What is varicella? Also called chickenpox, it is a disease common in children; they develop a rash with red spots and vesicles on their body.
This article will discuss what chickenpox is, which is the virus that causes it, and how it transmits from one person to another. We will also describe the signs and symptoms of the disease and if it can have any severe complications for the patient.
Keep reading this article to get more information on the diagnosis, treatment, and prevention of this disease, directly from a doctor.
What is varicella? What does chickenpox mean?
Varicella is a highly infectious disease that originates from the varicella zoster virus (VZV). People commonly know this disease as chickenpox, probably because of its blisters with a chickpea size.
The virus travels through the air in droplets from the respiratory system of infected patients, and healthy people inhale them, leading to infection. This means it easily transmits to one another since being in close contact with an infected person is very risky. It can also transmit from touching the highly contagious skin rash of people with the disease, although less common.
Chickenpox infections are 90% of children, and the disease in this group of people is usually mild. The real problem is when it affects vulnerable children with pre-existing conditions or when it affects adults.
Thankfully, the body develops immunity to the virus after getting it, meaning children won’t get it in adulthood. There is also a chickenpox vaccine that reduces infections significantly, or they turn out to be milder.
The varicella zoster virus infects the upper respiratory tract and then the adjacent lymph nodes 2 to 4 days later. Afterward, the virus proliferates in the body’s organs, specifically the liver and the spleen, to infect the skin and tiny blood vessels. This final infection causes the particular vesicles and chickenpox blisters that appear in the disease.
Several scientists have confidence that the varicella virus goes to the dorsal ganglion cells after the disease happens. These are cells in charge of receiving impulses from sensory nerves in several body parts. The spread to these dorsal ganglionic cells occurs the most in the thorax.
Sadly, when there is a weakened immune system, a distinct disease happens, called herpes zoster or shingles. This can happen to people under severe stressful circumstances, corticoid treatment, or immunological depressing diseases, like HIV.
Which are the signs and symptoms of varicella?
Varicella has a group of signs and symptoms that are important to know to differentiate it from other similar diseases. The main characteristic of chickenpox is the appearance of spots in the upper part of the body first.
This skin rash can appear in the scalp, face, thorax, upper limbs, neck, and the upper part of the back. They then progress to appear in the lower part of the body as they also turn into vesicles or blisters.
It is a very itchy rash; therefore, it can lead to secondary bacterial infection. This means that if the person scratches the skin lesion, it may cause another skin infection in the area.
The chickenpox rash can appear in the palms and soles, as well as mucous surfaces like the mouth and genitalia. In these tissues, it can also be very painful and become ulcers as well.
Afterward, there’s a crust formation over the vesicles that, when they heal, leave no scars unless there is another infection. The spots, vesicles, and crusts usually converge simultaneously and last overall approximately 4 to 5 days.
When the rash starts, there is an association between low fever and fatigue in children. In adults, mild fever can appear one day or two before starting the rash, along with the malaise. The VZV infection in this group generally represents more severe chickenpox symptoms and complications.
People who had varicella vaccination in the past and then acquired the disease will, in a normal scenario, develop around 50 vesicles in their whole body. Contrary to children or people with a weak immune system, that can get between 250 to 300 vesicles.
Is varicella dangerous?
A chickenpox infection usually does not turn into a severe disease with life-threatening complications, although there are exceptions.
At the same time, the most common complication is the least dangerous, which is a secondary bacterial infection. As we already know, this happens when the patient scratches the skin lesions, bringing bacteria to the damaged skin. In some cases, these infections can be more serious by presenting themselves as cellulitis, an infection under the skin. If these are large or are in a place like a face, they can threaten the patient’s life.
The varicella virus can cause pneumonia in adults or people with a weak immune system regarding the more severe complications. If people with a stark case of pneumonia do not receive treatment on time, it could lead to death.
In pediatric patients exists a complication due to aspirin treatment that is known as Reye syndrome. This syndrome happens because of excessive intake of aspirin, which causes liver failure and encephalopathy. The damage translates into a child with neurological changes and vomiting, which can be fatal if not taken care of.
In the case of a mother that contracts the chickenpox virus, various things can happen depending on the week of pregnancy. If it happens very early on, the baby can suffer from congenital varicella syndrome. This is the deformity of the limbs and hands, scarring of the skin, neurological problems, or death. When it happens later on in the pregnancy, the baby will already have the virus in their dorsal ganglion. This means that the baby can get shingles at some point in their life without a previously known infection.
How is chickenpox diagnosed?
Various test and laboratory methods exist to diagnose VZV’s presence, but a doctor’s examination is the most essential. It is very important to consider whether the patient was in contact with someone with chickenpox signs.
As the virus takes weeks to produce the disease, the most important contact happened weeks ago. The onset of the symptoms is vital in terms of recognizing the condition as it is very specific. Just knowing the clinical behavior of the disease orientates most of the diagnosis.
When there is a need to confirm the possible diagnosis, a Tzanck smear is the best test to do. It consists of a dab of the liquid inside a vesicle, which will demonstrate a set of characteristics in a laboratory setting. These will show a group of cells with various nuclei and skin cells with pink additions inside of them. This, along with the signs and symptoms, confirms a varicella infection.
There are other tests, such as a culture of the vesicle fluid or serology. Doing a varicella zoster culture takes too long and isn’t always as effective, meaning it isn’t the first choice.
Serology is a blood test in which we look for varicella zoster immune globulin, intending to prove the virus’ presence or body’s previous recognition and protection against the virus. Immune globulins are proteins made by the immune system to protect us from external threats. These can be specific to certain viruses, bacteria, parasites, and even the cells in our own bodies. So, in this case, we are looking for the specific immune globulins the body made after an infection occurred. Usually, these types of tests aren’t the best type since they can present mistakes, be unavailable, or take too long doing.
What is the treatment for varicella? How do I prevent it?
The treatment for a varicella infection in healthy individuals, especially children, is a symptomatic one. This means that the medicine applied aims to alleviate symptoms and not to combat the virus itself.
Some of the treatments are oral antihistamines, lotions, and creams to treat the itchiness and prevent infections. An easy way to prevent secondary bacterial infection is to trim the child’s fingernails so there are fewer bacteria present.
In adults, the treatment is also symptomatic, but oral antiviral medicine becomes necessary as well. This type of medicine interferes with the spread of the virus and shortens the infection, diminishing life threatening risks. In people who have a weakened immune system, there is a need to use a more aggressive approach with intravenous antiviral medication to work faster.
The key to eradicating varicella is to prevent it, and it is possible through the chickenpox vaccine. Everyone can and should get the vaccine, from children to adolescents and adults.
The chickenpox vaccination consists of two doses, one at 12 months old and the other at four years old. This can prevent chickenpox very effectively, and in case the person contracts the disease, it is very mild.
Everyone else must get vaccinated for people who have immunological problems that cannot get the varicella vaccination. This is because when other people get the varicella vaccine, herd immunity is developing within the families and communities.
Herd immunity happens when there are many vaccinated people, and the virus’s spread is greatly diminished. The use of the vaccine also prevents the possibility of having shingles later on in life.
Do you have symptoms of this disease?
This is a Chickenpox Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for this disease. Therefore, the tool will tell anybody who uses it the likelihood of their symptoms because of chickenpox. Using this tool is free and would only take a few minutes.