Chicken pox is an extremely contagious disease that is characterized by a blistery rash. It occurs most frequently in children between the ages of five and eight; less than 20 percent of the cases in the United States affect people over 15 years old. Chicken pox is transmitted so easily that, until the recent advent of a vaccine, almost everyone got it at some time.
Causes

Chicken pox is caused by infection with the varicella zoster virus. Chicken pox is contracted by touching an infected person's blisters or anything that has been contaminated by contact with them. The virus is also thought by some researchers to be airborne, since an infected person can transmit it before the rash develops. Another way to get chicken pox is by exposure to shingles, which is a localized rash caused by the same virus.

The incubation period (the time between exposure to the virus and the appearance of symptoms) of chicken pox is 10 to 21 days. It is contagious for about six to eight days after the rash appears or until all of the blisters have dried out.
Symptoms

The first symptom of chicken pox is usually a rash, which can be very itchy. It begins as small, red spots on the trunk. Within hours, the spots become larger, fluid-filled blisters on a red base that begin to spread out from the trunk to the face, scalp, arms, and legs. Over the next few days, the blisters continue to fill with pus, burst, and then form a scab or crust. New spots appear periodically during a two- to six-day period. They may spread to the soles and palms. The rash may even affect the eyes, mouth, throat, vagina, and rectum.

Another main symptom is a mild fever (101 degrees Fahrenheit to 103 degrees) that subsides as the last blisters crust over. Some children have a slight fever and feel sluggish a few days before the rash begins; however, this warning is more common in adults.

Adults usually have higher fevers, a more severe rash, headaches, and muscle aches, and they take longer to recuperate than children. Recovery from all symptoms takes ten days to two weeks.
Complications

Complications of chicken pox seldom develop in otherwise healthy people. The most common complication is bacterial infection of the blisters, which can occur if a blister is scratched and the skin is broken. In some instances, the rash spreads to the eyes, causing pain and possible damage. Generally, the chicken pox rash heals without leaving scars, unless the blisters have been scratched and become infected.

Treatment

Since there is no known cure for chicken pox, treatment consists of reducing the effects of the symptoms. A soothing lotion, such as calamine lotion, lessens itchiness. Baths in warm (not hot) water sometimes mixed with a special oatmeal solution keep the skin clean, reduce the risk of infection in the rash, and reduce itching. It is important to gently yet thoroughly dry the skin after bathing. If itching is severe, fingernails should be trimmed and gloves should be worn at night to minimize scratching. Children may need to wear mittens and socks all day for the duration of the rash.

Since an association has been established between aspirin use during a viral infection and Reye's syndrome in children, it is recommended that aspirin not be given to a child or teenager with chicken pox. A doctor can suggest an aspirin substitute if needed for discomfort or fever.
Prevention

The majority of people who grew up before the advent of the chicken pox vaccine have had chicken pox once; most of them did not get it again because the body manufactures antibodies to combat the virus once it has been exposed to it. Nevertheless, the same virus may cause shingles later in life.

The American Academy of Pediatrics recommends the varicella (chicken pox) vaccine for all children, adolescents, and young adults who have not already been infected with chicken pox. A single dose should routinely be given between 12 and 18 months of age. This immunization can be given at the same time as the child's first MMR (measles, mumps, rubella) vaccination. Older children may be immunized at the earliest convenient opportunity, also with a single dose. Individuals over the age of 13 who have not been immunized previously and have no history of varicella infection should receive two doses of the vaccine four to eight weeks apart. Once immunized, most individuals are protected from chicken pox for life.



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