$Unique_ID{BRK04308} $Pretitle{} $Title{Varicella Zoster Virus} $Subject{Varicella Zoster Virus Chickenpox Shingles-herpes Zoster Herpes Simplex (Cold Sores, Fever Blisters and Genital Herpes) } $Volume{} $Log{} Copyright (C) 1989, 1990, 1992 National Organization for Rare Disorders, Inc. 686: Varicella Zoster Virus ** IMPORTANT ** It is possible that the main title of the article (Varicella Zoster Virus) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Chickenpox Shingles-herpes Zoster Information on the following diseases can be found in the Related Disorders section of this report: Herpes Simplex (Cold Sores, Fever Blisters and Genital Herpes) General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. The varicella-zoster virus is a common herpes virus that causes chickenpox during childhood, and shingles (herpes zoster) during adulthood. Symptoms The varicella-zoster virus causes chickenpox in children. After exposure to, the virus, the incubation period is between 11 to 21 days. The severity of the chickenpox ranges from a slight rash to many hundreds of blisters and a fever as high as 105 degrees F. Chickenpox symptoms begin with a slight fever, sore throat, runny nose and a general feeling of discomfort. This precedes the rash by a few days. The rash first appears on the back and chest, quickly covering the body. Spots may also appear in the mucous membranes such as those of the mouth, vagina or in the ears. The rash develops quickly into clear, oval blisters of various sizes. These soon become cloudy in color and within three to four days turn to scabs. It may take another week for the scabs to fall off. After the rash first appears, it will continue to erupt for three to four days, and is often very itchy. During this time, and until all the lesions are scabbed over a child with chickenpox is still contagious, and should be kept isolated. Chickenpox dan be life-threatening to children with a compromised immune system such as cancer patients undergoing chemotherapy, or asthmatics taking steroid drugs for prolonged periods. Shingles (herpes zoster) occurs when the varicella-zoster virus is re- activated for unknown reasons. It is a non-seasonal infection occuring most often in older people and in those whose immune system is suppressed. Non immune individuals, especially children, may develop chickenpox after contact with a person who has active herpes-zoster virus. Shingles first appears as a rash, similar to chickenpox, but finer in appearance. The rash usually occurs on one side of the body or face, in an area involving one particular spinal nerve. The nerve pain (neuralgia), can persist for several months or even years. (For more information on this disorder, choose "Shingles" as your search term in the Rare Disease Database.) Causes The varicella-zoster virus is a member of the herpes virus family. It is transmitted in the form of airborne droplets. Affected Population Chickenpox affects males and females in equal numbers. It is most common in between the ages of 5 and 9. Shingles usually occurs in adults over the age of 50. These disorders are very prevalent in the United States and throughout the world. Related Disorders Symptoms of the following disorders can be similar to those of Varicella Zoster Virus. Comparisons may be useful for a differential diagnosis: Cold Sore and Fever Blisters are a common, recurrent infection by the herpes simplex virus. There are two types of Herpes Simplex. Type 1 causes infections around the lips and in the cornea. It is characterized by the appearance on the skin or mucous membranes of clusters of small blisters, filled with clear fluid on slightly red bases. Type 2 usually affects the genital area and is transmitted primarily by direct contact with lesions, most often during sexual intercourse. (For more information on this disorder, choose "Herpes Simplex" as your search term in the Rare Disease Database.) Therapies: Standard There is no specific treatment for Chickenpox. However, Calamine lotion has a soothing and drying effect on the rash and an antihistamine drug may be prescribed to reduce the itchiness. It is most important to keep the patient from scratching the blisters and scabs, because scarring and further infection can result. Acetaminophen, given every 4 hours will help reduce the fever and headache. Aspirin should NOT be given to children with Chickenpox because it can cause Reye's Syndrome. (For more information concerning this disorder, choose "Reye" as your search term in the Rare Disease Database.) There is no specific treatment for Shingles. Anesthetic medications for the rash, and aspirin or other analgesics for the nerve pain may be prescribed. Corticosteroids (if given early), may relieve pain in severe cases. Locally applied wet compresses may be soothing. For immunosuppressed patients, antiviral drugs, such as acyclovir and vidarabine have been used, with acyclovir found to be the most effective. Until a vaccine for chicken pox becomes commercially available, children with a compromised immune system should guard against exposure to the Varicella Zoster Virus. Therapies: Investigational Clinical trials are being conducted on the experimental drug Arabinosyl adenine (ARA-A) for treatment of Herpes Zoster (Shingles). A Chicken Pox vaccine is being tested by Merck, Sharp & Dohme. (For more information on this disorder, choose "Shingles" in the Rare Disease Database. Scientists are studying the effectiveness of the antiviral drug, acyclovir, in the treatment of children with Chicken Pox. The drug seems to speed up the recovery time of patients with the disease. This disease entry is based upon medical information available through January 1992. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Varicella Zoster Virus, please contact National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Centers for Disease Control (CDC) 1600 Clifton Road, NE Atlanta, GA 303332 (404) 639-3534 NIH/National Institute of Allergy and Infectious Diseases 9000 Rockville Pike Bethesda, MD 20892 (301)496-5717 References INTERNAL MEDICINE, 2nd Ed.: Section 7; Merle A Sande, M.D.; Little, Brown and Co., 1987. Pp. 1605. THE COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS COMPLETE HOME MEDICAL GUIDE, Stephen Atwood, M.D.; Crown Publishers Inc., 1985. Pp. 222. THE WORLD BOOK MEDICAL ENCYCLOPEDIA, Your Guide To Good Health; Stuart Levin, M.D., World Book Inc., 1988. Pp. 172. NIH CONFERENCE VARICELLA -ZOSTER VIRUS INFECTIONS. BIOLOGY, NATURAL HISTORY, TREATMENT, AND PREVENTION. SE Strauss, et al.; ANN INTERN MED (February, 1988 (August 29, 1988, issue 198(2)). Pp. 221-237. CURRENT THERAPY OF VARICELLA-ZOSTER VIRUS INFECTION IN IMMUNOCOMPROMISED PATIENTS. A COMPARISON OF ACYCLOVIR AND VIDARBINE. DH Shepp et al.; AM J MED 1988 (August 29, 1988; issue 85(2A)). Pp.96-98 IMMUNIZATION OF HEALTHY ADULTS WITH LIVE ATTENUATED VARICELLA VACCINE. AA Gershon et al.; J INFECT DIS (July 1988; issue 158(1)). Pp. 132-13. LIVE ATTENUATED VARICELLA VACCINE IN HEALTHY 12-to-24 MONTH OLD CHILDREN. CE Johnson et al.; PEDIATRICS (April 1988; issue 81(4)). Pp. 512-518.