Varicella, or chickenpox, is primarily a disease seen in childhood, but it is not uncommon in adults. Varicella is spread by direct contact or inhalation of airborne droplets. If a person touches the fluid from an infected lesion, they could contract the virus. If the individual with varicella sneezes or coughs, droplets of the infection are released into the air and can be inhaled by others in close proximity.
Contagious Period
Once a person has been exposed to the varicella disease, there is a period of time called the incubation period before the signs and symptoms actually appear. For varicella, the incubation period ranges from 10 to 21 days, with an average onset of 14 to 16 days. According to "Emergency Nursing Core Curriculum," a person is considered to be contagious one to two days before the rash appears, and the contagious period ends when all the lesions are crusted over, which is usually four to five days after the onset of the rash.
Signs and Symptoms
Patients will present with a rash that starts on the trunk and spreads to the face and extremities. The rash is very itchy for the patient. The rash will develop lesions that start as little spots on the skin and progress to fluid-filled blisters called vesicles. The "dew drop on a rose petal" appearance of the vesicle is a classic characteristic of the chickenpox rash, according to"Clinical Practice of Emergency Medicine." The vesicles will break open and become crusted over. The fluid from the vesicle is highly contagious until the lesion is crusted over. In addition to the rash, patients will present with a slight fever and complaints of fatigue.
Identification
The diagnosis of varicella is made based on the patient's symptoms and the characteristic rash. A culture can be done to confirm the diagnosis, but the results may not be immediately available.
Treatment
Treatment for varicella includes measures such as cool baths, calamine lotion and colloidal oatmeal baths to help alleviate the itching. In cases of severe itching, an over-the-counter antihistimine may be taken. It is important to check with a medical provider before trying treatments and medications at home.
Complications
Varicella usually does not cause major complications in healthy individuals, but there are always potential complications with any disease. The most common complication in varicella is a bacterial skin infection caused from scratching. Another complication seen with varicella is the development of a pneumonia, which can cause breathing problems, fever and chest pain. Varicella during pregnancy is a risk to both the mother and the unborn child. Pregnant women should notify their physician if they have been exposed to someone with varicella.
Varicella Vaccine
A vaccination for varicella is available in the United States and is approved for children and adults.
References
- "Clinical Practice of Emergency Medicine"; Lippincott Williams & Wilkins; 2010
- "Emergency Nursing Core Curriculum"; Saunders Elsevier; 2007
