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For the episode of South Park by that name, see Chickenpox (South Park).

Chickenpox
ICD-10 code:	B01
ICD-9 code:	052

Chickenpox, also spelled chicken pox, is the commonly known name for varicella disease, frequently but not exclusively contracted in childhood.

Chickenpox is caused by the varicella-zoster virus (VZV), also known as human herpes virus 3 (HHV-3), one of the eight herpes viruses known to affect humans. It is characterized by a fever, followed by itchy raw pox or open sores which heal without scarring.

Contents 1 Effects 2 History 3 Vaccination 4 References 5 See also 6 External links

Effects

Chickenpox has a two-week incubation period and is highly contagious by air transmission two days before symptoms appear. Therefore, chickenpox spreads quickly through schools and other places of close contact. Once someone has been infected with the disease, they usually develop protective immunity and cannot get it again. As the disease is more severe if contracted by an adult, parents have been known to ensure their children become infected before adulthood.

The disease is rarely fatal: if it does cause death, it is usually from varicella pneumonia, which occurs more frequently in pregnant women. In the US, 55 percent of chickenpox deaths were in the over-20 age group. Doctors advise pregnant women who come into contact with chickenpox should contact their doctor immediately, as the virus can cause serious problems for the fetus.

Later in life, viruses remaining in the nerves can develop into the painful disease, shingles, particularly in people with compromised immune systems, such as the elderly, and perhaps even sunburn. A chickenpox vaccine has been available since 1995, and is now required in some countries for children to be admitted into elementary school. In addition, effective medications (e.g., acyclovir) are available to treat chickenpox in healthy and immunocompromised persons.

History

One history of medicine book claims Giovanni Filippo (1510–1580) of Palermo gave the first description of varicella (chickenpox). Subsequently in the 1600s, an English physician named Richard Morton described what he thought was a mild form of smallpox as "chicken pox." Later, in 1767, a physician named William Heberden, also from England, was the first physician to clearly demonstrate that chickenpox was different from smallpox. However, it is believed the name chickenpox was commonly used in earlier centuries before doctors identified the disease.

There are many explanations offered for the origin of the name chickenpox, from the idea the specks that appeared looked as though the skin was picked by chickens, to the idea the disease was named after chick peas, from a supposed resemblance of the seed to the lesions. Another explanation is suggested by Samuel Johnson, that the disease was "no very great danger," thus a "chicken" version of the pox. A third possibility is that the term reflects a corruption of the Old English word, "giccin", which meant "itching". As "pox" also means curse, in medieval times some believed it was a plague brought on to curse children by the use of black magic. Incidentally, during the medieval era, oatmeal was discovered to soothe the sores, and oatmeal baths are today still commonly given to relieve itching.

Vaccination

Routine vaccination against varicella zoster virus is performed mainly in the United States, and the incidence of chickenpox has been dramatically reduced there (from 4 million cases per year in the pre-vaccine era to approximately 400,000 cases per year as of 2005). In Europe most countries do not currently vaccinate against varicella, however, the vaccine is gaining wider acceptance and Australia, Canada and other countries have now adopted recommendations for routine immunization of children and susceptible adults against chickenpox. Other countries, such as Germany and The United Kingdom have targeted recommendations for the vaccine, e.g. for susceptible health care workers at risk of varicella exposure. While chicknepox is most often a mild disease, it is inaccurate to characterize it as a harmless rite of childhood. Prior to the introduction of vaccine it killed about 150 people per year in the US and caused the hospitalization of about 10,000 each year. These preventable deaths and hospitalizations have also substantially declined in the US due to vaccination. The vaccine has more recently been determined to be effective at preventing shingles (zoster) in persons 60 years of age and older.

Contrary to some claims, the long-term duration of protection from varicella vaccine is unknown, but there are now persons vaccinated more than thirty years ago with no evidence of waning immunity. Assessments of duration of immunity are complicated in an environment where natural disease is still common, and we are only now entering an era in the US where the long-term efficacy of varicella vaccine can be accurately gauged.

References

• Bernstein, Henry, M.D. "Pediatrics Questions and Answers by Dr. Henry Bernstein: Who Discovered Chickenpox?" Family Education Network (retrieved Oct. 16, 2005)
• "Chickenpox (Varicella) Vaccine." (September 2003), Immuunization Action Coalition (retrieved Oct. 16, 2005)
• "International Data Base: Countries Ranked by Population." (August 26, 2005), United States Census Bureau (retrieved Oct. 16, 2005)
• Seward, Jane F., M.B.B.S., M.P.H.; Watson, Barbara M., M.B.Ch.B.; Peterson, Carol L., M.D., M.P.H.; Mascola, Laurene, M.D., M.P.H.; Pelosi, Jan W., M.P.H.; Zhang, John X., Ph.D.; Maupin, Teresa J., R.N., M.A.; Goldman, Gary S., Ph.D.; Tabony, Laura J., M.P.H.; Brodovicz, Kimberly G., M.P.H.; Jumaan, Aisha O., Ph.D., M.P.H.; Wharton, Melinda, M.D., M.P.H., February 6, 2002 "Varicella Disease After Introduction of Varicella Vaccine in the United States, 1995-2000." Journal of the American Medical Association 287, 606–611, reprinted by EpiCentro (retrieved Oct. 16, 2005)
• Oxman MN. Levin MJ. Johnson GR. Schmader KE. Straus SE. Gelb LD. Arbeit RD. Simberkoff MS. Gershon AA. Davis LE. Weinberg A. Boardman KD. Williams HM. Zhang JH. Peduzzi PN. Beisel CE. Morrison VA. Guatelli JC. Brooks PA. Kauffman CA. Pachucki CT. Neuzil KM. Betts RF. Wright PF. Griffin MR. Brunell P. Soto NE. Marques AR. Keay SK. Goodman RP. Cotton DJ. Gnann JW Jr. Loutit J. Holodniy M. Keitel WA. Crawford GE. Yeh SS. Lobo Z. Toney JF. Greenberg RN. Keller PM. Harbecke R. Hayward AR. Irwin MR. Kyriakides TC. Chan CY. Chan IS. Wang WW. Annunziato PW. Silber JL. Shingles Prevention Study Group. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.[see comment]. [Clinical Trial. Journal Article. Multicenter Study. Randomized Controlled Trial] New England Journal of Medicine. 352(22):2271-84, 2005 Jun 2.

See also

• Cowpox
• List of diseases
• List of vaccine-related topics
• Monkeypox
• Shingles
• Smallpox
• Vaccination schedule
• Vaccine controversy

External links

• CDC.gov - 'Varicella Disease (Chickenpox): Varicella, although a common disease, can be dangerous and even deadly' Center for Disease Control

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