Chickenpox is caused by the varicella zoster virus (which also causes shingles or herpes zoster). It is also called Human Herpesvirus 3. Providers must maintain standard, airborne, and contact precautions until lesions have crusted as the virus is highly contagious.
Children first present with a red maculopapular rash, which progresses almost immediately to vesicles, each with an erythematous base. It is important to remember that these will all be at varying stages.
As the virus progresses papules and vesicles crust presenting in varying stages at any one point in time.
The vesicles of this virus are extremely itchy and bothersome to the child. Encourage children not to scratch, as scarring can develop.
The rash has a centripetal distribution meaning it spreads to the face and proximal extremities; less on distal limbs and areas not exposed to heat.
Immunization is available to decrease incidence of this viral infection.
Priorities of treatment involve skin care to decrease pruritus or itching. Encourage children not to scratch, as it could result in scar formation. Applying calamine lotion to the skin or placing young ones in mittens can help prevent scratching.
Children should be isolated from contact with others until the vesicles have crusted. The virus is no longer contagious when the vesicles have dried or crusted and children can return to school, which is about a 1 week after the onset of the disease.
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