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CPD: Key questions on chickenpox



Learning Objectives

This module brings you all the latest on chickenpox, including:

  • When to prescribe aciclovir
  • Spotting complications
  • Chickenpox in pregnant women
  • Whether we can expect the chickenpox vaccine to enter the vaccination schedule

Author

Dr Philip Rice is a consultant virologist at the Norfolk and Norwich University Hospitals NHS Foundation Trust.

What evidence-based management options should be considered in the treatment of uncomplicated chickenpox in children and adults?

General common sense advice to all patients with uncomplicated chickenpox is to maintain adequate fluid intake, wear clothing less likely to get caught on or irritate the skin lesions, e.g. cotton fabric, and to keep nails short to minimise skin damage from scratching. The patient should also be advised to avoid contact with vulnerable groups, e.g. pregnant women, neonates and the immunocompromised. Despite placebo-controlled trials and meta-analyses, it is unclear if aciclovir provides any significant benefit to healthy children with uncomplicated infection. In adults, however, it is of benefit if you are able to prescribe it within 24 hours of the rash becoming apparent. As this therapeutic window of opportunity is narrow, in adults I would extend the period to perhaps 48 hours, especially if they themselves are secondary household cases, as these tend to have a more protracted and severe illness.

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