TeenHealthInfo on Mono:
Varicella is an infection commonly known as chickenpox. It occurs
most frequently in children between the ages of 5 and 9. It is
characterized by the formation of fluid filled bumps (vesicles) on the
face, body and inside the mouth. Chickenpox is caused by the varicella
virus. It is a type of herpes virus. It is not however, associated
with oral or genital herpes. The virus can be spread by contact with
fluid in the vesicles (vesicles contain live virus), or by respiratory
droplets (i.e. being sneezed by someone who has chickenpox).
It may take up to two weeks after exposure to the virus before any
skin changes become apparent. During this time, one may experience
fever, headache, decreased appetite, and fatigue. When the skin changes
finally appear, they usually begin on the chest and back. They begin as
flat red spots. This rash then progresses to bumps. The bumps then
progress to vesicles. The rash then progress to involve the face and
moist areas of the body (i.e. inside the mouth and around the genital
area). They vesicles look to be in different stages o healing. They
often cause moderate discomfort because of itching.
The severity of the infection varies. Some may have very
mild symptoms with few bumps. Others may have more severe involvement.
Individuals with varicella are infectious one day before the appearance
of vesicles. They remain infective until all the vesicles are dried
up. Dry vesicles have a crusty appearance.
The outcome of chickenpox depends on how healthy one was before
they got the illness. Young healthy individuals have few complications
outside of the possibility of scaring (mostly due to scratching). The
bumps may become infected. In some cases, encephalitis may occur.
Pregnant women who become infected with varicella are at
increased risk of developing other illness such as pneumonia. They are
also have an increased incidence of miscarriages. Their unborn children
are at increased risk for having birth defects.
Older people who get varicella usually have more severe
illness than seen in infections that occur in childhood. They are also
more vulnerable other infections that may lead to death (i.e. viral
Individuals that do not have a healthy immune system (i.e. as in HIV) develop severe illness and may die as well.
Finally, anyone who has previously had chickenpox may have
reoccurrence of the rash. This is called varicella zoster (AKA
shingles). This occurs because the virus never goes away. Instead it
lays dormant in the body. During this time, the individual is not
infective. Stress or illness have been known to trigger shingles. It
usually occurs in the same place as the initial infection. It can be
The diagnosis of chickenpox can be made by physical exam. It can
be confirmed by the presence of antibodies in the blood against the
virus, by examination of the vesicle fluid by special microscopy
(electron microscope), or the appearance of virally infected cells on a
tzanc smear (a special stain).
The best thing one can do to avoid getting chickenpox is to be
vaccinated against it. This should be done in any individual who has
never had the illness. It is usually advised to immunize children
against varicella between the ages of 12 and 15 months. People who have
had the disease have immunity. They rarely get infected again.
Young children usually recover from the illness without treatment. They may benefit from drugs that stop itching.
Pregnant women who do not have immunity against chickenpox
and become exposed should receive treatment with immune globulin and an
Individuals over 16 may benefit from antiviral therapy. Zoster can be treated by antiviral therapy as well
People who do not have healthy immune systems and are
infected with varicella should receive antiviral therapy (i.e.
acyclovir) as well as immune globulin.
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