Chickenpox (Varicella)

Chickenpox (varicella) is a highly infectious disease that mainly affects children. Characteristic of this infectious disease is a skin rash that has itchy red blisters. In most cases, the disease has a positive course.

Chickenpox is caused by the varicella-zoster virus, which sits unnoticed in the nerve endings for many years and can later cause shingles.

Before a general varicella vaccination recommendation was issued, there were about 750,000 new cases per year. According to this, antibodies against the varicella zoster virus are found in more than 95% of adults.

Chickenpox is caused by the varicella zoster virus, which belongs to the group of herpes viruses. The disease is transmitted by droplet infection, i.e. in the form of coughing, sneezing or talking. In rare cases, infection occurs as a result of touching the virus-containing vesicle contents. Infection by means of clothing, toys or bed linen is impossible, as the viruses are no longer infectious after about ten minutes in the air.

The incubation period for chickenpox is about two to three weeks. However, it should be noted that the disease is already transmissible one to two days before the first symptoms appear. The danger of infection is not over until a crust has formed on the blisters.

The first signs of chickenpox can be fever, fatigue and exhaustion. The typical skin rash usually first appears on the trunk and in the area of the face, before it later moves to the persistent scalp, as well as on the arms and legs.

Sometimes the mucous membranes in the area of the mouth as well as the genital organs can be affected by chickenpox.

The following symptoms are characteristic of chickenpox:

• Itchy rash
• Reddish small patches that take on a blister-like appearance within hours and form a crust after one to two days.
• Within three to six days, blisters may form again
• The number of blisters varies greatly. For example, small children develop fewer blisters than older people.
• Sometimes there may be a fever - The disease is less severe in children than in adults.

The diagnosis of chickenpox can be made very quickly in most cases by the doctor conducting a general questioning of the patient (anamnesis) and examining the external appearance. This is marked by a very characteristic skin rash in which itchy blisters are formed.

Theoretically, it is also possible to detect chickenpox directly from the viruses in the blister contents or from the varicella antibodies produced by the body in the blood. However, this is not necessary in most cases.

The main aim of treatment for chickenpox is to relieve the symptoms. This can be in the form of cold compresses, which reduce itching, or itch-relieving medications, such as ointments containing zinc, which are applied to the skin.

Sometimes, in the early stages of the disease, the itching can be so acute that the sufferer cannot get any sleep. In this case, the use of antihistamines may be considered, which are also administered for allergic diseases. However, fatigue may occur as a side effect.

If a chickenpox infection with a severe course occurs, therapy with viral drugs can help, such as aciclovir, which block the multiplication of the viruses. The administration of these drugs is particularly advisable if the affected person has a weakened immune system.

Once the disease has broken out, the affected person should stay at home in any case, otherwise there is a high risk of infection. This is only banished when all the blisters are encrusted and no more new ones appear.

The following factors should be observed in the case of a chickenpox infection:

• The blisters should not be scratched open, as otherwise there is a possibility of bacterial infection
• Hygiene is particularly important during the course of the disease
• The environment should be kept as cool as possible, as heat and sweat intensify the itching.

Normally, chickenpox heals on its own without any intervention. In children, the healing process is somewhat faster and usually lasts between seven and ten days; in adults, a somewhat longer duration is to be expected.

Active vaccination against chickenpox is generally recommended and is usually administered during the first two years of life. If a child is still not vaccinated, later vaccination is also advisable, as chickenpox can often cause complications later in life.

Adults who have not had a chickenpox infection in childhood should be vaccinated in the following cases:

• Women who wish to have children
• personnel who work in the health service
• Patients suffering from severe neurodermatitis or leukaemia, as well as patients undergoing immunosuppressive therapy and before organ transplants.

If one has already had chickenpox, there is lifelong immunity. Nevertheless, shingles (herpes zoster) can occur later. In contrast to chickenpox, this disease is less common and mainly affects older people and people with immune deficiency.

The best way to avoid chickenpox is through vaccination. According to the vaccination commission, children should be vaccinated between the ages of 11 and 14, and again between the ages of 15 and 23. If the vaccination is not given during this period, it should be given between the ages of 9 and 17 at the latest.

Adults should also be vaccinated under certain conditions. This is especially true for women of childbearing potential, people with chronic illnesses, and health care workers.

As chickenpox is highly infectious, affected persons should keep their distance from infected persons. If one nevertheless had contact with an infected person, the vaccination can be repeated within five days to achieve protection.