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Chickenpox and Shingles

CHICKENPOX

Chicken pox, a common infection in children caused by a virus known as varicella-zoster virus. It is a highly contagious disease that spread from person to person causing the infected person to develop fever and a blister like rash. The rash crops up first on the face and trunk and can spread over the entire body. It can be transmitted through the air when someone with chicken pox sneezing or coughing or by touching the watery stuff that comes out from the chicken pox blisters.

Symptoms of chickenpox

  1. Fever
  2. Loss of appetite
  3. Tiredness
  4. Headache
  5. Rash starting as small, itchy red spots like pimples all over the body including the mouth

Chicken pox infection generally will results in lifelong immunity. But the virus may remain hidden and reactivate as shingles in a proportion of adults and sometimes children.

SHINGLES

Shingles is an acute infection caused by the herpes zoster virus, the same virus as causes chickenpox. Shingles occurs because of exposure to chickenpox or reactivation of the herpes zoster virus. The virus remains latent (dormant) in nerve roots for many years following chickenpox. Thus, shingles only happens in people who already had chicken pox. Usually adults age ≥ 50yo will be affected.

Symptoms

  1. Pain in the affected nerve area, ranging from a tingling sensation to very severe burning pain that indicating nerve damage.
  2. Mild fever
  3. Tiredness
  4. Unilateral, localized rash that become blisters

DIFFERENCES OF CHICKENPOX AND SHINGLES


Characteristics
Chickenpox
Shingles
Definition
Chickenpox is a contagious disease casued by infection with varicella-zoster virus.
Shingles is an infection of a nerve and the skin around it, caused by the reactivation of the varicella-zoster virus.
Age of the patients
All ages are susceptible to chickenpox, but it is much more common in children.
The shingles occurs in adults.
Transmission
The transmission of the virus is by an air-droplet pathway. The contagion occurs when droplets containing the virus, formed by sneezing or coughing of an infected person, fall in the airways or the eyes of other people.After chickenpox, the infectious agent remains latent in the nerve ganglia of the body. Under certain conditions, the virus is reactivated and the shingles is induced.
Type of the infection
The chickenpox is a primary infection.
The shingles is a reactivation of old infection.
Symptoms
The symptoms of chickenpox are fever and itching rash. The rash appears, starting from the corpse and always affecting the hairy part of the head. On the face the rash is scarce, and at the palms and soles it is almost missing.
Pre-existing symptoms such as fatigue, muscle pain, burning and tingling in the area of the skin, which will later be affected by the rash may occur. This can be accompanied by fever. The shingles proceeds with very severe pain and rash. The rash affects a skin area innervated from a particular peripheral nerve.
Rash
Itching, non-grouped vesicles.
Painful , grouped vesicles.
Complications
The chickenpox is rarely complicated.
The shingles may lead to complications more often.


How is chicken pox and shingles being treated?  

General:

  • Keep the infected child at home (about 7 days from the onset of rash).
  • Drink plenty of water to prevent dehydration.
  • Take analgesic (eg.paracetamol, mefenamic acid, diclofenac) for fever or to  reduce pain.
  • Stay cool and wear loose-fitting clothes, preferably made of cotton.
  • Take balanced meals
  • Keeps hands clean

For itchiness:

  • Apply cooling gel or calamine lotion on the rash.
  • Keep fingernails short and clean to prevent scratching and possible scarring.
  • Use a cool compress to soothe the itch
  • Antihistamine medications (eg. Cetirizine, loratadine or chlorpheniramine) may be prescribed if the itch is very bad.

Antiviral medication to slow down the progression and stop the growth of virus. Example : acyclovir, famicyclovir , valacyclovir. It is usually prescribed for those at risk for severe disease, such as:

  • Those older than 12 years old.
  • Those with chronic lung disease/skin disease.
  • Those on long term salicylate therapy (like aspirin).
  • Those receiving short, intermittent, or aerosolized course of steroid therapy.
  • Some groups of pregnant mother.

Antiviral topical treatment to speed up the healing of the sores and decrease the symptoms (like tingling, pain, burning or itching).

  • Apply the antiviral cream 6 times per day for at least 5 days to stop the growth of virus.
  • Apply the cream onto the affected area and rub in gently. Make sure the cream is enough to cover all affected area.
  • Apply to skin only. Do not apply this medication in the eyes or nose, inside the mouth, or inside the vagina.                                                           

SUPPLEMENTS

Multivitamin and mineral

A high-potency multivitamin and mineral supplement may help to protect against cell damage. Look for a supplement with all the key ingredients, including vitamins C, E and selenium for antioxidant support. Vitamin B12 may help to support the formation of  myelin (a layer that cover the nerves). Keeping the myelin sheath healthy may even make the reactivation of the virus – which causes the symptoms of shingles – less likely.

Lysine

Lysine play an important role in the immune system. Combined supplement of lysine and zinc may help to reduce infection in people with compromised immune system. Lysine is also important for the body’s production of collagen, a protein that’s essential for healthy skin.

Probiotic

Probiotics are made of good live bacteria and/or yeasts that naturally live in our body. When you get an infection, there is more bad bacteria knocking the system out of balance. Good bacteria then works to fight off the extra bad bacteria and restore the balance within the body. Therefore, probiotic supplements are a way to add good bacteria to the body, supporting the immune system and controlling inflammation.

References

  1. Morgan, C. and Slater, O., n.d. Chickenpox and Shingles. [online] Natures Best. Available at: <https://www.naturesbest.co.uk/pharmacy/pharmacy-health-library/chickenpox-and-shingles/> [Accessed 20 June 2021].
  2. PORTAL MyHEALTH. 2012. Chickenpox – PORTAL MyHEALTH. [online] Available at: <http://www.myhealth.gov.my/en/chickenpox/> [Accessed 4 July 2021].
  3. PORTAL MyHEALTH. 2017. Varicella-Zoster Viral Infection – PORTAL MyHEALTH. [online] Available at: <http://www.myhealth.gov.my/en/varicella-zoster-viral-infection/> [Accessed 5 July 2021].