Shingles

Chickenpox

Chickenpox is caused by primary infection with varicella zoster virus. Shingles is a reactivation of the dormant virus in dorsal root ganglion

Chickenpox is highly infectious

• spread via the respiratory route
• can be caught from someone with shingles
• infectivity = 4 days before rash, until 5 days after the rash first appeared*
• incubation period = 10-21 days

Clinical features (tend to be more severe in older children/adults)

• fever initially
• itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
• systemic upset is usually mild

Management

Mainly supportive

• keep cool, trim nails
• calamine lotion
• school exclusion: NICE state the following: Advise that the most infectious period is 1-2 days before the rash appears, but infectivity continues until all the lesions are dry and have crusted over (usually about 5 days after the onset of the rash).
• immunocompromised patients and newborns with peripartum exposure should receive varicella zoster immunoglobulin (VZIG). If chickenpox develops then IV aciclovir should be considered

A common complication is secondary bacterial infection of the lesions