Chickenpox

For the episode of South Park by that name, see Chickenpox (South Park).

Chickenpox
Specialty	Infectious diseases, pediatrics

Chickenpox, also spelled chicken pox, is the commonly known name for varicella disease, frequently but not exclusively contracted in childhood.

Chickenpox is caused by the varicella-zoster virus (VZV), also known as human herpes virus 3 (HHV-3), one of the eight herpes viruses known to affect humans. It is characterized by a fever, followed by itchy raw pox or open sores which heal without scarring.

Effects

A patient with chickenpox on day 5.

Chickenpox has a two-week incubation period and is highly contagious by air transmission two days before symptoms appear. Therefore, chickenpox spreads quickly through schools and other places of close contact. Once someone has been infected with the disease, they usually develop protective immunity and cannot get it again. As the disease is more severe if contracted by an adult, parents have been known to ensure their children become infected before adulthood.

The disease is rarely fatal: if it does cause death, it is usually from varicella pneumonia, which occurs more frequently in pregnant women. In the US, 55 percent of chickenpox deaths were in the over-20 age group. Doctors advise pregnant women who come into contact with chickenpox should contact their doctor immediately, as the virus can cause serious problems for the fetus.

Later in life, viruses remaining in the nerves can develop into the painful disease, shingles, particularly in people with compromised immune systems, such as the elderly, and perhaps even sunburn. A chickenpox vaccine has been available since 1995, and is now required in some countries for children to be admitted into elementary school. In addition, effective medications (e.g., acyclovir) are available to treat chickenpox in healthy and immunocompromised persons.

History

One history of medicine book claims Giovanni Filippo (1510–1580) of Palermo gave the first description of varicella (chickenpox). Subsequently in the 1600s, an English physician named Richard Morton described what he thought was a mild form of smallpox as "chicken pox." Later, in 1767, a physician named William Heberden, also from England, was the first physician to clearly demonstrate that chickenpox was different from smallpox. However, it is believed the name chickenpox was commonly used in earlier centuries before doctors identified the disease.

There are many explanations offered for the origin of the name chickenpox, from the idea the specks that appeared looked as though the skin was picked by chickens, to the idea the disease was named after chick peas, from a supposed resemblance of the seed to the lesions. The simplest explanation is probably offered by Samuel Johnson, that the disease was "no very great danger," thus a "chicken" version of the pox. As "pox" also means curse, in medieval times some believed it was a plague brought on to curse children by the use of black magic. Incidentally, during the medieval era, oatmeal was discovered to soothe the sores, and oatmeal baths are today still commonly given to relieve itching.

Vaccination

Routine vaccination against varicella zoster virus is performed mainly United States. In Europe most countries do not vaccinate against varicella.

A lawyer, Andrew Schlafly, general counsel of the Association of American Physicians and Surgeons in his testimony against a proposed New Jersey rule mandating chickenpox vaccination, made the following comments on the history of chickenpox:

Prior to the development of the varicella (chickenpox) vaccine, the disease was widely recognized to be one of the most benign illnesses. The Encyclopedia of Medicine of the American Medical Association stated in 1989 that chickenpox is a "common and mild infectious disease of childhood" and that "all healthy children should be exposed to chickenpox … at an age at which it is no more than an inconvenience." Likewise, the American Academy of Pediatrics declared in a 1996 brochure that '[m]ost children who are otherwise healthy and get chickenpox won't have any complications from the disease.

Schlafly's essay also stated, "The risk of contracting and dying from chickenpox was little more than the risk of being struck and killed by lightning (about 89 cases per year in the U.S)." (this figure reflected a population of 295,734,134 in 2005, according to the United States Census Bureau) "Chickenpox mortality," continued Schlafly, "was among the lowest of all known diseases."

References

• Bernstein, Henry, M.D. "Pediatrics Questions and Answers by Dr. Henry Bernstein: Who Discovered Chickenpox?" Family Education Network (retrieved Oct. 16, 2005)
• "Chickenpox (Varicella) Vaccine." (September 2003), Immuunization Action Coalition (retrieved Oct. 16, 2005)
• "International Data Base: Countries Ranked by Population." (August 26, 2005), United States Census Bureau (retrieved Oct. 16, 2005)
• Schlafly, Andrew (May 12, 2003). "AAPS Testimony Against Proposed New Rule N.J.A.C. 8:57-4.17 (Varicella Vaccine Mandate)", Association of American Physicians and Surgeons, Inc. (retrieved Oct. 16, 2005)
• Seward, Jane F., M.B.B.S., M.P.H.; Watson, Barbara M., M.B.Ch.B.; Peterson, Carol L., M.D., M.P.H.; Mascola, Laurene, M.D., M.P.H.; Pelosi, Jan W., M.P.H.; Zhang, John X., Ph.D.; Maupin, Teresa J., R.N., M.A.; Goldman, Gary S., Ph.D.; Tabony, Laura J., M.P.H.; Brodovicz, Kimberly G., M.P.H.; Jumaan, Aisha O., Ph.D., M.P.H.; Wharton, Melinda, M.D., M.P.H., February 6, 2002 "Varicella Disease After Introduction of Varicella Vaccine in the United States, 1995-2000." Journal of the American Medical Association 287, 606–611, reprinted by EpiCentro (retrieved Oct. 16, 2005)

See also

• Cowpox
• List of diseases
• List of vaccine-related topics
• Monkeypox
• Shingles
• Smallpox
• Vaccine controversy

External links

• CDC.gov - 'Varicella Disease (Chickenpox): Varicella, although a common disease, can be dangerous and even deadly' Center for Disease Control