FEATURE: A RISE IN CHICKEN POX CASES

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There has been an immoderate increase in the incidence of chicken pox reported here so far this year, and this is causing the Ministry of Health much concern.

To date, (as at April 4) according to a senior health official, 257 cases of the disease had been reported to the Queen Elizabeth Hospital and the various polyclinics across the island. This contrasts with 68 cases recorded for the corresponding period last year.

During 2008, some 349 cases of Chicken Pox were recorded with 123 or 35% occurring during the last nine weeks of that year.

Senior Medical Officer of Health, Dr. Karen Springer, confirmed that although there were 35 cases last year compared to 30 cases this year for epidemiology weeks 9 to 11,  there were almost 3.5 times as many cases (number = 42)  reported in epidemiological week 13 (week ending 4th April)  in 2009 compared to 12 for the corresponding week in 2008.

Chicken pox is an acute, infectious disease which is caused by the varicella-zoster virus.

It may initially begin with cold-like symptoms, followed by a high temperature and an intensely itchy, vesicular (fluid-filled blister-like) rash.

Clusters of vesicular spots appear over 3 to 5 days, mostly over the trunk and more sparsely over the limbs. It can affect persons of any age but is most commonly seen in children under 10 years old. The severity of infection varies and it is possible to be infected but show no symptoms.

According to Dr. Springer, “chicken pox is a viral infection and will therefore not respond to antibiotics. Treatment should be based on reducing symptoms such as fever and itchiness.”

While noting that persons may turn to home treatments, she said, parents could do several things at home to help relieve their children’s chicken pox symptoms.

"Scratching the blisters may cause them to become infected, so keep your child’s fingernails trimmed short,” she urged.  

Dr. Springer suggested that Calamine Lotion and Oatmeal baths may help to relieve some of the itching and advised individuals not to use aspirin or aspirin-containing products to relieve a child’s fever.

“The use of aspirin in children with chicken pox has been associated with the development of Reye’s syndrome (a severe disease affecting all organs, but most seriously affecting the liver and brain that may cause death). Use non-aspirin medications such as Panadol,” she suggested.

Dr. Springer stressed that if a child with chicken pox acquired a fever lasting longer than four days, with a tendency to rise above 102ºF, a medical doctor should be contacted.

“If the individual with chicken pox seems extremely ill, is difficult to wake up or appears confused, has difficulty walking, has a stiff neck, is vomiting repeatedly, has difficulty breathing, or has a severe cough, a doctor should be called immediately,” she advised. 

The senior health official also added that a medical practitioner should be called immediately, “if any areas of the rash or any part of the body becomes very red, warm, or tender, or begin leaking pus (thick, discoloured fluid), since these symptoms may indicate a bacterial infection”.

While the disease occurs throughout the year in most countries, it is most common during the cooler months of the year.

Most individuals are infected in childhood and they remain immune for life. Chicken pox is highly contagious, infecting up to 90% of people who come into contact with the disease. The mode of transmission is through direct person to person contact, airborne droplet infection or through contact with infected articles such as clothing and bedding. The incubation period (the time from when a person becomes infected to when symptoms first appear) is from 10 to 21 days.

The most infectious period, however, is from 1 to 2 days before the rash appears, but infection continues until all the lesions have crusted over (commonly about 5 to 6 days after the onset of illness).

Following chicken pox infection, the virus can lay dormant in the nervous tissue for several years, but may reappear because of reactivation of the virus as shingles (also called herpes zoster). It is not known what causes the virus to reactivate, but reactivation is usually associated with conditions that depress the immune system such as old age, immunosuppressive therapy and HIV infection.

Dr. Springer indicated that people at higher risk of developing serious complications from shingles or chickenpox (individuals with chronic skin or lung disease, persons receiving steroid therapy or individuals 13 years of age or older) should be given antiviral drugs such as acyclovir, which might prevent severe illness developing. This should be given within 48 hours of seeing lesions to be effective. She noted that while a vaccine is available in Barbados, public sector distribution is restricted to front line health sector workers. Members of the general public who have never had chicken pox may obtain the vaccine from private doctors.

jgill@barbados.gov.bb

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