Understanding Chickenpox: Symptoms, Causes, Treatment, Nursing Care and Prevention

What is Chickenpox

It is an acute highly infectious disease caused by Varicella-zoster virus. It commonly occurs in children aged 2 to 8 years, but affects people of all ages. It is transmitted directly through droplet infection from infected respiratory secretions. It is also transmitted indirectly through contact with freshly soiled articles with discharges from the mucus membrane and vesicles of infected persons. A person with chickenpox is considered contagious 1 to 2 days before onset of rash until all the chickenpox lesions have crusted. The incubation period is between 10 to 21 days. It rarely affects individuals the second time. The virus is dormant after the infection. But when it is reactivated, it results in shingles.

Signs & Symptoms of Chickenpox

• Malaise
• Low grade fever
• Anorexia
• Headache
• Rash – macules to papules to vesicles to crusts within several hours. The evolution of the rash is rapid and follows the stages indicated.
• Rash first appears on the chest, back, and face, and then spreads over the entire body. The extremities are less affected (centripetal distribution).
• Severe pruritic lesion, scratching and scarring
• Ulceration of mucous membranes of the mouth, conjunctiva and genitalia

Diagnostic Investigations & Test

• Physical examination for signs and symptoms
• Full blood count for high WBCs

Chickenpox Treatment

• Antihistamine to relieve itching. E.g. Cetirizin
• Antipruritics to relieve the itching and discomfort. E.g. Calamine lotion, Sodium bicarbonate
• Antipyretics for the fever. E.g. Paracetamol
• Varicella-zoster immune globulin for faster protection
• Acyclovir can be given but it is not recommended for an uncomplicated infection.

Nursing Management of Chickenpox

The following are the measures to put in place in the care of patient's with Chickenpox

• Isolation and barrier nursing until rash disappears.
• Bath patients daily with antiseptic lotion and soft sponge.
• Trim patient’s fingernails to avoid injury from scratching.
• Monitor and record vital signs.
• Administer prescribed drugs and monitor for desired and side effects.
• Change bed linen daily or whenever necessary.
• Serve easily digestible foods high in protein.
• Ensure patient have enough rest.
• Teach patient to avoid Salicylates such as Aspirin to prevent Reye’s syndrome which affects the liver and brain.
• Proper disposal of discharges of infected persons.
• Infected persons should cover their mouth and nose when sneezing and coughing.
• Identify contacts, investigate them and isolate them early.
• Close contact with infected persons should be avoided to avoid breathing in the organisms.