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Chickenpox: Mode Of Transmission And Treatment – OpEd

Chickenpox is a highly contagious disease caused by the varicella-zoster virus (VZV). It mainly affects children but can also occur in adults. Once someone contracts chickenpox, they usually become immune for life. However, the virus can remain dormant in the body and reappear later in life as shingles (herpes zoster). a. Key Features: Cause: Chickenpox is caused by the varicella-zoster virus, which is part of the herpesvirus family. Mode of Transmission: The virus spreads through airborne respiratory droplets (from coughing or sneezing) or direct contact with the fluid from the blisters of an infected person. Incubation Period: Symptoms typically appear between 10 to 21 days after exposure to the virus. b. Common Symptoms: Fever, fatigue or tiredness, loss of appetite, headache, and an itchy, blister-like skin rash that eventually turns into scabs. Rash Pattern: The rash usually begins on the face, chest, and back, then spreads to other parts of the body. Duration of Illness: Chickenpox typically lasts about 5 to 10 days. Contagious Period: A person with chickenpox is contagious from 1 to 2 days before the rash appears until all the blisters have dried up and formed scabs.  Prevention and other way outs c. Prevention: The best prevention is vaccination. The varicella vaccine is safe and effective and is typically given in two doses during childhood. Avoiding close contact with infected individuals also helps prevent the spread of the virus. d. Treatment: Most cases of chickenpox require only symptomatic treatment, such as: Rest and adequate fluids, calamine lotion or cool baths to relieve itching, paracetamol (acetaminophen) for fever and discomfort (Note: Avoid aspirin in children due to the risk of Reye’s syndrome), in more serious cases or for individuals at risk of complications, doctors may prescribe antiviral medications like acyclovir. Main Causes a. Varicella-Zoster Virus (VZV): Chickenpox is caused by the varicella-zoster virus, which belongs to the herpesvirus family. This virus is highly contagious and primarily responsible for the infection. b. Airborne Transmission: The virus spreads through tiny droplets in the air when an infected person coughs or sneezes. Inhaling these droplets can lead to infection. c. Direct Contact with Blisters: Coming into direct contact with the fluid from the blisters or rash of an infected person can transmit the virus. Even touching contaminated objects or surfaces can sometimes cause infection. d. Close Contact with an Infected Person: Spending time in close proximity to someone who has chickenpox increases the risk of catching the virus. The person is contagious from 1–2 days before the rash appears until all blisters form scabs. e. Weakened Immune System: People with low immunity (due to illness, medications, or age) are more susceptible to getting infected, even though mild exposure. f. Lack of Vaccination: Individuals who have not received the chickenpox vaccine are at much higher risk of contracting the virus, especially children. g. Exposure in Crowded Places: Being in crowded environments like schools, day-cares, or public gatherings increases the chance of virus spread due to closer interaction with others. Diet for Chickenpox Patients a. Drink plenty of water, fresh fruit juices, coconut water, and soups. Helps prevent dehydration and flush out toxins from the body. b. Soft and Bland Foods: Include soft foods like khichdi, porridge, boiled vegetables, rice, and dal. Easier to digest, especially if there are mouth sores. c. Fruits Rich in Vitamin C: Eat oranges, lemons, amla, and guavas (if not irritating). Boosts the immune system and helps in faster healing. d. Protein-Rich Foods: Include milk, curd, paneer, eggs, and lentils to aid tissue repair. Supports skin recovery and immunity. e. Avoid Spicy, Fried, and Oily Foods: These can irritate the digestive system and worsen itching or inflammation. Stick to light and non-irritating meals. f. Avoid Acidic or Salty Foods: Foods like pickles, citrus juices (if they cause burning), and chips should be avoided. These can irritate mouth ulcers or the throat. Precautions a. Avoid Scratching the Blisters: Scratching can cause skin infections and permanent scars. Keep nails trimmed and use calamine lotion or cold compress to relieve itching. b. Maintain Proper Hygiene: Take regular lukewarm sponge baths or gentle baths. Keeps the skin clean and reduces chances of secondary infection. c. Isolate the Patient: The patient should be kept away from others, especially pregnant women, infants, and unvaccinated individuals. Prevents virus transmission. d. Wear Loose, Comfortable Cotton Clothing: Tight or synthetic clothes can irritate the skin. Loose clothing helps the skin breathe and reduces friction. e. Rest and Sleep: Adequate rest is crucial to allow the immune system to fight off the infection. f. Avoid Aspirin: Do not give aspirin to children with chickenpox. It can lead to a serious condition called Reye’s syndrome. G. Consult a Doctor if Severe: If there are high fever, breathing difficulty, or pus in blisters, consult a doctor immediately. May require antiviral treatment or hospitalization in rare cases. Advancements in the Treatment a. Development of Effective Vaccines: The varicella vaccine (live attenuated) has significantly reduced the number of chickenpox cases globally. Two-dose immunization schedules are now standard in many countries, offering long-term protection. b. Use of Antiviral Medications: Drugs like acyclovir, valacyclovir, and famciclovir are used to treat moderate to severe cases. These help in reducing symptoms, duration, and complications—especially in high-risk individuals. c. Improved Diagnostic Methods: Newer molecular tests (like PCR) offer fast and accurate detection of the virus. Helps differentiate chickenpox from other skin conditions quickly. d. Better Management of Symptoms: Advances in topical lotions, antihistamines, and pain relievers provide more comfort during recovery. New skin-calming agents are being developed to reduce scarring and itching. e. Post-Exposure Prophylaxis (PEP): Varicella zoster immune globulin (VZIG) is used to protect high-risk individuals who are exposed but not immune. Especially useful for pregnant women, new-borns, and immunocompromised patients. Future Prospects a. Universal Vaccination Programs: Many countries are moving toward universal chickenpox vaccination in childhood schedules. Future goal: Eradication or near-elimination of the disease through high vaccination coverage. b. Combination Vaccines: Ongoing development of combined MMRV vaccines (Measles, Mumps, Rubella, and Varicella) to simplify immunization programs. Improves compliance and cost-effectiveness. c. Enhanced Vaccines: Research is ongoing to develop next-generation vaccines with longer-lasting immunity and fewer side effects. Includes potential mRNA-based varicella vaccines, inspired by COVID-19 vaccine technology. d. Preventing Shingles through Chickenpox Control: Since shingles is a reactivation of the chickenpox virus, controlling chickenpox in early life helps reduce shingles cases in adulthood. e. Global Health Integration: Chickenpox surveillance and control are being integrated into broader infectious disease programs under WHO and CDC initiatives. Ensures global preparedness and response. In India, chickenpox (varicella) remains a significant public health concern, particularly due to its exclusion from the Universal Immunization Programme (UIP).