With Bird Flu apparently on the rise again in Cambodia, will it fly across the
Mekong and infect Thailand? Of course it will, and probably has done already.
But since the world statistics from Bird Flu (A/H5N1) has only been 564 cases
over eight years, you are more likely to be run over on the road (especially
during Songkran).
However, there is another “chicken” disease, Chicken pox!
Actually, chicken pox (AKA Varicella) is not really caused by chickens, nor even
carried by them. Chicken pox is a very common disease caused by the varicella
zoster virus which is a member of the herpes virus family. It is very contagious
and all communities experience epidemics.
A few years back there was a real outbreak in Thailand, with
22,833 patients with the complaint between January and May. This nasty condition
never actually leaves the community, lying quiet for a while and then attacking
in epidemic proportions. Make no mistake about this one, it is a most aggressive
disease that sweeps through schools and institutions and while generally a
disease of children, it can attack adults too with devastating results.
The varicella zoster virus is known for the characteristic
chickenpox lesions. These come out very quickly after an initial period of vague
symptoms such as fever and aches in muscles and joints. The lesions (vesicles)
are very superficial on the skin and grow like a mini-Vesuvius, burst and then
crust over. That cycle of events takes around four days, but new crops of
vesicles come up in waves in the first three or four days, so you can have some
vesicles growing bigger while earlier ones are drying up and crusting over.
The vesicles generally come out on the trunk and face first,
but can spread to all over the body and even inside the mouth and on the tongue.
Now while scarring is always a worry for the Mums of this world, there are far
worse effects from this little virus. There is a distinct possibility of an
encephalitis in older children and adults can actually develop a varicella
pneumonia. Pregnant women who get chickenpox also run the risk of infecting the
unborn child, and this can run as high as 10 percent. Very often, especially if
the child scratches the lesions, there can be an added infection by an
opportunistic bacterium on top of the viral lesions, so you get a double
problem.
So what do you do when chickenpox is doing the rounds? The
first thing is to keep away from those who have the disease. It is highly
contagious and is spread by inhalation of micro droplets in the air, or by
direct contact with weeping vesicles. In a family, this means that little Johnny
gets his own towel that no-one else must use and a bed-time kiss is strictly
forbidden.
Calomine lotion does help with itchy and weeping vesicles and
trim the fingernails in young children to lessen the chances of scratching. With
very little ones, I even suggest putting their hands in socks, just as you do
with little babies.
If the temperature is raised (more than 37.5 Celsius) then a
little paracetamol will help (but not aspirin as this drug should not be used
with children), and if there is the “super-infection” by a bacterium it will be
necessary for your doctor to prescribe an appropriate antibiotic.
The other important duty that you have as a parent, is do not
send little Johnny back to school until the very last vesicle has dried up. This
is generally around a week to ten days, but is so important in trying to stop
the epidemic.
The other nasty part of this virus is that it lies dormant in
your system and can strike back many years later as Shingles, or as we medico’s
call it, Herpes Zoster. No, chickenpox is not fun, and to those of you who are
struggling with it right now, you have my sympathies.
However, we do have a varicella vaccine these days, and
vaccination is recommended from about 12 months of age. Like all vaccination
programs, this will radically reduce the impact of epidemics.
