Chickenpox

Varicella-Zoster Virus (VZV)

Varicella-Zoster Virus (VZV) is a member of the herpesvirus family responsible for two critical human diseases: chickenpox (varicella) and shingles (herpes zoster). The virus is highly contagious and primarily spreads through direct contact with respiratory secretions or fluid from skin lesions. Understanding the characteristics of VZV, associated diseases, and prevention methods is essential for public health awareness.


What is Varicella-Zoster Virus (VZV)?

Varicella-Zoster Virus is a double-stranded DNA virus that infects only humans. Following initial infection (chickenpox), the virus remains dormant in sensory nerve ganglia and can reactivate later in life, leading to shingles.


How Does VZV Spread?

  • Direct contact with blister fluid from chickenpox or shingles

  • Respiratory droplets during coughing or sneezing

  • Indirect transmission through contaminated surfaces followed by self-inoculation


VZV-Related Infections and Diseases

1. Chickenpox (Varicella)

  • Occurs mainly in children but can also affect adults

  • Symptoms: fever, fatigue, itchy rash, and vesicular blisters

  • Usually mild in healthy children but may cause complications in adults, neonates, or immunocompromised individuals

2. Shingles (Herpes Zoster)

  • Results from reactivation of latent VZV in nerve ganglia

  • Symptoms: localized painful rash, burning or tingling sensation, blisters on one side of the body

  • Potential complication: postherpetic neuralgia, characterized by persistent nerve pain even after the rash heals

3. VZV-Associated Complications

  • Viral pneumonia

  • Encephalitis and meningitis

  • Secondary bacterial skin infections

  • Congenital varicella syndrome (if maternal infection occurs during pregnancy)


Diagnosis of VZV Infections

  • Clinical evaluation based on rash distribution and characteristics

  • Laboratory confirmation through PCR, direct fluorescent antibody (DFA) tests, or serology (antibody detection)


Treatment for VZV Infections

  • Antiviral therapy: Acyclovir, Valacyclovir, or Famciclovir to reduce severity and duration

  • Pain management: Analgesics and topical agents

  • Supportive care: Adequate rest, hydration, and antihistamines for itching


Prevention of VZV Infection

  • Varicella vaccine (Varivax): Recommended in childhood to prevent chickenpox

  • Shingles vaccine (Zoster vaccine): Recommended for adults, particularly those aged 50 years and above

  • General measures: Avoid close contact with infected individuals and maintain good hygiene


Frequently Asked Questions (FAQs)

Q1: What is Varicella-Zoster Virus (VZV)?

VZV is a human herpesvirus that causes chickenpox (varicella) during the initial infection and can remain dormant in the body, later reactivating as shingles (herpes zoster).

Q2: How is VZV transmitted?

  • Respiratory droplets from coughing or sneezing

  • Direct contact with fluid from chickenpox or shingles blisters

  • Indirectly via contaminated surfaces followed by self-inoculation

Q3: Who is most at risk for severe VZV infection?

  • Adults who never had chickenpox or the vaccine

  • Pregnant women

  • Newborns whose mothers were infected during pregnancy

  • Immunocompromised individuals (cancer patients, transplant recipients, HIV patients)

Q4: What are the main complications of VZV infection?

  • Chickenpox: pneumonia, encephalitis, bacterial skin infections

  • Shingles: postherpetic neuralgia (chronic nerve pain), vision loss (if affecting the eye)

  • Pregnancy: congenital varicella syndrome

Q5: Is chickenpox a mild disease for everyone?

No. While usually mild in children, chickenpox can cause severe illness in adults and high-risk groups, sometimes requiring hospitalization.

Q6: Can I get chickenpox twice?

It’s very rare. After the first infection, the virus usually stays dormant. However, it may reactivate later as shingles, not chickenpox.

Q7: How is shingles different from herpes simplex (cold sores)?

Shingles is caused by Varicella-Zoster Virus, while cold sores are caused by Herpes Simplex Virus (HSV-1 or HSV-2). They are different viruses within the herpesvirus family.

Q8: Are there vaccines for both chickenpox and shingles?

Yes.

  • Varivax (chickenpox vaccine) is recommended for children and non-immune adults.

  • Shingrix or Zostavax (shingles vaccines) are recommended for adults over 50 years.

Q9: Is the VZV vaccine safe?

Yes. The chickenpox and shingles vaccines are safe and effective, with only mild side effects like redness, soreness, or a low-grade fever.

Q10: What should I do if exposed to chickenpox or shingles?

  • If you are vaccinated or had chickenpox before, you’re usually protected.

  • If unvaccinated and high-risk, contact a healthcare provider immediately for post-exposure prophylaxis (Varicella vaccine or VariZIG immune globulin).


Who Should Get the Varivax Vaccine?

Varivax is approved for use in individuals aged 12 months and older. The following groups are strongly encouraged to receive the vaccine:

  • Children (first dose at 12–15 months; second dose at 4–6 years)

  • Teenagers and adults who have never had chickenpox or the vaccine

  • Healthcare workers

  • Teachers and childcare workers

  • Women of childbearing age (who are not pregnant)

  • International travelers


Who Should NOT Get Varivax?

Varivax is not recommended for:

  • Pregnant women or those planning pregnancy within 3 months

  • Individuals with severe allergic reactions to neomycin, gelatin, or any component of the vaccine

  • People with weakened immune systems due to disease or medical treatment

  • Those with active untreated tuberculosis

  • Individuals with moderate to severe febrile illness


Chickenpox Vaccine Price in Bangladesh

As of the latest update, the price of the Varivax vaccine in Bangladesh is:

šŸ’‰ BDT 10,823.00 for a 0.5 ml vial

The vaccine is available at specialized vaccine providers such as Pledge to Protect and select healthcare institutions. While the cost may seem high, it is a worthy investment for long-term protection against chickenpox and its complications.


Overview of Varivax: The Trusted Chickenpox Vaccine

  • Brand Name: Varivax

  • Generic Name: Varicella Virus Vaccine, Live

  • Manufacturer: Merck & Co.

  • Distributed in Bangladesh by: Healthcare Pharmaceuticals Ltd.

  • Formulation: 0.5 ml/vial (for subcutaneous injection)

Varivax is a live attenuated vaccine, meaning it contains a weakened form of the varicella-zoster virus. It stimulates the body’s immune system to produce protective antibodies without causing the disease in healthy individuals.


Final Thoughts

Varicella-Zoster Virus is clinically significant due to its ability to cause primary infection (chickenpox) and secondary reactivation (shingles). While chickenpox is generally mild in children, it may be severe in adults and immunocompromised individuals. Shingles, conversely, is associated with complications such as postherpetic neuralgia, which can severely affect quality of life.

šŸ’” Availability:

The VARIVAX Vaccine is offered by Healthcare Pharmaceuticals LtdĀ and can also be obtained viaĀ Pledge to ProtectĀ (pledgetoprotect.net) for safe and reliable access.

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