INVC,,
New Delhi,,
March is the season for chicken pox. Primary infection with varicella virus causes chickenpox in susceptible hosts. It can cause significant complications, such as soft tissue infection, pneumonia, hepatitis and encephalitis in adults, pregnant women and immuno-suppressed hosts. All adults and older children should receive anti viral drugs said Dr K K Aggarwal, President, Heart Care Foundation of India and Editor eMedinewS.
Treatment Guidelines
1. Anti allergic drugs can be given for pruritis.
2. Fingernails should be closely cropped to avoid significant excoriation and secondary bacterial infection.
3. Paracetamol should be used to treat fever, particularly in children, since the administration of aspirin has been associated with the onset of Reye syndrome.
4. Acyclovir, an anti viral drug (nit a trade name) is effective therapy for primary varicella in both healthy and immunosuppressed hosts.
5. Acyclovir is safe and effective for varicella if given during the first 24 hours of rash.
6. Acyclovir should be given to all older children and adults (older than 12 years of age), secondary household cases, history of chronic cutaneous or cardiopulmonary disorders, on steroids, on chronic salicylates.
Vaccination
1. Varicella vaccination is recommended for all children between 12 and 15 months of age without evidence of immunity.
2. Routine second dose of varicella vaccine at age four to six years.
3. All susceptible children aged 19 months to 13 years should be fully vaccinated (with two doses) by their 13th birthday.
4. Routine vaccination for all healthy persons aged >13 years is recommended for those without evidence of immunity.
5. Two doses of single-antigen varicella vaccine should be given four to eights weeks apart.
6. Varicella vaccine is highly recommended in VZV-seronegative adults with ongoing risk of exposure (eg, day care employees), those who are household contacts of immunosuppressed hosts and in women of child-bearing age.
7. A second dose of varicella vaccine is recommended for adolescents and adults who had previously received only one dose.
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