Controlling Chicken Pox

By Menu Otuo

Chicken pox, which is caused by the varicella-zoster virus, is one of the most easily communicated diseases and is, therefore, highly contagious.

It is a common disease, being, for example, the second most frequently reported infectious disease in the USA. The potential number of individuals affected by varicella worldwide each year is 60 million, an increasing proportion of which are adolescents and young adults.

Although in most cases childhood varicella disease is not a life-threatening condition, it can cause major financial and social problems to parents in lost working time spent looking after their sick children, while the children themselves suffer from the disease and lose valuable time away from school.

Medical costs are also involved, such as hospital and doctor's charges and associated drug costs. Moreover, if an adolescent or adult becomes ill, the problems pertaining to lost working time and medical cost are even greater.

The disease

Varicella, commonly called chickenpox, is a viral disease caused by first exposure to the varicella-zoster virus. It presents itself as fever with a characteristic vesicular-papular rash and is highly contagious.

The virus then remains latent in the body and can later be reactivated and cause shingles (herpes zoster)

How does it spread?

The varicella virus especially attacks the mucous tissues of the upper respiratory tract. Airborne droplets generally from coughing or sneezing easily spread the virus from person to person.

It can also be spread directly, for example, by dirty handkerchiefs and by direct contact with the chicken pox lesions.

The likelihood that varicella will spread among children in schools or among family members is over 90 per cent. Isolating infected children by keeping them away from school will help but only vaccination will help reduce the spread of varicella.

The transmission is most likely within the first two days of the appearance of the rash. Varicella is contagious for up to five days but not after day six, and generally children can go back to school after this time.

The time from first contact with the virus until symptoms develop can range from nine to 21 days, but in most patients it is between 13 and 17 days.

Who can get it?

Many people contract varicella during childhood or adolescence but seronegative adults can contract varicella.

Complications

Although for many children chicken pox does not produce major health problems, complications can develop in some cases, especially pneumonia, which may be fatal.

Bacteria super infection of the skin is generally seen in immunocompetent children less than five years of age and can lead to unsightly scaring, particularly of the face, which may cause cosmetic concerns for life.

Varicella is more serious in adolescents and in adults than in children. The fever is higher and continues for much longer and the rash is much heavier.

The most important point is the much greater likelihood of complications: pneumonia, for example, can occur in up to 14 per cent of adult patients. Death also tends to be higher when varicella is contracted later in life.

The social and economic impact of chicken pox The full impact of childhood varicella on patients and on their families is often not appreciated.

Physically, varicella is very uncomfortable for patients because they have to endure discomfort from symptoms such as the characteristic pruritis, fever, chills, nausea and vomiting. Patients often need to be isolated while suffering from varicella and in many cases they suffer from permanent scaring as a result of bacteria super infection of the skin.

Moreover, the complication can be fatal. Varicella can cause financial problems because of lost earnings when parents stay at home to look after their kids or because older patients need to stay away from work.

Medical costs may also be high, especially if complications set in and the sufferer, whether child, adolescent or adult, needs to stay in hospital.

The vaccination option

As almost everyone will contract varicella at some point, the annual patient group size will equal the entire worldwide birth cohort. More importantly, where varicella is more prevalent among older age groups — in whom complications are more likely — it represents a major health threat.

It follows that some means of controlling the situation is vital, and vaccination is most effective.

It has been shown that routine vaccination programme for healthy children would prevent 94 per cent of all potential cases of chicken pox.

From a social perspective (including work-loss cost and medical cost) such a programme would save more than $5 for every dollar invested in vaccination

Vaccines such as varilrix from GlaxoSmithKline Biologicals and available at Akai House Clinic and other centres undertaking vaccinations have been shown to be effective and safe. Why not take advantage of the relief that vaccination brings!