What is it?

Chickenpox or Varicella, is a mild but irritating infectious viral disease caused by the so-called Herpes Zoster virus. This is the same virus that, after years of dormancy, may cause the feared shingles disease in adults. The disease mainly affects the skin and the lining of the mouth and throat. It is primarily spread by respiratory routes through coughing and sneezing, but occasionally also by contact with infected lesions. The contagious period starts 1 to 2 days before the occurrence of the rashes and lasts till all the lesions have crusted. The virus incubation period is between 10 to 20 days. In Thailand the disease often occurs around February-March, i.e. at the end of the cool season.

What are the Symptoms?

The main symptom of chickenpox is an extensive and annoying skin rash. Groups of very itchy red spots that gradually turn into blisters, gradually appear all over the body. After a few days the spots burst or dry out and become crusted scabs. Spots in the mouth, around the eyes or in the vagina may be quite painful. A child may develop a light fever, which generally manifests itself just prior or on the same day as the rashes. Children recover rather quickly i.e. with 7 to 10 days, but adults are more likely to develop complications and thus can take somewhat longer to recover.

What are the complications?

In general one can expect a complete recovery and a consequent life-long immunity. If the spots are scratched excessively they can become infected and turn into permanent scars. Adolescents and adults with chickenpox run a small danger of pneumonia. Severe reactions can occur in immuno-compromised persons, such as for example persons suffering from cancer or patients on steroids.

What is the treatment?

The treatment is merely supportive. If there is fever, the patient should take paracetamol (such as Tylenol) but never Aspirin. Persons with chickenpox taking aspirin run the risk of the so-called Reye Syndrome, which can be life-threatening. Against the itchiness you can apply a lotion or cream (such as Caladryl) and/or take an anti-histamine (such as Atarax). If the spots in the mouth, eye or vagina become too painful, you can ask your doctor to prescribe an appropriate medication. Antibiotics (orally or as ointment) may be given if the lesions become bacterially infected.

How can it be prevented?

Vaccination of children against Chickenpox is an option from the age of one onwards. Such a vaccination is highly recommended for adolescents and adults who never had chickenpox before.