss of appetite for a day or two before breaking out in the classic pox rash. These symptoms last 2 to 4 days after breaking out.
The disease is usually mild, although serious complications sometimes occur. It is rarely fatal. Adults and older children usually get sicker than younger children do and it is generally more severe in adult males. Pregnant women and those with a suppressed immune system which may be caused by an illness or medicines such as chemotherapy and steroids are at highest risk of severe complications.
Some people can develop serious bacterial infections involving the skin, lungs, bones, joints, and the brain (encephalitis). Even kids with normal immune systems can occasionally develop complications, most commonly a skin infection near the blisters.
The most common late complication of chicken pox is shingles (pain and blisters along a nerves’ distribution), caused by reactivation of the varicella zoster virus decades after the initial episode of chickenpox. People who haven’t had chickenpox or the vaccine also can catch it from someone with shingles, but they cannot catch shingles itself.
Chickenpox is usually diagnosed from the classic rash and the child’s medical history. Blood tests, and tests of the pox blisters themselves, can confirm the diagnosis if there is any question.
In most cases, it is enough to keep children comfortable while their own bodies fight the illness. It gets cured on its own. A virus causes chickenpox, so the doctor won’t prescribe antibiotics. However, antibiotics may be required if the sores become infected by bacteria. The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. Safe antiviral medicines have been developed. To work well, they usually must be started within the first 24 hours of the rash.
Once you get the disease, the management mainly focuses on relieving the symptoms. The blisters itch, but you’re not supposed to scratch them. Keep cool because heat and sweat will make you itch more. You can put a cool, wet washcloth on the really bad areas.
Trim your fingernails, so if you do scratch, you won’t tear your skin. Medicines and creams that may stop the itch can also be helpful. Do not take aspirin because it can cause a rare but serious illness in kids called Reye syndrome. The outcome is generally excellent in uncomplicated cases.

Prevention

Prevention is the most crucial part in the control of the disease. Because chickenpox is airborne and very contagious before the rash even appears, it is difficult to avoid. Until all chickenpox sores have crusted over or dried out, avoid playing with other children, going back to school, or returning to work. The best protection from getting or spreading the disease is receiving the chickenpox vaccination. It is possible that a person who has had the chickenpox vaccination may still get chickenpox, but the disease is generally far milder and the duration is shorter. Immediate preventive measures may be important. Giving the vaccine early after exposure may still reduce the severity of the disease.
Chickenpox makes your body sick and weak, which makes you in need of paying more attention on your nutrition and your cleanliness. Acts lead by your mythical beliefs can sometimes make your condition worse.