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Chicken pox

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Chickenpox (or chicken pox) is a highly contagious viral infection.  It is a disease that is endemic to all countries worldwide.  And it is caused by the Varicella Zoster virus [VZV]

In temperate countries, chickenpox is primarily a disease of children, with most cases occurring during the winter and spring. It is one of the classic diseases of childhood, with the highest prevalence in the 4–10 year old age group. In temperate countries, most people become infected before adulthood but 10% of young adults remain susceptible.

In the tropics, chickenpox often occurs in older people and may cause more serious disease.  In adults the pock marks are darker and the scars more prominent than in children.  Infection in otherwise healthy adults tends to be more severe and may be fatal. 

Symptoms

The early symptoms in adolescents and adults are nausea, loss of appetite, aching muscles, and headache. This is followed by the characteristic rash, malaise and a low-grade fever that signal the presence of the disease.

In children the illness is not usually preceded by prodromal symptoms and the first sign is the rash. The rash begins as small red dots on the face, scalp, torso and upper arms and legs; progressing over 10–12 hours to small bumps, blisters and pustules; followed by umbilication and the formation of scabs.

At the blister stage intense itch is usually present. Blisters may also occur on the palms, soles and mucous membranes, and painful, shallow ulcers may appear in the mouth, the top of the throat and the genital area. These symptoms appear from 10 to 21 days after infection.

Adults may have a more widespread rash, and longer fever; and are more likely to experience complications.

Chickenpox is generally more severe in adult males than in adult females or children.  

VZV is a virus able to become 'latent'.

Virus latency (or viral latency) is the ability of a pathogenic virus to lie dormant (latent) within a cell, it is a type of persistent viral infection.

Latency is the phase in certain viruses' life cycles in which, after initial infection, proliferation of virus particles ceases. However, the viral genome is not fully eradicated. The result of this is that the virus can reactivate and begin producing large amounts of viral progeny without the host being infected by new outside virus, denoted as the lytic part of the viral life cycle, and stays within the host indefinitely.

Wikipedia
"After primary infection, VZV spreads from mucosal and epidermal lesions to local sensory nerves. VZV then remains latent in the dorsal ganglion cells of the sensory nerves. Reactivation of VZV results in the clinically distinct syndrome of herpes zoster (i.e., shingles), postherpetic neuralgia, and sometimes Ramsay Hunt syndrome type II".

And in this, they are both right and wrong, for scientists are starting discover that  the herpes zoster virus can do a great deal more damage than give you shingles. 

It is essential that you are able to see all the complications this virus can cause, as it may influence your decision on how to treat chicken pox and also decide what to do about vaccination.  So to obtain more details follow the link to the page for Varicella Zoster Virus.

Cause

Chickenpox (or chicken pox) is caused by primary infection with the varicella zoster virus (VZV).

Treatment

Prevention

 Chicken pox is extremely difficult to prevent.  It is highly communicable, with an infection rate of 90% in close contacts. 

Chickenpox is an airborne disease spread easily through coughing or sneezing of ill individuals or through direct contact with secretions from the rash. A person with chickenpox is infectious one to two days before the rash appears. They remain contagious until all lesions have crusted over (this takes approximately six days). 

The chickenpox virus is susceptible to disinfectants, notably chlorine bleach (i.e., sodium hypochlorite). Also, like all enveloped viruses, it is sensitive to desiccation, heat and detergents.

A vaccine is available which gives the person a milder dose of the illness, but for more details of the effects and repercusions see the VZV entry.

Treatment

There is no cure. Treatment mainly consists of sleeping, resting in bed, staying very warm and drinking plenty of fluids to prevent dehydration, preferably with minerals and electrolytes to ensure the mineral balance is maintained. Zinc is important to keep the immune system active.

Gloves – preferably cotton – to prevent scatching can be worn.

“The condition resolves by itself within a couple of weeks. The rash caused by varicella zoster virus may however last for up to one month. It is important to maintain good hygiene and daily cleaning of skin with warm water to avoid secondary bacterial infection. Scratching may increase the risk of secondary infection."

The body fights viruses using the imune system, so it is exceptionally important you do not compromise the immune system.  Again go to the secton on VZV for more details.

The body expels the virus via the blisters and spots.  Thus it often helps the person to give them a warm shower - NO SOAP, NO DETERGENTS, JUST WATER - every few hours, which helps to wash away the virus.  Dry them with a clean towel and after drying them,  wash the towel in boiling water.  Then wrap the patient in a soft absorbent towelling robe or pyjamas.  This will also soak up the pus and the virus with it.  Keep the fluid intake up, so that the body is able to create plenty of pus with which to expel the viruses.

Imagine they are like a sponge full of paint that you need to clean, by continually adding water and figuratively squeezing them.

Change the towelling robes or pyjamas frequently and also boil these, or put them on the hottest wash of your washing machine.  By continually changing the pus covered absorbent coverings and boiling them, you kill the viruses, until the body expels the virus of its own accord. 

Note that by using this regime, it is possible that the virus is not given time to become latent.  This is the best possible news as your patient will have built up immunity, but will not be harbouring the virus.

The main things that help the immune system and the person are lots and lots of sleep, and quiet.  And warmth, as much warmth as possible.

Most people with chicken pox want nothing to eat.  As a child I thought I could manage  chocolate spread on dry crackers - I couldn't.  The result was, I have to say, not a pleasant sight.  My Mum was a hero, she said nothing, but sighed and went to look for a bucket to mop it all up.

How it works

A person suffering from basic chicken pox usually obtains their spiritual experience from the very high temperatures the body generates in an attempt to kill of the virus.  Fever is the body's principle defence against viruses of this sort, but fever can produce delirium.

Where complications of chicken pox have occurred other mechanisms start to take over.

In a compromised immune system, the virus is able to enter the cerebrospinal fluid and passing the blood brain barrier enter the brain, where, via inflammation and damage, it causes the experiences.

In effect, the ultimate cause of any experience is temporary [or permanent] Brain damage.

References and further reading

[Varicella zoster virus infection of the central nervous system with symptoms resembling cardiac phobia and schizophrenia]. Ullmann H, Kühn J.Nervenarzt. 1988 Feb;59(2):113-7. German. No abstract available. PMID: 3362259

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