By: Dr. Tii Ngwachi Munghieng, MD. Medically reviewed by the DLHA Editorial Team
A child with chickenpox rash showing fluid-filled blisters across the body, a symptom of the varicella-zoster infection.
Chickenpox is a reality in Africa. It occurs across all socio-economic groups and geographical regions in the continent. It is not uncommon in a typical African home or community to see a child with some sort of rashes all over the body. The rashes may initially contain fluids, but later burst and dry off accompanied by fever. Children in other homes or in the community, especially at school, who had never had similar issues could easily pick up the same rashes if they come in contact with the affected child. This is the typical situation in which chickenpox occurs and spreads in African communities. Although in-depth studies of the condition across African countries are limited, it remains significantly important to raise awareness and provide reliable and accurate basic education about the cause, symptoms, diagnosis, treatment and prevention of chickenpox to people within the continent. So, read on and learn!
Chickenpox, also called varicella, is a highly contagious infectious disease (i.e., spread from one person to the other). It is extremely common in children, although adults with low immunity may also have the disease.
The very first infection in a person by this virus (varicella zoster virus) causes chickenpox and when it is reactivated or becomes active again, it causes shingles (Herpes zoster).
Chickenpox is caused by the Varicella-Zoster Virus (VZV), a member of the herpesvirus group.
Approximately 90% of close contacts, who are non-immune (not vaccinated or never had chickenpox in the past), will catch chickenpox after exposure to persons with the disease. [2]
A person with varicella is contagious from 1-2 days before rash onset until the sores have crusted (dried off). The incubation period (time from infection with the virus to the onset of symptoms) is approximately 10-21 days (average of 14-16 days) after exposure to the virus.
Chickenpox is spread partly through the air (i.e., airborne) by coughing or sneezing, and partly through direct contact with an infected person’s blister fluid, saliva, mucous or contaminated beddings.
In African communities, the sense of unity and communal living usually facilitate the spread of chickenpox. Often, going close to a sick person to show support and sympathy can lead to easy transmission of the virus through air droplets or contact with the blisters.
Knowing the symptoms and signs of chickenpox makes it easier to identify.
Chickenpox or Varicella typically starts with fever, then the appearance of itchy fluid-filled rashes/blisters, which eventually bursts and dries off. [1]
Fever, lethargy (body weakness), loss of appetite, headache and tiredness may occur 1 to 2 days before rash onset, particularly in adults.
In children, the rash is often the first sign of disease and usually appears first on the head, chest, and back before spreading to the rest of the body. The rash is itchy and progresses rapidly from flat sores to fluid-filled blisters before crusting.
Generally, lesions appear in clusters, and are therefore present in different stages of development – some at the papule (pimple-like), others at the blister and still others at the crusted (dried) stage.
Asymptomatic infection (without rash, or with very few blisters) may occur.
A person of any age can contract chickenpox and it is a potentially serious disease when it occurs in children, adults, pregnant women, and people with compromised or weak immune systems. The risk of catching chickenpox is higher in those who work in or attend a school, child care facility or live with children.
The following groups are highly at risk for varicella;
It should be noted that anyone can catch chickenpox if they have not had it previously, or if they have not been vaccinated against varicella.
Generally, chickenpox is diagnosed clinically and typically requires no specific medical treatment. The disease will run its course with supportive care. You should however see a doctor once you notice symptoms and signs that you have the condition. This will enable your doctor to rule out other conditions that may mimick chicekenpox and require specific treatment.
Chickenpox is diagnosed clinically without the need for extensive laboratory testing. However, the following tests (if locally available) help in confirming the clinical diagnosis:
What Else May Look Like Chickenpox?
The following listed conditions or diseases may look clinically like varicella:
The treatment of chickenpox is usually symptomatic. While the disease is self-limiting, supportive treatment include;
Although varicella is a mild illness, it can have some serious complications if neglected.
In children, secondary bacterial infections of the skin lesions is the most common complication, usually due to Staphylococcus aureus. In adults, pneumonia is a common complication. [3]
Severe complications are rare, but include;
People at high risk for complications or severe infections include; immunocompromised persons, people with HIV/AIDS, and pregnant women.
Infection during the 1st or early 2nd trimester of pregnancy may occasionally cause complications in the baby called congenital varicella syndrome.
Mortality or death rate following chickenpox (varicella) is lowest for children (1/100,000 cases) but higher for adults (25/100,000 cases) [1].
The most important and common way to prevent varicella infection is through vaccination. Vaccination against varicella is not part of the Expanded Programme of Immunisation in most African Countries, [4] but is indicated for children and adults in high risk categories. The ideal age of vaccination is between 12-15 months [5]. Individuals vaccinated against chickenpox can still get the disease, though they usually suffer from milder symptoms.
Although chickenpox affects people globally, there are several factors that could increase the burden of varicella disease in Africa. These factors include;
No. Chickenpox is generally not deadly as most cases are mild and resolve without complications. However, it can be serious and even life-threatening for individuals with weakened immune systems.
Yes, adults can have chickenpox, and they are at a higher risk of experiencing more severe symptoms and complications compared to children. Adults who have never had chickenpox or the vaccine are susceptible to the virus. It is therefore important for unvaccinated adults to consider vaccination to reduce their risk.
To care for a child with chickenpox, especially in Africa, the following are recommended;
1. Keep your child at home to avoid further spread of the virus
2. Keep their fingernails trimmed short to avoid scratching which can lead to infections
3. Use calamine lotion or any anti-itch lotion to reduce the itches
4. Tepid sponge (wipe with lukewarm water) to reduce fever. Use acetaminophen to reduce fever and pain
5. Avoid aspirin and Ibuprofen use. Aspirin has been shown to cause Reye's syndrome in children with chickenpox. Ibuprofen has been associated with life-threatening skin infection.
6. Keep the child properly hydrated. Let the child drink enough water every day.
7. Practise good hygiene to help prevent infections
Chickenpox is an important public health concern, particularly in Africa where healthcare resources are limited. It is essential that individuals are aware of how to identify the condition, how to prevent it and its possible complications. In addition, by raising awareness and promoting prevention through vaccination within communities, the burden of chickenpox can be reduced across African nations.
1. Hussey H, Abdullahi L, Collins J, Muloiwa R, Hussey G, Kagina B. Varicella zoster virus-associated morbidity and mortality in Africa - a systematic review. BMC Infect Dis. 2017 Nov 14;17(1):717. doi: 10.1186/s12879-017-2815-9. Available from here.
2. Feng H, Zhang H, Ma C, Zhang H, Yin D, Fang H. National and provincial burden of varicella disease and cost-effectiveness of childhood varicella vaccination in China from 2019 to 2049: a modelling analysis. The Lancet Regional Health – Western Pacific, 2023; Volume 32, 100639 Available from here.
3. Centers for Disease Control and Prevention (CDC). Clinical overview of chickenpox (Varicella). [Internet, n.d.]. Cited December 21, 2024. Available from here.
4. WHO Position Paper. Varicella vaccine. [Internet[. Weekly Epidemiological Report.1998;73 (32), 241-248, [Cited December 20, 2024]. Available from here.
5. Lee YH, Choe YJ, Lee J, Kim E, Lee JY, Hong K, Yoon Y, Kim YK. Global varicella vaccination programs. Clin Exp Pediatr. 2022 Dec;65(12):555-562. doi: 10.3345/cep.2021.01564. Available from here.
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Published: December 26, 2024
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