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About - Varicella

An acute contagious disease that usually occurs in children and is caused by the varicella-zoster virus.

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Acyclovir can reduce the number of days with fever in otherwise healthy children with chickenpox, but its effect on sores and itching is not yet certain

Chickenpox (varicella) is caused by a virus. It begins with a fever, followed by a rash of red pimples which become itchy sores that form scabs. Chickenpox usually affects children from one to 14 years. In young babies, adults or people with impaired immune system, chickenpox is more severe. Treatments include lotions to relieve itchiness, paracetamol (acetaminophen) for fever and the antiviral drug acyclovir. The review of trials found that acyclovir reduces the number of days of fever from chickenpox in otherwise healthy children, usually without adverse effects. It is not clear whether it improves sores and itching.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

How can you avoid getting chickenpox?

Chickenpox is highly contagious. If you are not vaccinated and have never had chickenpox, contact with someone who has it will almost always lead to infection. Early vaccination and being careful around those who have chickenpox are the most important precautions you can take.Chickenpox is caused by the varicella-zoster virus, which is one of the herpes viruses. The German Standing Committee on Vaccination (STIKO) at the Robert Koch Institute recommends being vaccinated to lower your chances of infection. If you or someone in your family gets chickenpox there are several things you can do to avoid spreading it to others.Most importantly, people who have chickenpox should avoid contact with anyone who hasn’t had it and with people who have a greater risk of developing more severe symptoms. This especially includes people with a weakened immune system, newborn babies, and non-vaccinated adults. The virus can harm unborn children during pregnancy, and can be life-threatening for newborns. Generally speaking, though, chickenpox rarely has any serious consequences in children who are otherwise healthy. But it can be unpleasant.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Chickenpox: Overview

The typical signs of chickenpox are a very itchy skin rash with red blisters and a mild fever. This contagious viral infection mainly affects preschool and school-age children between the ages of two and ten. Chickenpox is unpleasant, but it rarely leads to any serious complications in otherwise healthy children.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Post‐exposure prophylaxis vaccine to prevent varicella (chickenpox)

This review assessed how useful the varicella (also known as chickenpox) vaccine is in preventing chickenpox when given to children or adults who have never been immunised or previously had chickenpox, but who receive the vaccine within a short time following exposure to a person infectious with chickenpox. Varicella is a highly contagious viral infection characterised by a widespread pustular rash, fever and generally feeling unwell. We identified three trials involving 110 healthy children who were siblings of household contacts.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Varicella and influenza vaccines may reduce morbidity in patients with blood cancers

Viral infections cause significant disease and even death in patients with blood cancers. In the current systematic review of randomized controlled trials (RCTs) we aimed to evaluate the efficacy and safety of viral vaccines in these patients. The pre‐defined primary outcome was incidence of the infection concerned. Secondary outcomes were mortality due to the viral infection, all‐cause mortality, incidence of complications, incidence of severe viral infection, hospitalization rate, in vitro immune response and frequency of adverse effects. Eight RCTs were included. They evaluated heat‐inactivated varicella zoster virus (VZV) vaccine (two trials), influenza vaccines (five trials) and inactivated poliovirus vaccine (one trial). There were no RCTs on other viral vaccines (hepatitis A, hepatitis B, measles, mumps, rubella). Only the two trials on VZV vaccine reported our pre‐defined primary outcome. All trials reported some of the pre‐defined secondary outcomes. We found that inactivated VZV vaccine might reduce the severity of herpes zoster when given before and after stem cell transplant in adults with lymphoma or leukemia. Inactivated influenza vaccine might reduce upper and lower respiratory infections and hospitalization in adults with multiple myeloma who are undergoing chemotherapy, or children with leukemia or lymphoma within two years post‐chemotherapy. However, the quality of evidence is not high. Local adverse effects occur frequently with the vaccines, although serious adverse effects appear uncommon. Further high‐quality RCTs are needed to clarify the benefits and optimal regimens of viral vaccines for patients with blood cancers.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Shingles: Overview

If you've had chickenpox, you may get shingles. Both conditions are caused by the same virus. Having a weakened immune system – due to severe stress or old age, for instance – can increase the risk of developing this often very painful rash. It usually takes about two to four weeks for shingles to clear up.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Immunogenicity and safety of measles-mumps-rubella-varicella vaccine: a systematic review

Bibliographic details: Wu YM, Li G, Zhao WL.  Immunogenicity and safety of measles-mumps-rubella-varicella vaccine: a systematic review. Chinese Journal of Evidence-Based Medicine 2010; 10(7): 862-868

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Does methotrexate increase the risk of varicella or herpes zoster infection in patients with rheumatoid arthritis? A systematic literature review

OBJECTIVES: Methotrexate (MTX) has become the foundation disease-modifying anti-rheumatic drug (DMARD) for RA. However, concern exists regarding its possible association with infectious complications including varicella zoster virus (VZV) and herpes zoster (HZ). Furthermore, no consensus exists regarding pre-MTX VZV screening or the use of VZV vaccine.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Vaccination in paediatric patients with auto-immune rheumatic diseases: a systematic literature review for the European League against Rheumatism evidence-based recommendations

OBJECTIVES: To analyze available evidence on vaccinations in paediatric patients with rheumatic and autoinflammatory diseases. This evidence formed the basis of the recently constructed European League against Rheumatism (EULAR) recommendations for vaccination of these patients.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Efficacy and safety of measles, mumps, rubella and varicella live viral vaccines in transplant recipients receiving immunosuppressive drugs

The authors concluded that available published data on the efficacy and safety of live viral vaccines was insufficient to derive evidence-based guidelines for use of such vaccines in transplant recipients on immunosuppression. The reliability of the authors’ conclusion is unclear given multiple flaws in the review methods and small number of low quality studies reviewed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Acyclovir versus Valacyclovir for Herpes Virus in Children and Pregnant Women: A Review of the Clinical Evidence and Guidelines [Internet]

Although acyclovir has traditionally been seen as the drug of choice in pregnancy and pediatrics, valacyclovir has the benefit of decreased dosing frequency and potential increased compliance as a result. This report aims to review recent evidence and relevant practice guidelines on the comparative effectiveness of acyclovir and valacyclovir in children with chickenpox and in pregnant women with Herpes Simplex Virus infections, chickenpox and shingles.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 5, 2014
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Metaanalysis of vaccine effectiveness in varicella outbreaks

This review estimated vaccine effectiveness for one dose of immunisation with the live-attenuated OKA-strain of varicella vaccine and assessed the time course of waning immunity. The authors found limited vaccine effectiveness for one dose of this vaccine in varicella (chicken-pox) outbreaks. Due to methodological and reporting weaknesses, the authors' conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Antenatal Care: Routine Care for the Healthy Pregnant Woman

The original antenatal care guideline was published by NICE in 2003. Since then a number of important pieces of evidence have become available, particularly concerning gestational diabetes, haemoglobinopathy and ultrasound, so that the update was initiated. This update has also provided an opportunity to look at a number of aspects of antenatal care: the development of a method to assess women for whom additional care is necessary (the ‘antenatal assessment tool’), information giving to women, lifestyle (vitamin D supplementation, alcohol consumption), screening for the baby (use of ultrasound for gestational age assessment and screening for fetal abnormalities, methods for determining normal fetal growth, placenta praevia), and screening for the mother (haemoglobinopathy screening, gestational diabetes, pre-eclampsia and preterm labour, chlamydia).

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: March 2008
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Valacyclovir compared with acyclovir for the treatment of herpes zoster ophthalmicus in people with an otherwise normal immune system

The aim of this Cochrane Review was to find out if valacyclovir performs better than acyclovir in the treatment of a painful itchy rash caused by the chickenpox virus (herpes zoster ophthalmicus). Cochrane researchers collected and analysed all relevant studies to answer this question and found one study.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Vaccines for preventing herpes zoster (shingles) in older adults

There is a vaccine to prevent shingles. Our objective was to evaluate the effectiveness and safety of the vaccine to prevent shingles in healthy older people.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Fever in children: When is it a good idea to go to the doctor?

When children have a fever, the cause is usually a harmless viral infection. They are only rarely seriously ill. It is good for parents to know which symptoms could be signs of a serious illness, though.Many parents of children who have a fever feel worried and ask themselves the following questions: Is it something serious? Should we go to the doctor? Does the fever need to be lowered?Parents are in the best position to judge whether their child is behaving abnormally – for instance reacting differently to them or to a toy. The child may be much less active, feel very unwell or stop drinking. Their judgment and experience are very important, and can also be of help to the doctor.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Fever in children: Overview

Many parents start feeling anxious when their child has a hot, flushed face and is running a high fever. Most of the time a harmless viral infection is the cause. But it is still good for parents to know the signs of more serious medical problems and to realize when a doctor is needed.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Eczema: Overview

Eczema is an inflammatory skin condition that often occurs in children. The main symptom is a very itchy rash. Acute flare-ups can greatly affect quality of life, but eczema often gets better over time or even clears up completely.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 23, 2017

Respiratory Precautions for Protection from Bioaerosols or Infectious Agents: A Review of the Clinical Effectiveness and Guidelines [Internet]

There are a number of infectious diseases that are transmitted from person to person via the respiratory route, including influenza, tuberculosis (TB), and severe acute respiratory syndrome (SARS) coronavirus, and these infectious agents are associated with considerable morbidity and mortality. Healthcare workers (HCWs) are vulnerable to exposure to these agents given the nature of their jobs, and as a result, risk both becoming infected, and spreading the infectious agents to other patients. To avoid transmission of these infectious diseases to (HCWs), exposure-appropriate respiratory precautions are sometimes necessary to protect both HCWs and the patients they care for. However, the selection of respiratory equipment depends on the pathogen, aerosol generation rate, and ventilation rate.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: August 19, 2014
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Crohn's Disease: Management in Adults, Children and Young People

This guideline intends to show the place of both new and established treatments in the wider care pathway for Crohn's disease. This will be useful for clinicians and people with Crohn's disease because new drugs have been licensed for Crohn's disease in the last decade. The guideline also deals with those medications which are unlicensed for treatment of the condition, but which have been used in this way (off-label) for many years and their role is recognised in other NICE documents as well as the British National Formulary. They include azathioprine, mercaptopurine and methotrexate. The guideline aims to help improve the care offered to people with Crohn's disease and provide information about the clinical and cost effectiveness of potential care pathways. Management of Crohn's disease in specific populations (for example, in pregnancy) may require special consideration.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: October 10, 2012
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