Prevention[edit]
Hygiene measures[edit]
The spread of chickenpox can be prevented by isolating affected individuals. Contagion is by exposure to respiratory droplets, or direct contact with lesions, within a period lasting from three days prior to the onset of the rash, to four days after the onset of the rash.[31] The chickenpox virus (VZV) is susceptible to disinfectants, notably chlorine bleach (i.e.,sodium hypochlorite). Also, like all enveloped viruses, VZV is sensitive to desiccation, heat and detergents. Therefore these viruses are relatively easy to kill in the environment.[citation needed]
Vaccine[edit]
Main article: Varicella vaccine
A varicella vaccine was first developed by Michiaki Takahashi in 1974 derived from the Oka strain. It has been available in the US since 1995 to inoculate against the disease. Some countries require the varicella vaccination or an exemption before entering elementary school. Protection from one dose is not lifelong and a second dose is necessary five years after the initial immunization,[32] which is currently part of the routine immunization schedule in the US.[33] The chickenpox vaccine is not part of the routine childhood vaccination schedule in the UK. In the UK, the vaccine is currently only offered to people who are particularly vulnerable to chickenpox. A vaccinated person is likely to have a milder case of chickenpox if infected.[34]
Treatment[edit]
Varicella treatment mainly consists of easing the symptoms as there is no actual cure of the condition. Some treatments are however available for relieving the symptoms while the immune system suppresses the virus in the body. As a protective measure, patients are usually required to stay at home while they are infectious to avoid spreading the disease to others. Also, sufferers are frequently asked to cut their nails short or to wear gloves to prevent scratching and to minimize the risk of secondary infections.
The condition resolves by itself within a couple of weeks but meanwhile patients must pay attention to their personalhygiene.[35] The rash caused by varicella zoster virus may however last for up to one month, although the infectious stage does not take longer than a week or two.[36]
Although there have been no formal clinical studies evaluating the effectiveness of topical application of calamine lotion, a topical barrier preparation containing zinc oxide and one of the most commonly used interventions, it has an excellent safety profile.[37] It is important to maintain good hygiene and daily cleaning of skin with warm water to avoid secondarybacterial infection.[38] Scratching may also increase the risk of secondary infection.[39]
Acetaminophen (paracetamol) but not aspirin may be used to reduce fever. Aspirin use by someone with chickenpox may cause the serious, sometimes fatal disease of the liver and brain, Reye syndrome. People at risk of developing severe complications who have had significant exposure to the virus may be given intra-muscular varicella zoster immune globulin (VZIG), a preparation containing high titres of antibodies to varicella zoster virus, to ward off the disease.[40][41]
Children[edit]
If oral acyclovir is started within 24 hours of rash onset it decreases symptoms by one day but has no effect on complication rates.[42][43] Use of acyclovir therefore is not currently recommended for immunocompetent individuals (i.e., otherwise healthy persons without known immunodeficiency or on immunosuppressive medication). Children younger than 12 years old and older than one month are not meant to receive antiviral medication unless they are suffering from another medical condition which would put them at risk of developing complications.[44]
Treatment of chickenpox in children is aimed at symptoms while the immune system deals with the virus. With children younger than 12 years cutting nails and keeping them clean is an important part of treatment as they are more likely to scratch their blisters more deeply than adults.[45]
Aspirin is highly contraindicated in children younger than 16 years as it has been related with a potentially fatal condition known as Reye's syndrome.[46]
Some parents believe that it is better for children to contract chickenpox than to get the vaccine, and deliberately expose their children to the virus, sometimes by taking them to "chickenpox parties." Some doctors counter that children are safer getting the vaccine, which is a weakened form of the virus, than getting the disease, which can be fatal.[47]
