East Montgomery Times

The Vaccine Update's "Fast Facts" series continues, focusing on chickenpox this month. Healthcare providers are reminded to stay informed about this vaccine-preventable disease as cases sometimes appear in daycares and clinics.

Chickenpox, a highly contagious infection, is caused by the varicella-zoster virus. The disease is transmitted through respiratory droplets or direct contact with fluid from skin blisters. Prior to the vaccine's introduction in 1995, the infection was common among children in the U.S., affecting about 4 million people annually, resulting in approximately 10,000 hospitalizations and 100 to 150 deaths. Thanks to widespread vaccination, these numbers have significantly decreased to fewer than 150,000 cases and less than 30 deaths each year in the United States. However, outbreaks can occur if vaccination rates drop, particularly in areas with low vaccine uptake.

According to the article, "two doses of varicella vaccine are highly effective, providing close to 98% protection against any infection and nearly 100% protection against severe disease."

Chickenpox symptoms begin with mild fever and energy loss, followed by an itchy rash described as "dewdrops on a rose petal." The rash starts on the face, chest, and back, spreading to the limbs. In vaccinated individuals, breakthrough cases of chickenpox are milder, with atypical lesions.

Healthcare providers play a pivotal role in recognizing chickenpox, as the condition can be mistaken for other skin issues like herpes or insect bites. It is important to contact local health departments for assistance when in doubt. Reporting cases of varicella is mandatory for the providers.

The confirmation of chickenpox can be done through laboratory testing if the initial diagnosis is uncertain, particularly in vaccinated individuals showing atypical symptoms. PCR testing of lesion fluid or crusts provides the most accurate results.

In healthy children, chickenpox usually resolves without medical intervention, but supportive care, such as fever control and hydration, can aid recovery. For certain groups, including those unvaccinated and immune-compromised individuals, antiviral treatment may be recommended. Monitoring for complications, which can be severe, is crucial.

The varicella-zoster virus can remain dormant in the body after initial infection, potentially reactivating as shingles later in life. Vaccination against chickenpox reduces the risk of shingles, though a separate shingles vaccine is advised for adults over 50.

Infection control measures should be in place to prevent the spread of chickenpox, especially in settings like schools and healthcare facilities. Infected patients should be isolated during contagious periods. "Protecting patients suspected of having chickenpox should be isolated immediately," advises the article. Healthcare staff should have documented immunity and use personal protective equipment when dealing with suspected cases.

For individuals exposed to chickenpox, post-exposure steps are recommended, including receiving the varicella vaccine or varicella-zoster immune globulin, depending on timing and risk factors.

Understanding chickenpox's presentation is critical for healthcare providers to enable prompt diagnosis and minimize the spread of this infection.