Affiliations: Department of Pediatrics, University of Calgary,
Alberta Children's Hospital, Calgary, Alberta, Canada | Department of Pediatrics and Human Development,
Michigan State University, East Lansing, Michigan, USA
Abstract: Chickenpox, caused by the varicella-zoster virus, is mostly a mild
disease in healthy children, but can be debilitating in immunocompromised
individuals or susceptible adults. The disease is highly contagious. The
lesions start as rose-colored macules, and progress rapidly to become papules,
vesicles with the classic "dew drop on a rose petal" appearance, pustules
and, finally, crusts. The distribution of the lesions is typically central,
with the greatest concentrations on the trunk. Characteristically, lesions are
intensely pruritic and appear in crops. The most common complication associated
with chickenpox is secondary bacterial infections of the skin followed by
post-inflammatory scarring of the lesions. The diagnosis is mainly clinical and
treatment symptomatic. Oral acyclovir should be considered in high-risk
individuals. Intravenous acyclovir is effective for the treatment of chickenpox
in immunocompromised individuals and for serious complications of chickenpox in
normal patients. To eradicate chickenpox, universal childhood immunization with
varicella vaccine is the way to go. The Advisory Committee for Immunization
Practices of the Centers for Disease Control and Prevention and the American
Academy of Pediatrics recommend a routine two-dose varicella vaccination
program for children, with the first dose administered at 12 to 18 months and
the second dose at 4 to 6 years of age. The Advisory Committee on Immunization
Practices further recommends two doses of varicella vaccine, 4 to 8 weeks
apart, for all susceptible adolescents and adults and a catch-up second dose
for everyone who received one dose of varicella vaccine previously.
Keywords: Chickenpox, complications, universal immunization, two doses
