CHICKENPOX (Varicella) TREATMENT

A viral disease of high infectivity, chickenpox is probably spread by droplet infection and by conveyance of material from the skin lesions either on the hands or clothes of a third person, or possibly by air. The incubation period is usually from thirteen to sixteen days. It is rarely less than 11 days or more than 20 days. The disease is probably infective for at least 24 hours before the appearance of the rash. The duration of infectivity is uncertain, but for practical purposes may be regarded as persisting until the last crust has separated from the skin.
Chickenpox is not a notifiable disease, but should smallpox be prevalent in a particular area, chickenpox cases may have to be reported to the local Public Health Authority.
Preventive Treatment.—There is no method of preventing chickenpox. Indeed attempts to avoid infection in childhood should not be made since in the adult chickenpox is almost always a more severe illness. It should be remembered that the viruses of chickenpox and herpes zoster are probably identical and that herpes zoster often produces chickenpox in susceptible contacts.
Curative Treatment.—General Management.—The treatment of chicken-pox is on general lines, no specific remedy being available. Even in mild attacks the patient should be confined to bed during the efflorescence of the eruption. When the rash is profuse it is wise to insist on rest in bed until the lesions have crusted. If there is a tendency to scratch the pocks, the hands may be wrapped in lint or gauze, or the arms lightly splinted. If itching is intense, the application of either calamine lotion or 2^ per cent. phenol in petroleum jelly or olive oil will give relief, or the skin may be dusted freely with a good sterilized talcum powder or with a powder consisting of equal parts of boric acid, zinc oxide and starch.Complications.—In children complications are rare. If severe secondary infection of the skin lesions occurs bacteriological examination should always be carried out and the appropriate antibiotic prescribed. The most severe forms of chickenpox are seen in the adult and are often a sequel to radiotherapy or to treatment with steroids. A primary chickenpox pneumonia is a common complication in such cases. When the patient is already receiving steroids the dose should be temporarily increased and indeed in any patient who develops chickenpox pneumonia the treatment should be a combination of tetracycline andprednisolone