Chickenpox or varicella zoster is a common viral infection occurring mostly in childhood. Typical symptom is blistering or vesicular rash mostly on trunk, scalp, face, hands and legs, accompanied with fever and malaise. Ninety percent of cases occur in children less than 10 years of age.
Many myths are prevalent on this common disease, in this post, we have tried to counter these myths with facts.
Myth: chickenpox is only a childhood disease
Fact: false
Chickenpox can occur in adults too. In adults, disease is severe with rashes on extensive area of body, high fever and malaise. The complications are also more common in adults as compared to childhood varicella.
Myth: chickenpox is due to goddess anger
Fact: False (absolute nonsense)
In Hindu religion, it was believed that chickenpox is caused by anger of goddess (‘ChotiMata’) which enters your body and remains there for 10-15 days. It is nothing more than an absolute superstition. Chickenpox is caused by a virus called as Varicella Zoster.
Myth: patient should remain in solitude
Fact: partially false
Chickenpox is highly contagious. It spreads through direct contact and from inhalation of aerosols from respiratory secretions of patients. A person remains contagious from 1-2 days before onset of rash till all the scabs have fallen. It takes from 10-21 days after exposure to the virus for someone to develop varicella. Based on studies of transmission among household members, about 90% of susceptible close contacts will get varicella after exposure to persons with disease. So it is important that person should be kept in solitude, get medical leave from school or workplace. Though confinement of the patient should not be absolute as disease has already been transmitted to others even before onset of rash and diagnosis of disease.
Special precaution is required for susceptible and immunodeficient individuals as aged, infants and pregnant females, these should avoid contact with patient.
Myth: don't bath for a week during active blistering
Fact: false
Patient can take a bath during blistering, it is good for hygiene but avoid scrubbing or scratching of lesions as there may be a secondary bacterial infection and scarring.
Myth: chickenpox is completely harmless disease
Fact: false
Generally children have milder disease as compared to adults. Majority of children get mild infection and recover completely after healing of lesions.
But in some individuals with weakened immunity, there can be serious complications. Such susceptible individuals include adults, infants, immunodeficient children, pregnant females, people with HIVAids or on cancer chemotherapy. Such complications include bacterial skin infection, sepsis, pneumonia, bleeding disorder or dehydration.
In pregnant females, chickenpox infection can cause congenital anomalies or serious disease in newborn.
Shingles or herpes zoster is a delayed complication of varicella. Sometimes, an infection during childhood may not recover completely and the virus lies dormant in nerves in body. Later in adulthood, varicella virus reactivates and causes rash and pain along the nerve course supplying the area.
Myth: all children should be exposed to infection as soon as possible
Fact: false
As chickenpox causes mild disease in children as compared to adults, some parents think that it is better to get children exposed to infection and make them immune till adulthood. But this should be avoided as varicella infection can be dangerous to infants(babies less than 1 year) and children with low or weakened immunity.
Myth: there is no medical treatment of chicken pox
Fact: false
In children with milder disease, the condition improves by only symptomatic treatment. For example, fever is relieved by paracetamol, itching can be relieved by oral antihistamines or application of calamine lotion.
In adults, adolescents(>14 year of age)and pregnant females with chickenpox infection or those with serious disease or developing complications require antiviral medicine(as aciclovir, famciclovir). These drugs limit the severity of disease, these do not kill virus but stop multiplication of virus. The antiviral drugs should be started within 24 hours of appearance of rash for better effect, if started beyond this time, these would be ineffective.
In high risk patients as those with weakened immunity(those with HIVAIDs, on cancer chemotherapy, immunodeficient disease),newborn babies whose mother developed chickenpox within 5 days of delivery or within 2 days of delivery are given Varicella zoster immunoglobulin . It should be given within 72 hours of exposure.
Myth: chickenpox vaccine provides 100% lifetime protection
Fact: false
Best way to prevent chickenpox is by vaccination. Chickenpox vaccine is made from a live but weakened or attenuated virus, that is capable of stimulating antibodies against virus and body’s immune system. Chickenpox vaccine is very safe and effective at preventing the disease. Many children who get the vaccine will not get chickenpox, but many times, even a vaccinated person gets chickenpox. However, it is usually mild—with fewer red spots or blisters and mild or no fever. The chickenpox vaccine prevents many cases of severe disease.
Children, adolescents and adults should get two doses of vaccine. In routine vaccination, one dose of vaccine is given at 12-18 month of age, then a booster is repeated at 4-6 year of age. In older unvaccinated children, two doses are given at an interval of 4-6 months.
Myth: you get chickenpox only once in lifetime
Fact: partially true
This is correct for the majority of people. Like many other diseases, your body fights it off with antibodies and develops a resistance to it, but still some people don’t constantly produce these antibodies after the recover. So there can be a chance of contracting chickenpox a second time.
Dr Monika Misra
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