How to treat chickenpox in Nigeria including drugs and vaccine, drugs for chickenpox in Nigeria, chickenpox vaccine in Nigeria, chickenpox treatment in Nigeria.
Chickenpox virus or varicella zooster virus (VZV) is a dermotropic (skin loving) and neutropic ( nervous system loving) virus that produces primary infect, usually in childhood, which may reactivate in later life. chickenpox virus is spread via aerosols, droplets and direct contact. It is highly infectous to persons that were not immunized.
Disease in children is usually well tolerated. Manifestations are more severe in adults , pregnant women and people with weak immune system such as HIV patients, cancer patients, diabetics and so on.
When chickenpox becomes reactivated especially in adulthood, it is known as shingles.
Sign and symptoms of chickenpox
The incubation period is 11-20 days, after which a vesicular skin eruption begins often on the mucosal surface (mouth, eyes) first, followed by rapid dissemination (spread) in centripetal distribution (mostly on the trunk and fewer on the limbs).
The pruritic(itchy) rash of chickenpox is typically concentrated on the trunk and face and less so on the arms and legs (ie, centripetal distribution).
New rashes occur every 2-4 days and each is crop is associated with fever. Due to the severe itching, the skin becomes secondarily infected from scratching and this is the most common complications of primary chickenpox.
Sometimes, the infection may spread to the brain but this is self limiting and a rare complication.
Adults, pregnant women and persons with weak immunity are at increased risk of visceral involvement which manifest as pneumonia, hepatitis or encephalitis(brain infections).
Pneumonia can be fatal and is more likely to occur in smokers. Maternal infections in early pregnancy carries 3 percent risk of neonatal damage with developmental abnormalities of the eyes, central nervous system and the limbs (TORCHES SYNDROME).
Chickenpox within 5 days of delivery leads to severe neonatal varicella with involvement of the internal organs and bleeding.
The diagnosis of chickenpox is purely clinical (from signs, symptoms and medical evaluation). Sometimes your doctor may request for a DNA (PCR) test of aspirated fluid from the rash (vesicular fluid). Serology may also come in handy. These tests are very very expensive except your insurance covers it. Persons especially adults with chickenpox must compulsory do an HIV test because it may be a point to sometime sinister.
TREATMENT OF CHICKENPOX
The treatment of chickenpox is almost always support. The benefits of antiviral drugs for uncomplicated chickenpox infection are marginal and treatment may not be required.
Antivirals are, however, used for uncomplicated chicken pox in pregnant women, HIV patients, cancer and diabetic patients.
Sometimes, the disease may be so severe in persons with low immune system that they may require some injections to get better.
Common drugs used to treat chickenpox and dosage in children and adults
1. ACYCLOVIR: acyclovir shortens symptoms in chickenpox by an average of one day. In shingles, acyclovir helps relieves pain and shortens the recovery time. Oral acyclovir 800mg 5 times daily for 5 days.
2. Famciclovir 500mg 3 times daily for 5 days
3. Valaciclovir 1g 3 times daily for 5 days.
Pregnant women and HIV patients will initially require intravenous medications of acyclovir before tablets.
For shingles, treatment and dosage is same as chickenpox but the duration is for 7 -10 days.
Other supportive treatment of chickenpox
WATER : drink plenty of water to keep rehydrated.
LORATIDINE/DIPHENYHYDRAMINE: Taking tablets of antihistamines such as Loratidine or diphenyhydramine will help reduce itching..
PARACETAMOL/DICLOFENAC: tablets if paracetamol or diclofenac will relieve the fever and pain associated with the rash of chickenpox or shingles.
ANTIBIOTICS: This will help remove the secondary bacterial infection.
CALAMINE LOTION:Rubbing it on your skin help reduce itching.
PREVENTION – CHICKEN POX VACCINATION
The best, safest and cheapest way to prevent chickenpox is by getting vaccinated. Ensure you take your baby to the nearest primary health care centre in Nigeria to get the chickenpox vaccine. Chickenpox vaccine is free in Nigeria for those that want to know the price.
Here is a breakdown of chickenpox vaccination in Nigeria
Name of vaccine: Varicella (VAR)
Minimum age: 12 months
Routine vaccination: 2-dose series of VAR vaccine at ages 12 – 15 months for first dose and 4 -6 years for second dose . The second dose may be administered before age 4 years, provided at least 3 months have elapsed since the first dose. If the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid.
All persons aged 7 – 18 years without evidence of immunity have 2 doses of varicella vaccine.
For children aged 7 – 12 years, the recommended minimum interval between doses is 3 months (if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid); for persons aged 13 years and older, the minimum interval between doses is 4 weeks.
CAVEAT: This article is for your education and purely not a substitute to seeing a medical doctor.. Do not treat chickenpox at home especially in children.
Davidson’s Principles and Practice of Medicine (22nd Edition).
Ask The Paediatricians