From the Guidelines
Varicella, also known as chickenpox, is a highly contagious disease caused by the varicella zoster virus (VZV), characterized by fever, malaise, and a generalized vesicular rash typically consisting of 250-500 lesions. This condition usually lasts 4-5 days and is self-limited, but it can lead to complications, especially in infants, adolescents, adults, and immunocompromised persons 1. The disease is responsible for significant morbidity and mortality, with an estimated 4 million cases, 11,000 hospitalizations, and 100 deaths each year in the United States before the availability of the varicella vaccine 1.
Key Characteristics of Varicella
- Highly contagious disease caused by the varicella zoster virus (VZV)
- Characterized by fever, malaise, and a generalized vesicular rash
- Typically consists of 250-500 lesions
- Lasts 4-5 days and is usually self-limited
- Can lead to complications, especially in high-risk individuals
Prevention and Management
The varicella vaccine, licensed in the United States in 1995, is a crucial tool in preventing the disease, with the Advisory Committee on Immunization Practices (ACIP) issuing recommendations for its use in 1996 1.
- The vaccine is typically given to children in two doses, providing about 90% protection against infection
- Prevention is key, as treatment focuses on symptom management rather than curing the infection
- For severe cases, antiviral medications like acyclovir may be prescribed if started within 24-48 hours of rash onset It is essential to note that the virus remains dormant in nerve tissue after recovery and may reactivate later in life as shingles. Therefore, prevention through vaccination is crucial in reducing the incidence of varicella and its potential complications 1.
From the Research
Definition and Overview of Varicella
- Varicella, also known as chickenpox, is the primary form of Varicella-zoster virus (VZV) infection, which appears most commonly in preschool and school children 2.
- It is generally a mild and self-limiting disease in healthy children, but can be severe and life-threatening in adults, immunocompromised patients, and pregnant women 3, 4, 5.
Clinical Features and Complications
- The clinical course of chickenpox includes gradual onset, constitutional symptoms, signs of upper respiratory tract, and polymorphous rash 5.
- Complications of varicella can be divided into viral and bacterial complications, with viral complications including pneumonia, haemorrhagic rash, and viral meningitis, and bacterial complications including secondary bacterial skin infections, otitis media, and bronchopneumonia 2, 5.
- Immunocompromised patients are at a higher risk of developing serious and life-threatening complications, including visceral dissemination and central nervous system complications 2, 5.
Treatment and Prevention
- Acyclovir is an effective antiviral drug for the treatment of varicella, particularly in high-risk groups such as adults, immunocompromised patients, and pregnant women 2, 4, 5.
- Vaccination is also an effective way to prevent varicella, with live attenuated vaccines available for use in immunocompetent children and adults 3, 5.
- Symptomatic therapy, including hygiene and supportive care, is usually adequate for chickenpox in immunocompetent patients, but antiviral and antibiotic therapy may be necessary in more severe cases 6.