Chickenpox

Question 1

How is chickenpox spread?

Answer 1

Respiratory route

Question 2

Can chickenpox be caught from someone with shingles?

Answer 2

yes

Question 3

How many days before the rash is it infective?

Answer 3

4 days

Question 4

How many days after the rash is it infective?

Answer 4

5 days after the rash first appeared

NOT until scabs have healed over BUT School exclusion criteria say until rashes have scabbed over.

Question 5

What is the incubation period of chickenpox?

Answer 5

10-21 days

Question 6

What are the clinical features of chickenpox?

Answer 6

• Fever initially
• Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
• Systemic upset is usually mild

Question 7

How long does the HPA say they should be kept off school?

Answer 7

Until the vesicles have crusted over.

Question 8

What is a common complication of VZV?

Answer 8

• Secondary bacterial infection

Question 9

What are some rare complications?

Answer 9

• Pneumonia
• Encephalitis (cerebellar involvement may be seen)
• Disseminated haemorrhagic chickenpox
• Arthritis, nephritis and pancreatitis may very rarely be seen

Question 10

Who should receive VZVIG?

Answer 10

• Immunocompromised patients
• Newborn babies with peripartum exposure
• Pregnant mothers who have never had chickenpox & are VZV IgG negative

Question 11

Why does the UK not offer vaccination for chickenpox (unlike America which does)?

Answer 11

1. It is a mild condition in childhood
2. If it were to stop circulating in childhood it would leave unvaccinated people vulnerable to the infection in adulthood which can be more severe.
3. It could increase the incidence of shingles as adult immunity would not be boosted by initial exposure to chickenpox.

Question 12

Who is entitled to get the VZV vaccine?

Answer 12

• Healthcare workers, Carers and close contacts of whom catching chickenpox could be dangerous. (e.g. immunosuppressed patients)
• But they do not need it obviously if they have already had chickenpox.