Contents
What is chicken pox?
Chickenpox , a disease also known as chickenpox , is a primary infection caused by the varicella-zoster virus. It is a disease characterized by the lesions it causes on the skin and its high rate of transmissibility.
It is a very common condition in children, despite being a disease that can happen at any age. Usually, once infected, the patient becomes immune to the virus. Because of this, it is estimated that 90% of the population in large urban centers are immunized.
In healthy children, it is a disease considered self-limited and with a benign prognosis. In adults, on the other hand, it can manifest itself more intensely and with greater complications.
The disease becomes a greater risk in adults precisely because they have a complete immune system. Thus, when infected by the virus, the body produces a more severe or more intense inflammatory response, which results in the appearance of more intense and persistent symptoms.
The best way to prevent chicken pox is through vaccination and avoiding contact with people who are infected.
Thus, the main characteristics of the infection are the manifestation of skin rashes, itching, fever and tiredness . For these symptoms, the treatment is nonspecific, performed only to alleviate the symptoms until total remission.
Until the last skin lesion is healed, the patient can still transmit the disease. Therefore, in order to curb dissemination, he should not attend classes, work and environments with circulation of people.
Typically, chickenpox cures within 1 to 2 weeks. But in these cases, even with the remission of the disease, the virus remains inactive in the patient’s body. Thus, it remains throughout the patient’s life, being able to be reactivated and causing herpes zoster (shingles), the secondary infection caused by the varicella-zoster virus.
In the International Disease Code (ICD 10), chicken pox (chickenpox) can be found under code B01.9. Continue reading and find out how to prevent yourself.
Causes
Chickenpox is caused by contact with the varicella-zoster virus, a virus that is part of the Herpesviridae family , which also includes genital and labial herpes viruses .
Upon entering the body, the microorganism causes an infection in the nerves and manifests various symptoms in the patient.
Also known by names like chicken pox virus, chickenpox virus, human herpesvirus type 3 (HHV-3) and zoster virus, it is able to affect only humans and can manifest itself in the infected patient in two different ways.
In primary infection, more common during childhood, it causes chickenpox (chickenpox). When it remains in a state of latency (inactive) in the nerves, it can late “wake up” causing the patient to have herpes zoster.
How does the transmission happen?
Transmission occurs through contact with virus particles that spread through the air, during coughing or sneezing, but also through direct contact with the liquid present in the vesicles and mucous membranes on the patient’s skin.
Chicken pox is also contagious due to contact with saliva, so you should avoid sharing personal items such as glasses, plates, cutlery and other belongings.
People who have had chickenpox in the past are not at risk of reinfection, however, it is recommended that they take basic care to prevent the development of herpes zoster if they have a weakened immune system.
The incubation period of the virus lasts, on average, 15 days, and the manifestation of symptoms can take between 10 to 22 days after the initial contact with the agent. However, the patient can begin to transmit the disease within 1 or 2 days before the lesions appear on the skin until complete healing of the last vesicle.
Groups and risk factors
Chickenpox is a more common disease in children aged 1 to 10 years, but it can also occur during adulthood, usually in a more severe form than that which occurs in childhood.
Many factors favor it to be more common during childhood, considering that some of the risk factors for transmission include staying indoors and in crowded places, such as classrooms and daycare centers.
In addition, the disease also becomes more frequent during winter and early spring, seasons when people tend to keep windows closed, leaving environments with poor ventilation.
Other risk groups include people who have never had the disease and people who cannot receive the vaccine, such as immunocompromised people (patients with HIV / AIDS and undergoing cancer treatments ) and pregnant women.
Symptoms
Chickenpox symptoms usually manifest in the patient between 10 and 22 days after contamination, the most characteristic symptom of the disease being the presence of skin lesions, which can cause great discomfort and itching.
Symptoms can be divided in two ways, including nonspecific symptoms for diagnosis, which are usually the first signs to appear, and skin lesions.
During the period that the symptoms remain, which can last between 7 and 10 days, it is recommended that the patient does not go to the day-to-day commitments to not transmit the disease, as soon as the disease is easily transmitted while there are wounds (vesicles) ) in the skin..
How is chicken pox at first?
Possibly, the first sign of chicken pox to appear is fever, which can reach 39.5ºC. The patient may experience malaise, tiredness, headache , vomiting and loss of appetite.
These symptoms can be persistent for a few hours or days, being more common when the infection occurs in adults. In healthy children, the first symptoms of chicken pox are usually the rashes themselves, with moderate fever during the first 2 or 3 days and nonspecific symptoms for diagnosis.
Cutaneous symptoms
Skin rashes caused by chicken pox are usually distributed in the center of the patient’s body (centripetal distribution), initially appearing on the face, trunk and scalp.
These lesions appear, at first, as spots (macules) and develop into papules, vesicles, pustules (bubbles) filled with liquid, which burst and form the crusts. It is usually during the healing of these wounds that the itching becomes even more intense.
This period, from the onset of nonspecific symptoms to the healing of all skin lesions, can take up to 2 weeks.
The amount of skin wounds and the affected body region can vary, so some patients have more than others and in different places, and can also occur in the mucosae of the genital region and the mouth.
These are usually injuries that do not present a major health risk unless the patient is exposed to other infectious agents.
With this exception, the biggest damage associated with injuries is the discomfort and itching that they can cause, making children, especially, more irritated and impatient with the condition.
Chicken pox in pregnancy
Chickenpox when it occurs in healthy people, especially if it is in childhood, is considered a disease without great risks. However, during pregnancy, the infection is a threat to the baby’s health.
Depending on the period of pregnancy, the risks alternate. When the infection still occurs between the first or second trimester of pregnancy, for example, there is a greater possibility of malformation of the fetus or, more rarely, abortion.
When the baby is affected by chickenpox, congenital chickenpox syndrome is characterized. Among the complications for the child are malformation of the extremities, low weight, microphthalmia (reduced dimensions of one or both eyes), cataracts , skin scars and mental retardation.
It is also known that the congenital varicella syndrome in newborns of mothers who had the disease in the first half of pregnancy can be 1.2%. In cases where chickenpox occurred during the 13th and 20th week of gestation, this risk rises to 2%.
Risks of complications and mortality can also occur in newborns exposed to the disease, although it is not uncommon. In general, children of mothers who have antibodies to the disease can maintain immunity for up to 1 year after delivery.
However, if the newborn’s infection occurs, the chances of lethality can reach 30%, due to the immune system still developing.
Chickenpox becomes an even greater risk considering the fact that pregnant women cannot receive the vaccine during this period.
So, to avoid this type of complication, pregnant women who have not received the vaccine or who are not immune because they have already suffered from chickenpox at another time, can receive human immunoglobulin (antibodies) against the varicella-zoster virus at the Reference Centers of Special Immunobiologicals (CRIEs).
These centers are focused on the personalized immunization of patients in special health conditions, such as pregnant women or those who are immunocompromised, who cannot receive vaccines stipulated by the National Immunization Program (PNI).
To receive human immunoglobulin, pregnant women need to present a medical prescription and clinical report confirming the need for this preventive treatment.
The main symptoms of chickenpox in pregnancy are the presence of hives in the upper body and face, which can spread within a few hours to the rest of the body. Other common symptoms include fever, itching, diarrhea , vomiting and headache.
When noticing these or other symptoms, the pregnant woman should immediately seek medical attention. The best way to prevent chickenpox during pregnancy is to avoid contact with infected patients.
Chickenpox and shingles
The varicella-zoster virus, in primary infection, results in the appearance of chicken pox. However, even after remission of the disease, the microorganism may enter a long latency phase (time interval without symptoms), and may later manifest herpes zoster, or shingles, as it is popularly known in the patient.
Herpes zoster is, in this sense, the reactivation of the varicella-zoster virus, which remained dormant in the infected patient’s body.
It is a disease that can happen to anyone who has suffered from the infection previously, but there are some factors that increase the chances of this occurring, such as age (people aged around 50), weakened immune system, use of some medications and immunosuppressive treatments.
And, like chicken pox, shingles also cause skin rashes. The blisters and redness present during the disease usually appear on only one side of the body (usually in bands), as they accompany the infected nerves. The patient may also experience pain, itching, burning and tingling in the affected area.
Also like chicken pox, herpes zoster is transmissible. Therefore, the same precautions must be maintained when this reactivation of the virus occurs.
Complications seen in herpes zoster include severe pain that persists even after the lesions have resolved, which can be severe enough to interfere with the patient’s daily activities.
Less common, but also possible, herpes zoster can reach the optic nerves and cause inflammation of the cornea and other complications for the health of vision.
Diagnosis
The diagnosis of chicken pox is made through the analysis of symptoms, often eliminating the need for laboratory tests. It is usually performed by a general practitioner, infectious disease or pediatrician.
Although not the most common, your doctor may also order a blood test to confirm your infection with the virus.
With a common blood collection, the laboratory investigates the presence of varicella-zoster-specific IgM antibodies.
Can chickenpox cure?
The picture of chicken pox, yes . It is a disease that has complete remission of symptoms and, in most cases, the person becomes immune and does not have a new infection and manifestation of chicken pox.
However, even after chickenpox is cured, the varicella-zoster virus remains lodged in the patient’s body, more specifically in the cells of the central nervous system (nervous ganglion) next to the spine, where it can remain inactive for years or decades. When it manifests, it causes herpes zoster (shingles).
Treatments
The treatment of chicken pox in healthy people is done to alleviate the symptoms. Because it is a self-limited disease – that is, a disease that has a certain period to end – and with uncommon complications, the treatment aims to keep the symptoms under control and avoid complications until the total remission of the disease.
For this, the doctor must analyze the urgencies of each patient, being able to indicate medications to relieve fever, itching and, when there is an infection by other agents such as bacteria that enter the wounds, the use of antibiotics can be prescribed.
In addition to drug treatment, the patient can be instructed to take some extra care with the wounds, such as:
- Do not itch;
- Cut your nails properly, reducing the risk of accidentally injuring blisters and rashes;
- Avoid the consumption of very acid and salty foods when there are sores on the lining of the mouth;
- Take warm or cold baths, 2 to 3 times a day, to help relieve discomfort and itching.
Medicines
To help control the symptoms of chicken pox, the doctor in charge can prescribe antihistamines, ointments, pain relievers and antipyretics.
For the hygiene of wounds, it is important to check which soap is most suitable, so that the situation does not get worse.
The most specific drug treatment for chickenpox is by antiviral administration, with acyclovir . It is most recommended when the patient has a severe condition or when his health condition is more vulnerable, as in patients with weakened immunity.
However, its use is indicated for adults or patients over the age of 12, when chicken pox is usually more severe.
If the patient has any impairment of the immune system, as in the case of patients with HIV, treatment with this medication may be a possibility in children under 12 as well.
Other medications that can be prescribed include:
- Paracetamol (to help lower the fever);
- Polaramine , antiallergic ointment that helps to reduce itching;
- Dipyrone , to relieve fever.
Some products that can be included during treatment and aim to alleviate the symptoms are:
- Antiseptic soaps based on triclosan;
- Talent Mentolado ADV , to help alleviate itching;
- Talent Menthol LBS , to relieve itching.
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Living together
Patients with chicken pox, while the disease has not fully resolved, can take some basic care for wounds and injuries. Some tips can help reduce discomfort and prevent complications, such as secondary infections. Are they:
Keep your nails clean and well cut
Very long nails with inadequate hygiene can be responsible for causing secondary infections, because by scratching the wounds, the patient makes the body itself more exposed to the bacteria present in the nail.
Avoid scratching the wounds
It can be very difficult to resist itching while living with chicken pox, as this is certainly a very uncomfortable symptom. However, it is important for patients to keep in mind that the practice can end up making the wounds even more serious, which can delay healing.
Using measures that prevent friction on the skin are ideal, such as wearing gloves to sleep.
Take warm or cold baths
Warm to cold baths can help to improve the itchy feeling, especially during the first few days.
Taking a cold shower at 4-hour intervals, for example, or using a towel soaked in cold water, applying it to the most itchy wound sites can minimize the itchy sensation.
Opt for lighter and more comfortable clothes
Avoiding uncomfortable and very tight clothes can make this moment easier, by avoiding friction with skin lesions and also by avoiding excessive sweating, which usually aggravates itching.
Choose hygiene products that do not irritate the skin
Stop using soaps, creams, perfumes and talc when you realize that they are causing skin irritation. The recommendation is that patients follow medical recommendations regarding less irritating products.
Take good care of your food and stay hydrated
Drinking water and taking care of food is important to strengthen the immune system, so choosing healthy and nutritious meals is essential. Patients who have sores inside their mouths should also avoid very citrusy and salty foods.
Chickenpox in babies
Some doubts may arise in relation to chickenpox with regard to the care that parents need to take with children and babies, so as not to catch the disease or prevent transmission to other children, for example.
In such cases, one of the most important measures is to be immunized. When it comes to family members who have already received the vaccine, the risk of transmission is considered to be minimal. If contagion occurs even after vaccination, chickenpox symptoms are usually milder and less persistent.
Thus, in addition to vaccination, other precautions include:
- Avoid contact with the infected child;
- Use gloves when there is contact with the child;
- Wear a mask, as the disease is also transmitted through inhalation (sneezing and coughing, for example;
- Wash your hands more frequently with antiseptic soap and alcohol.
Read more: Food in childhood: what to know
Prognosis
Chickenpox (chickenpox) in children is usually considered to be a disease with a positive prognosis, as it usually does not cause complications.
In general, most people recover within 1 to 2 weeks, being a risk disease only in adult patients, with low immunity, pregnant women or people undergoing drug treatment that weakens their defense system.
Complications
In healthy people, chickenpox does not usually cause complications, especially when it affects children who do not have a weakened immune system. In adults, despite being an uncommon condition (3% of cases), it is usually more serious.
In these cases, the fever is prolonged and higher, the skin lesions (rashes) occur in greater quantities, as well as the other symptoms become more intense.
However, the greatest risk during chickenpox is the possibility of secondary infections.
The main complications observed are:
Ataxia is very cheerful
This is an inflammatory syndrome characterized by dysfunction of the cerebellum, part of the brain responsible for functions such as control of voluntary movements, muscle tone, balance and learning, for example.
It usually happens as a complication of a viral infection, with the varicella-zoster virus being one of the most frequent agents.
The symptoms in this condition vary for each patient, with high fever, tremor, spontaneous eye movements, uncoordinated movements of the limbs and neck, altered consciousness, nausea, vomiting and headache.
Thrombocytopenia
The thrombocytopenia is a condition in which there is a deficiency in the number of platelets (thrombocytes) in the blood cells important for blood clotting and blood stagnation.
This insufficiency of thrombocytes can cause light or severe bleeding, causing external or internal bleeding.
It is a condition that occurs for several causes, the presence of a viral infection such as chickenpox being one of the risk factors.
Fetal infection during pregnancy
Chickenpox is a problematic disease for pregnant women. In the first months of pregnancy, the infection represents a greater risk of malformation for the fetus and after the 5th month of pregnancy a risk for premature birth . In addition, when fetal infection occurs, the disease is usually more severe.
Secondary bacterial infection
Secondary bacterial infections are one of the most frequent risks in patients with chickenpox. It usually happens when other infectious agents invade the body through lesions (skin rashes).
It is common to happen when the patient scratches the wounds and prevents healing, leaving them open and susceptible to secondary infection.
Usually, these secondary infections occur due to the entry of bacteria such as Streptococcus pyogenes and Staphylococcus aureus, which are usually harmless, but which can also cause boils, cellulite and acnes.
Generally, these infections are limited, reaching the skin and subcutaneous tissues (as in the case of cellulite). However, there is also a risk of them spreading through the bloodstream, infecting specific organs (such as the lung) or causing sepsis , that is, a generalized infection.
This type of secondary infection can cause bacterial pneumonia , being more common in children under the age of 1 year.
Some of the most frequent infections include:
- Erysipelas (inflammation of the skin that causes redness, sores and pain);
- Arthritis (inflammation of the joints);
- Endocarditis (inflammation of the walls of the heart).
- Meningitis (inflammation of the membrane that surrounds the brain);
- Glomerulonephritis (inflammation that affects the kidneys);
- Cellulite (inflammation of the deeper layers of the skin);
- Impetigo (bacterial infection of the most superficial layer of the skin);
- Abscess (spaces that form in the skin or organs and accumulate pus).
Reye syndrome
Reye’s syndrome is a rare and serious disease that affects the entire body, but especially the brain and liver. Therefore, characteristically, it causes mental confusion, accumulation of fat in the liver and swelling in the brain.
The condition can be lethal, due to viral infections like chicken pox and flu . From an infection, if the patient uses medicines derived from salicylates (treatment of fever) and aspirin, there are greater risks of Reye’s Syndrome to manifest itself. Symptoms such as confusion, delirium, nausea and vomiting may occur.
Nevralgia
The neuralgia , and neuralgia , is a disease characterized by severe and persistent pain in one or more nerves of the body. It can occur for four to six weeks after the rash of chicken pox, being more frequent in women, the elderly and after the involvement of the cranial nerve called trigeminal.
When chicken pox occurs in adults, the symptoms are more intense and capable of damaging the nerve fibers located in the skin, which affects the electrical stimuli sent to the brain.
These stimuli become more intense and exaggerated, which generates the chronic pain present in cases of neuralgia.
Scars
Chickenpox can cause high scars on the skin (keloids), atrophic or depressed. It is not a recurrent complication in all people who have had chickenpox, as it is related to the severity of the condition and the patient’s predisposition to develop scarring.
How to prevent?
The main way to prevent chicken pox is through vaccination. It is important that people know when doses are to be applied and that parents or guardians make sure that the child has their vaccination schedule up to date.
Along with immunization, some precautions and preventive measures can help to reduce the risk of contamination by the varicella-zoster virus.
In addition to the vaccine, another measure is to avoid contact with infected patients as much as possible. People close to the patient who have never had the disease should avoid the approach, as the varicella-zoster virus can be transmitted through contact with the liquid from the bubbles that appear on the patient’s skin, or also through the air, through droplets of saliva when coughing or to sneeze.
Sharing personal belongings should also not be done, such as sharing glasses, cutlery and plates.
Avoiding transmission
Patients also need to follow some precautions to contain the transmission. It is recommended that they follow the following guidelines:
- Wash your hands well after having contact with the lesions;
- Isolate yourself, avoiding contact with other people who have not had chicken pox;
- Return to school, day care, work or other activities only after complete remission of the disease;
- Keep your nails short and do not scratch the lesions, to reduce the risk of secondary infections.
Chickenpox vaccine
Vaccination is one of the most effective ways to protect against numerous diseases, the same is true when it comes to chicken pox.
There are two different forms of immunization from this, one made with the vaccine exclusively produced against the varicella-zoster virus, which uses the live attenuated virus, and the other, made from the tetra viral vaccine (which is the attenuated combination of the viruses causing measles , mumps , rubella and chickenpox).
The isolated chickenpox vaccine is only available in the private health network, while the viral tetra is offered free of charge to all children of vaccination age.
According to the Brazilian Society of Immunizations (SBIm) and the Brazilian Society of Pediatrics (SBP), two doses of the varicella vaccine are recommended, the first being administered at 12 months and the second between 15 and 24 months of age.
As the age predicted for the second dose of the varicella vaccine coincides with the time of the tetra viral vaccine (SCR-V), only immunization with tetraviral is necessary.
Learn more: read the instructions for the vaccine against chicken pox !
Since 2013, according to the Ministry of Health, the chickenpox vaccine has become part of the vaccination schedule that, previously, relied only on the triple viral (against mumps , rubella and measles).
Now, both are offered by the Unified Health System, and the triple viral should be applied at 12 months and tetra viral at 15.
This vaccine is part of the National Vaccination Calendar, which currently focuses on children between 15 months and 5 years old who have already received the first dose of the triple viral (measles, rubella and mumps ).
In case the child has not received the triple vaccine before the age of 15 months, it is recommended that it be administered as soon as possible and that the viral tetra is scheduled at least 30 days after the application.
Doses
The tetra viral vaccine (SCR-V), which protects against chicken pox and other diseases, is available in a single dose for children aged 15 months (or up to 4 years, 11 months and 29 days) who have already received the triple viral vaccine.
When administered to older children, adolescents and adults who have not received the triple and viral tetra in the right period, for example, two doses are indicated at an interval of 30 days.
In cases of outbreaks of the disease, the application of the chickenpox vaccine can be done from 9 months of age. However, this dose is applied as a form of emergent prevention, being disregarded in the vaccination booklet and requiring the application of the other routine doses.
Indications
The indication for the tetra viral vaccine is made for all children who fit the recommended age range for the doses, being applied before 15 months, exceptionally, in cases of risk, as seen above.
Adults, adolescents and older children who have not been immunized should also receive the vaccine, it is important to individually evaluate the vaccination booklet.
According to the Ministry of Health, in addition to these general recommendations, there are also other specific groups that should be vaccinated:
- Indigenous population (from 4 years of age);
- Health professionals, family members and caregivers living in hospital or home who are at risk of complications;
- Patients suffering from chronic kidney disease;
- HIV virus carriers;
- Patients with severe dermatological diseases;
- In cases of hospital outbreak, it is recommended to vaccinate 9-month-old children with low immunity and other people susceptible to infection who are in the environment, within 5 days after the onset of the outbreak.
Contraindications
The vaccine should not be applied to people who have had a severe allergic reaction ( anaphylaxis ) to any of the components present in the vaccine or who have already manifested an allergy in previous vaccinations.
It should also not be administered to pregnant women and people with a weakened immune system, as due to diseases or treatments that make them immunosuppressed.
Side effects
In healthy people, the vaccine does not usually cause adverse reactions. The possibility of side effects, when they occur, varies from 5% to 35%, according to the Brazilian Society of Immunizations.
Among the symptoms that can manifest, there is the occurrence of redness (5% of cases) and pain at the site (26% of those vaccinated). Between 1% to 3% of cases, lesions similar to chicken pox may occur, which normally remain for 5 to 26 days after vaccination.
When the lesions appear 2 or more weeks after the vaccine, it may be indicative of the disease caused before the immunization, this period being the period in which the virus is incubated.
In people with weakened immune systems, the adverse effects can be more serious, but they happen rarely.
Read more: see the complete package insert for the Proquad tetra viral vaccine
Common questions
Can I get chicken pox more than once?
In spite of rare, a reactivation of the virus can occur, which is “asleep” or in a latency period in the body.
If there is a severe drop in immunity, there may be a tendency for the disease to recur (herpes zoster)
How do you get chicken pox?
Chickenpox catches itself when having contact with people who are contaminated, the transmission is made through saliva, contaminated objects, sneezing, coughing and coming into contact with the liquid present in the bubbles.
What is the period of transmission of chicken pox?
The virus incubation time is usually 4 to 16 days, but the transmission period occurs between 1 and 2 days before the appearance of the wounds and up to 6 days after, until all the lesions are healed. During this period, the patient must avoid contact with other people, due to the high risk of transmission.
When will the chicken pox spots go away?
It depends. Each patient may have a different time for the remission of the spots, which tend to be gradually alleviated. However, some patients can maintain scars, especially if the wounds are very intense.
One of the factors that favors the persistence of stains is sun exposure without the use of sunscreen. To avoid these stains, the patient with chicken pox should not puncture them and pass the sunscreen with SPF 30, at least, daily.
It may be an option for people who have had the permanence of stains as a complication, resort to aesthetic treatments to minimize them, according to the evaluation of the professional dermatologist or beautician.
Who is already infected can get the chicken pox vaccine?
No , the vaccine does not provide protection for those who have had chickenpox. In general, once infected, the patient naturally creates immunity against the virus, eliminating the need to receive immunization.
However, in the case of the tetraviral vaccine, which also offers protection from other diseases, administration can be done in order to make the patient immune to other pathologies.
Is chicken pox in pregnancy serious?
Yes, chicken pox during pregnancy can be serious, being more problematic when the infection happens between 5 days before delivery. During this period, the baby’s chances of developing the disease are greater.
In other stages of pregnancy, the observed risks include the child’s chance of being born with low weight, malformation of legs, arms or brain. For these reasons and the impossibility of the pregnant woman to receive the vaccine, care must be redoubled.
Chickenpox is a very common condition in childhood, but it can happen in any age group. Its symptoms can be quite uncomfortable and unpleasant, but which, fortunately, can be treated and alleviated.
In addition, it is a disease that usually has its remission within 1 to 2 weeks, without leaving any complications.
We seek to clarify in this article how chicken pox affects people, their risks and complications. Share this information so that more people can get to know about this condition. Thanks for reading!
