In around 90% of the population, the infection occurs by the age of 14, and in 10% it occurs in adulthood with a more severe course. About 5% of those infected do not develop a rash. Transmission occurs through smear or airborne droplet infection.
Symptoms of chickenpox
Approximately 14 – 21 days after exposure to the virus, a rash appears, often starting on the scalp and then appearing all over the body. Fatigue and moderate fever may precede the rash, but in adults more serious symptoms such as headache, vomiting and higher fever may occur. Scattered red spots initially appear, particularly on the head and torso, which then turn into small nodules and within hours into small blisters on a reddened background. As the disease progresses, the contents of the bladder become cloudy. Pus blisters form which fall off as crusts after 2 – 3 weeks. The number of bubbles can vary from a few to many hundreds.
The disease usually has an uncomplicated course. A common consequence is bacterial infection of the scratched blisters. This can cause bowl-shaped scars, particularly on the forehead and cheeks. In adulthood, the viral infection can lead to inflammation of various organs such as the brain or lungs in patients with weakened immune systems and can potentially be life-threatening.
The risk of infection usually occurs 3 days before to 7 days after the onset of the rash.
Chickenpox during pregnancy and after childbirth
Chickenpox in pregnancy is rare, especially because over 90% of women of childbearing age have already had a VZV infection. An initial infection during the first half of pregnancy can lead to premature birth and birth defects in the child.
Chickenpox in the last trimester of pregnancy is often associated with severe cases and pneumonia, which can lead to premature birth or death of the mother and child.
If the maternal illness occurs 5 days before to 2 days after delivery, life-threatening chickenpox can be expected in the newborn in around 30% of cases. For women without immune protection, a protective vaccination against pregnancy is also possible.
Therapeutic measures for chickenpox
The treatment of chickenpox infection includes the local application of itch-relieving lotions, antibiotic creams for additional bacterial infections and, if necessary, the taking of itch-relieving drops or tablets (antihistamines). In general, rest is recommended; if you have a fever, you should stay in bed. Antiviral tablet therapy is only necessary for severe disease or complicating comorbidities.
Children can go back to school or kindergarten at the earliest 7 days after the outbreak of the rash and adults can resume their professional activities if they are feeling well. In severe cases, a pediatrician, general practitioner or internist should be consulted to rule out organ involvement.
Prevention of chickenpox disease
Previously, the vaccination recommendation applied to people with weakened immune systems, women who wanted to have children and those with neurodermatitis. The chickenpox vaccination is generally recommended by the Standing Vaccination Commission at the Robert Koch Institute, as the disease is associated with complications in 5% of those affected.
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