“People are constantly asking me for things and I can’t oblige. Now at long last, when I am in a position to give something freely, they are avoiding me.”
Definition
Highly Contagious viral illness, mostly affecting children with pruritic diffuse papulovescicular rash appearing in crops.
Prognosis
Good in immunocompetent children and adults. Infants and immunocompromised need immunoglobulin protection.
Treatment
Fever, vesicular rash starting on trunk but more on limbs, Polymorphic ie. Papules, vesicles and scabs all seen at the same time.
Abstinence from school till scabs fall, to prevent spread. Isolate from other children in the house. Tab. HERPEX 20mg.kg x 4times daily x 5 days. Syp. CROCIN 1 tst TDS and if fever. Syp. Cetzin 1 tst daily if itching (Anti histaminic) Syp. WYMOX 1 tsp tds – if vesicles are infected. Vaccinater the contact at home.
Prevention: Varilix- Varivcela vaccine: 0.5ml subcut, single dose. In adults who have never had chicken pox in childhood, repeat the dose after 6-10 weeks.
Keep in bed until afebrile, and isolate until primary crusts have disappeared. Daily baths using antibacterial soap to reduce bacterial infection. Keeping finger nails trimmed to avoid infection due to scratching. To exclude from public mixing for 7 days to avoid spread.
Advice to Patient
See ‘General Measures’
Inadequate Response
If worsening of general condition due to complications, to consider Antiviral therapy.
Prevention
With Varicella Zoster Immuno Globulin- indicated for – (a) Immuno-compromised individuals with significant exposure to a case, (b) Pregnant women, (c) Premature infants less than 28 weeks gestation, (Done) Premature infants whose mothers do not have history of chicken pox, (e) New born of mother with chickenpox within previous five days, or within 2 days after delivery. Varicella live virus vaccine – approved by FDA for immunization of healthy individuals 12 months and above, who have not had chickenpox. Duration of immunity is not known. 12 months to 12 years single dose of 0.5 ml SC. 13 years and above-two doses of 0.5 ml Sc doses 4-8 weeks apart. Shown to prevent or at least reduce severity of attack if given within 72 hours and possible up to 5 days post exposure in several studies. Up to 8 weeks after vaccination, vaccinated individuals should avoid immunocompromised persons, pregnant women and newborns, who have not had chickenpox.
