Saturday, January 29, 2011

Bulutong Tubig , Chicken Pox or Varicella Zoster





A 30 year old female consulted for low grade fever 2 days prior to consultation with associated muscle pain, sore throat and lack of appetite. A day before she developed pruritic rashes, starting from the face and scalp down to the chest and abdomen.
On examination patient had fever ,38.2 Centigrade, with red papular rashes,"tear drop",vesicles on face, trunk and in the upper extremities.Patient also had generalized lympadenopathies " kulani" and admitted that a household member exhibited similar symptoms about two weeks ago.She was diagnosed with Chicken pox or Varicella Zoster, or Bulutong Tubig
Patient was given Diphenhydramine 50mg cap, an Anti-histamine 3x day to relieve itchiness. Ascorbic acid 500mg , for faster wound healing,was also given as well as Paracetamol 500mg Tab every 4 hours for fever, in some cases Ibuprofen 400mg or Mefenamic acid 500mg may be given for pain relief. In cases where the rashes develop within 24 hours prior to consultation, anti virals, like Acyclovir 800 mg tab 5x a day for 7 days,maybe given to shorten the time of viral shedding,lessens appearance of new lesions,reduce duration of fever and for faster healing. Acyclovir cream may also be applied to lesions 5x a day , especially in the facial area, to lessen discomfort and scarring. Oral rehydrating salts (Hydrite, Glucolyte etc.) may also be given to prevent dehydration.
Varicella, commonly known as "bulutong" or chickenpox, is caused by the varicella-zoster virus. The disease is generally regarded as a mild, self-limiting viral illness with occasional complications. Usual complications are acute respitatory infections, infected skin lesions while the most serious complications are varicella pneumonia and encephalitis which are associated with a high mortality rate.
Varicella spreads primarily by airborne droplets. The infectious particles are cell-free virus particles derived from skin lesions or the respiratory tract. The disease is infectious a day before the rash appears. The incubation period is typically 10-14 days, although it may extend to 21 days.
The best option to prevent Varicella or Chikenpox is thru vaccination which is available but a bit expensive(Varilrix, Okavax, V-Z Vax).The first dose should be given when the child is 12 - 15 months old.Children should receive the second dose when they are 4 – 6 years old. However, the second dose can be given before age 4, as long as as 3 months have passed since the first dose.
People 13 and older who have not received the vaccine and have not had chickenpox should get 2 doses 4 to 8 weeks apart while people 13 and older who have had a previous dose and have not had chickenpox should receive a second dose.

Reminder: Article was written as a physician's personal experience and should be viewed for information and guide only, and was not intended to replace actual consultation with a medical practitioner.