Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are the possible complications of chickenpox?
Complications can and do occur from chickenpox. Infection of the open pox sore by bacteria can injure the skin, sometimes causing scarring,
especially if the patient scratches the inflamed area. Bacterial skin infection is, in fact, the most common
complication of chickenpox in children. The next most common
complications in children affect the central nervous system and include a
disorder of the cerebellar portion of the brain (cerebellar ataxia
with wobbliness, dizziness, tremor, and altered speech), encephalitis
(inflammation of the brain with headaches, seizures, and decreased
consciousness), damaged nerves (nerve palsies), and Reye's syndrome, a
potentially fatal combination of liver and brain disease that can be associated with aspirin.
(Children with fever should not take aspirin.) Especially
serious complications can occur in patients with AIDS, lupus,
leukemia, and cancer. Complications also occur in people taking immune-suppressing drugs,
such as cortisone-related medications. Newborn infants whose mothers have chickenpox in
the last trimester of pregnancy are at increased risk from the
disease. If the mother develops the disease from five days before to two
days after delivery, the fatality rate for the baby is up to 30%.
Can chickenpox be prevented with a vaccine?
Most people develop lifetime immunity to chickenpox after the first occurrence and never experience it again. But the virus can sometimes resurface later in life as shingles (zoster). The current aim in the U.S. and many other countries is to achieve universal (or nearly universal) immunization of children with the chickenpox vaccine. The vaccination requires only two shots. The first vaccination is given at about
1 year of age, and the second (booster) is given at 4 years of age. If an older person has not had chickenpox, the shot may be given at any time. There have been few significant adverse reactions to the chickenpox vaccine. All children, except those with a compromised immune system, should have the vaccination. Vaccination has been associated with a 90% decrease in the incidence of chickenpox and significantly lower complication rates in those who do develop the symptoms.
Chickenpox is caused by the varicella-zoster virus which also causes shingles.
Chickenpox is highly contagious and spreads by contact with someone with chickenpox.
Fever, malaise, and a rash (red spots, blisters, and crusted lesions) are all symptoms
and signs of chickenpox.
Treatment for chickenpox is basically supportive.
Although usually self-limited, chickenpox can also cause more serious complications, including pneumonia, encephalitis, and secondary skin infections.
The chickenpox vaccine has resulted in a decrease in chickenpox incidence by 90% in the United States.
REFERENCE:
Marin, M., H.C. Meissner, and J.F. Seward. "Varicella Prevention in the United States: A Review of Successes and Challenges." Pediatrics 122.3 Sept. 1, 2008: e744-e751.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Shingles (herpes zoster) is a skin rash caused by the same virus that causes chickenpox. Under certain circumstances, such as emotional stress, immune deficiency, or with cancer, the virus re-activates causing shingles. Shingles are catching and can spread from an infected person to others who have not had chickenpox. There are a variety of treatments for shingles.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Becoming infected with chickenpox during pregnancy could cause birth defects in your unborn child. Likewise, shingles could also cause problems for your unborn child. If you are pregnant and haven't had chickenpox, avoid exposure to infected people. Zostavax, the shingles vaccine, can reduce the incidence of shingles by half. Women should wait at least three months after receiving the vaccine before trying to get pregnant.
Reye's syndrome (RS, or Reye syndrome) is a sudden, sometimes fatal, disease of the brain with degeneration of the liver. Reye syndrome occurs in children and comes after the chickenpox or an influenza-type illness, is also associated with taking medications containing aspirin. Symptoms include vomiting, listlessness, irritability or combativeness, confusion, delirium, delusions, convulsions, and loss of consciousness. Treatment depends on early diagnosis and focuses on protecting the brain against irreversible damage by reducing brain swelling, reversing the metabolic injury, preventing complications in the lungs, and anticipating cardiac arrest.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
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