Fight against herpes to the end!

This is the 5283rd article of Da Yi Xiao Hu

Recently, a young lady with chickenpox and lung infection was admitted to the infectious disease department of our hospital. She was very confused and anxious about this, and asked the medical staff one question after another, "How can I, an adult, get chickenpox? What if I infect my children? How long will it take to recover from chickenpox? Will I have scars on my face? If my family takes the children to get the chickenpox vaccine now, will they still be infected?"

1. What is chickenpox?

Chickenpox is a common, highly contagious acute respiratory infectious disease caused by the varicella-zoster virus. Its main clinical manifestations are the simultaneous appearance of skin and mucous membrane macules, papules, blisters and scabs.

Varicella is more common in winter and spring, with May to July and October to January of the following year being the peak periods of chickenpox in China.

2. How is chickenpox transmitted?

Patients with chickenpox and herpes zoster are the main sources of infection. It is mainly transmitted through respiratory droplets, direct contact with herpes fluid, and can also be transmitted through contact with objects contaminated by secretions. After pregnant women are infected, it can be transmitted vertically to the fetus.

3. What are the symptoms of chickenpox?

Prodromal stage

After 1-2 days, some patients may experience fever, headache, general discomfort, loss of appetite, decreased food intake, and upper respiratory tract symptoms such as cough, runny nose, and nasal congestion. Occasionally, a prodromal rash may occur, such as a red rash. Infants and young children often have no prodromal symptoms.

Rash period

The rash usually appears on the day of fever, first on the trunk and head, then on the limbs and then on the whole body. The rash develops rapidly, and becomes less frequent as it gets closer to the extremities. The rash begins as red maculopapules or macules, then turns into oval, teardrop-like blisters that are as clear as dewdrops and surrounded by a red halo. After 1-2 days, the blisters begin to dry up and form scabs in the center, and the red halo disappears. The scabs fall off and heal in about a week, usually without leaving scars. [2]

4. How to prevent it?

1. Control the source of infection

Chickenpox patients need to be isolated from the time they visit the doctor until all the blisters have crusted over.

2. Cut off the transmission route

Keep a distance from chickenpox patients, maintain good personal and environmental hygiene, wash hands frequently, wear a mask, use the patient's belongings only by one person, and keep the room ventilated and the bedding out of sunlight.

3. Protect vulnerable groups

Currently the simplest and most effective prevention method is vaccination with the inactivated attenuated varicella vaccine.

5. How to treat chickenpox?

1. Chickenpox is usually self-limiting, meaning that it generally does not require special treatment or medical intervention, and can be cured by one’s own immune system, usually within 7-10 days. Although chickenpox can provide lifelong immunity after recovery, it can also develop into herpes zoster, in which the virus lurks in the human ganglia and becomes active again when the person’s immunity is weakened. [3]

2. During the illness, pay attention to keeping your skin clean, avoid scratching herpes with your hands, prevent bacteria from contaminating the damaged areas of chickenpox, and prevent infection.

3. For those with itchy skin, you can apply calamine lotion to relieve itching. You can take it as prescribed by the doctor or apply acyclovir, famciclovir or other antiviral treatments on the affected area.

4. After being infected with chickenpox, you should go to a regular medical institution for treatment in time and isolate yourself at home until all the blisters and herpes are scabby and fall off to avoid infecting others.

References:

【1】You Yixian, Jiang Wei, Lü Xiaoju, et al. Interpretation of "Varicella Diagnosis and Treatment Program (2023 Edition)"[J]. Chinese Journal of Antibiotics, 2024, 49(7): 737-742. DOI: 10.3969/j.issn.1001-8689.2024.07.003.

【2】Duan Lijin, Gao Hui, Mao Qian, et al. Research and development progress of varicella-zoster vaccine[J]. Chinese Journal of Preventive Medicine. 2023, 24(11). DOI:10.16506/j.1009-6639.2023.11.021

【3】Yin Dapeng, Lu Li, Liu Yanmin. Expert consensus on varicella vaccination[J]. Capital Public Health, 2023, 17(5): 257-266.

Author: Department of Infectious Diseases, Zhoupu Hospital, Pudong New Area, Shanghai

Nurse Bao Tingting

Xi Hongni, Head Nurse

Zhou Qiong, Head Nurse