A Vaccine Preventable Disease

Identification and Definition

Chicken pox is a highly contagious but well known disease caused by the varicella-zoster virus. Patients develop a blister-like rash which then dries and creates an inching sensation. The Varicella-zoster virus is known to be an acute infectious disease, meaning that its an infection that occurs for a prolonged or brief period of time.

History of Chickenpox

In 1767, William Heberden was the first physician to demonstrate that chickenpox was different from smallpox. Prior to the creation of a vaccine, chickenpox as known to be a childhood disease, but the number of chickenpox cases has dramatically declined to less than 200,000 in the United States. In 1988, the vaccine was licensed for use in Japan and Korea, and in 1995, it was licensed for use in the United States.

Signs and Symptoms of Chickenpox

The symptoms of chickenpox that appear 1-2 days before the rash:

- high fever

- tiredness

- loss of appetite

- headache

The rash then appears, turning into itchy, fluid-filled blisters eventually turning into scabs (usually a week). Rashes usually first appear on the face, chest, and back then to the rest of the body.

Transmission of Chickenpox

The varicella-zoster virus can spread in the air when an infected person coughs or sneezes 1-2 days before the onset of the rash. The virus is also active when an infected person is in the stage of a blistering rash, it can spread by breathing in particles from the rash or simply by touching the rash. Chickenpox is the result of the primary infection, reactivation of the latent varicella-virus infection results in shingles or herpes zoster.

Complications of Chickenpox

People who typically have more severe symptoms and are considered high risk for complications are:

  • infants
  • adolescents
  • adults
  • pregnant women
  • individuals with weakened immune systems due to illness or medications including - individuals with HIV/AIDS or cancer, who have had a transplant, on chemotherapy, immunosuppressive medications, or long-term use of steroids

Immunocompromised Individuals have a high risk of developing visceral dissemination - varicella-zoster virus infection of internal organs - resulting in pneumonia, hepatitis, encephalitis, and disseminated intravascular coagulopathy. Usually have an atypical rash but with more lesions which lasts longer.

Children with HIV or AIDS usually have an atypical rash with new crops of lesions for the duration of weeks or maybe even months. They can develop chronic infection with new lesions appearing for more than a month.

Varicella in adults with HIV or AIDS is uncommon since they have already had the varicella disease allowing them to be varicella-zoster virus seropositive.

Pregnant women have an increased risk for developing pneumonia and may also die from the virus. If she gets the virus during the first or second trimester, the baby has a very small risk - .04% to 2% - of being born with congenital varicella syndrome. If the rash develops 5 days before or 2 days after birth, the newborn is at risk for neonatal varicella.

Serious complications from chickenpox include:

  • dehydration
  • pneumonia
  • bleeding problems
  • infection or inflammation of the brain
  • bacterial infections of the skin and soft tissues in children - including Group A streptococcal infections
  • blood stream infections
  • toxic shock syndrome
  • bone and joint infections

Recommended Control Measures For Chickenpox

Chickenpox can be prevented with the varicella-zoster virus. In the United States, more than 3.5 million cases, 9,000 hospitalizations, and 100 deaths from the varicella-zoster virus are prevented by the vaccination. In 26 states, there was an overall 82% decrease of the virus from 2000 to 2010. The varicella-zoster virus can occur in all countries. From 1990 to 2013, the number of cases of the disease went from 8,900 to 7,000. In temperate countries, children account for most cases during the winter and spring, due to contact at school. As for countries in the tropics, older people account for majority of the varicella cases, and also have more serious side effects from the disease.
The pictures above were taken from Lopez Family Now blog. Their daughter Keira had chickenpox in 2011 and the decided to document the progression of the virus over a 7-day period.

Jennifer Kim