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| chickenpox |
I recently had a patient who had rashes very suspiciously looking like chickenpox. They were scattered and look forming blisters which may confirm chickenpox. However chickenpox is very rare nowadays in Singapore because of vaccination against the chickenpox. They disappeared the next day after taking some antihistamines. So it was not chickenpox.
Chickenpox is a mild infectious illness common among children but can occur at any age.
A fever appears followed by an itchy rash of spots that look like blisters all over the body on the second or third day and may be accompanied by flu-like symptoms.
Chickenpox is caused by the varicella-zoster virus.
Chickenpox usually starts with a mild fever of 37.7 - 38.8 Celsus with or without headache.
It is followed by a red, itchy rash on the skin that usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body.
The rash begins as multiple small, red bumps and rapidly develop into thin-walled blisters filled with clear fluid, which becomes cloudy. The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs.
Chickenpox blisters can also occur in the mouth causing pain and discomfort when eating.
Some children have abdominal pain, sore throat, headache,and in some cases a severe cough.
Younger children often have milder symptoms and fewer blisters than older children or adults.
Chickenpox is contagious from about 2 days before the rash appears and lasts until all the blisters are crusted over.
A child with chickenpox should be kept out of school until all blisters have dried, usually about 10 days.
Chickenpox is very contagious — most children with a sibling who's been infected will get it as well, showing symptoms about 2 weeks after the first child does.
To help keep the virus from spreading, make sure your children wash their hands frequently, particularly before eating and after using the bathroom.
And keep a child with chickenpox away from unvaccinated siblings as much as possible.
Pregnant women and anyone with immune system problems should not be near a person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth defects. If she develops chickenpox just before or after the child is born, the newborn is at risk for serious health complications.
Since May 2006 the chickenpox vaccine is given to children 12 to 15 months old and a booster shot at 4 to 6 years old. The vaccine is about 85% effective at preventing mild infection, and more than 95% effective in preventing moderate to severe forms of the infection.
Healthy children who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness.
Treatment of Virus:
A virus causes chickenpox, so the doctor won't prescribe antibiotics. However, antibiotics may be required if the sores become infected by bacteria.
The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. The drug, which can make the infection less severe, must be given within the first 24 hours after the rash appears.
Treatment of Symptoms:You can help relieve the itchiness, fever, and discomfort of chickenpox by:
1.Using cool wet compresses or giving baths in cool or lukewarm water every 3 to 4 hours for the first few days.
2.Patting (not rubbing) the body dry.
3.Putting calamine lotion on itchy areas or acyclovir cream lightly over the rashes
4.Giving your child foods that are soft and bland because chickenpox in the mouth may make drinking or eating difficult.
5.Make the child drink lots of fluids
6. Anti itch medicine like antihistamine or pain relieving medicine like paracetamol may be given to relieve itch or pain.
7.As much as possible, discourage scratching. This can be difficult for the child, so consider putting mittens or socks on your child's hands to prevent scratching during sleep.
In addition, trim fingernails and keep them clean to help lessen the effects of scratching, including broken blisters and infection.
Typically, chickenpox is a mild illness, but can affect some infants, teens, adults, and people with weak immune systems more severely.
Some people can develop serious bacterial infections involving the skin(especially in children with eczema), lungs(pneumonia) and the brain (encephalitis).
Most children recovered completely from chickenpox within 7-14 days of the onset of symptoms.
Adults may take a longer time to recover(10-21 days) and the symptoms are more severe.
Pox marks due to infections of the skin and deep scratching of blisters may remain and serve as a reminder of chickenpox.
A person usually has only one episode of chickenpox, but the virus can lie dormant within the body and cause a different type of skin eruption later in life called shingles (or herpes zoster).
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