For many, the words chickenpox evoke images of itchy skin, blisters, and pimples. Being one of the most contagious diseases around, it strikes fear into the hearts of parents and children alike.
Usually transmitted via inhalation of airborne droplets or direct contact with a skin lesion, Dr Thabani Dlamini from Durban says chickenpox is caused by the varicella-zoster virus.
“It usually manifests itself as an intensely pruritic rash characterised by sequential clusters of papules, vesicles, and pustules that can be found anywhere in the body. It is extremely contagious, mostly two days before a lesion and five days after the lesion,” he explains.
Living with the itch
After being in contact with her son, who got chickenpox from schoolmates, Bassie Thage from Pretoria got infected by him last year in October at the age of 32 and says she experienced fever-like symptoms for a few days until chicken pox started to show.
“I have never had chickenpox before and was shocked, but my family and friends were not surprised as this is a common disease that can happen to anyone.
“Timewise, I had it for two weeks, and the itchiness was not that severe; it only happened for a few hours on the second day, and I used to manage it by taking a warm shower to ease the pain.
Bassie Thage
“Also, I was not in close contact with anyone as it is easily transferable, so I kept my distance until I received medical treatment, which was mostly painkillers and ointments,” she says.
Kholofelo Phohu (16) from Mpumalanga, who recently also had chickenpox for two weeks, says she contracted it from her schoolmates due to always being in close contact with them.
“When I got chickenpox, I had many sores, and they were itchy after they started to be painful, and they had water inside them. It was very painful, so I had to pour vinegar on them for the sores to stop itching. I am also a young traditional healer, so I managed to heal myself through herbs,” says Phohu.
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According to Dlamini, immunocompetent people, meaning people who are HIV-negative and not on chemotherapy or have a long history of steroid use, don’t need antiviral treatment because it is self-limiting as their immune systems are still strong and can withstand and fight the virus.
Healthy vs immunosuppressed individuals
“In healthy children, the chickenpox infection generally has a benign course and heals without any consequences. It can rarely be found in adults and is associated with more severe forms and complications.
“This is simply because adults who have this disease are immunosuppressed most of the time (HIV infection, chemotherapy, chronic smokers), so they can present with infections in the brain (encephalitis), lungs (pneumonia), and shingles, and they can have secondary infections.
“After the resolution of chickenpox in adults, the virus can remain in the nerve root and become latent; it can become reactivated during stress or immunosuppression and cause shingles,” he explains.
“If they need admission to the hospital, they must be admitted and isolated on admission to avoid spreading the infection to other inpatients. We also notify the department of health of this.”
Protective measures
Since it primarily affects children, Dlamini further shares precautions to be taken when living with or caring for someone with chickenpox.
“Protective measures are key to avoiding cross-infection: wear gloves all the time, wash hands before and after touching the child, and use sanitiser after wearing a mask, face shields, and, if available, disposable gowns.
Dr Thabani Dlamini
“If they don’t require admission, they need to take days off school. Someone who’s in close contact should be screened. Should there be a need for post-exposure prophylaxis, they should be given more, especially immunosuppressed individuals or children who are not vaccinated. They should avoid contact with rashes, wear masks, and practice hand hygiene,” advises Dlamini.
He also recommends vaccination against chickenpox and mentions that ever since the introduction of the chickenpox vaccine, they have observed a drop in cases of the disease.
Decline in vaccine popularity and cases
“Before the chickenpox vaccine was introduced, 90% of children had been infected by age 15. The Centres for Disease Control recommend two vaccine doses for children: the first dose at 12–15 months and the second at 4-6 years. They are, however, not popular here in South Africa due to infection decline over the years and their association with self-limiting without need for admission or antivirals,” he says.
With chicken pox vaccinations being effective, we may see a future where chickenpox is a thing of the past. However, until then, it’s important to practise safety precautions, as it is still highly contagious.
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