Chickenpox

It is an acute febrile illness caused by

Varicella-Zoster virus. It is characterized
by variable constitutional symptoms and
characteristic skin rash and sudden onset.

The skin rash starts as maculopapular and
changes to vesicular in due course of the
disease.
It is distributed mainly on the trunk
(centripetal) and polymorphic( more than
one type of rash exist at any time).
The importance of chickenpox lies in two
points:
1. Its differentiation from smallpox, which
was common and serious disease.
2. The complications: Atypical
pneumonia in adults and encephalitis
in children. Neonates of non immune
mothers are at special risk of
complication when they contract
infection during or within few days of
delivery. The same is true for those
with leukaemia and those on
corticosteroids.
Reservoir: Man
Incubation period: 2-3 weeks
Mode of transmission: Direct
contact, droplet infection or
indirectly through freshly
contaminated articles.
Period of communicability: From
5 days before the appearance of
rash till 6 days after the
appearance of the last crop of
rash.
Susceptibility: General. Natural
infection is followed by life-long
immunity.
Prevention: No specific
preventive measure is
available.
Control:
1. Notification to health authorities.
2. Isolation and concurrent
disinfection.
3. Immuniglobulins with 4 days of
exposure are of value in people on
corticosteroids and neonates of
non-immune mothers
4. Exclude smallpox through careful
differentiation as follows:

Chickenpox Smallpox Characteristic
Prodromal symptoms severe Mild until just
for 2-4 days before rash before rash
Skin rash
Type One crop and appears Several crops over
Within 1-2 days several days

Distribution Same stage and centrifugal Polymorphic and
centripetal

Individual lesions -Axilla spared Axilla involved
-Palms and soles Palms and soles
Involved spared oftenly
-Circular Oval
-Deep Superficial
- Vesicle are mutilocular Vesicles are unilocula

Scar Depressed Superficial