Chickenpox

Chickenpox (varicella) is a highly contagious viral disease caused by varicella-zoster virus (VZV). The main symptom is a blistering skin rash. Outbreaks are more common in winter and early spring. A vaccine is available.

Chickenpox is spread by air-borne droplets from the upper respiratory tract (coughing, sneezing) or from the fluid in the skin blisters (lesions). An infected person is contagious for 1–2 days (possibly five days) before the onset of the rash and remains infectious until the blisters form scabs (usually around day five of the illness). Children with chickenpox should not go to school or kinder until the last blister has dried. You should tell your child’s school or kinder if your child gets chickenpox, as other children may need to be immunised or treated.

For most healthy people, chickenpox is mild and the person recovers fully without specific treatment. However, complications occur in approximately one per cent of cases. It is more severe in adults and anyone of any age with impaired immunity. Immunisation is the best way to prevent chickenpox.

Symptoms
The symptoms of chickenpox include:

* The person develops a low-grade fever.
* The person experiences general discomfort, illness or lack of wellbeing (malaise).
* A skin rash appears as little blisters surrounded by irregular-shaped patches of inflamed skin (‘dew drop on a rose petal’).
* The rash usually starts on the body, then progresses to include the head and limbs.
* Ulcers may develop in certain areas, including the mouth and vagina.
* The rash is intensely itchy.
* The little blisters burst and develop crusts, usually about day five.

How it is spread
Chickenpox is spread by air-borne droplets from the upper respiratory tract (when the infected person coughs or sneezes) or from touching the fluid in the skin blisters (lesions). An infected person is contagious for 1–2 days (possibly five days) before the onset of the rash and remains infectious until the blisters form scabs (usually around day five of the illness).

The time from infection to appearance of the rash (incubation period) for chickenpox is around 14–16 days. A few days prior to the rash appears, the person may feel feverish with a sore throat and headache. Their skin may be marked for some months after the rash has cleared.

Children with chickenpox should not go to school or kinder until the last blister has dried or until all blisters are covered. You should tell your child’s school or kinder if your child gets chickenpox, as other children may need to be immunised or treated.

Immediate Treatment for Injuries

If you suffer an injury during exercise, following a few simple recommendations can help you recover quickly and avoid a chronic problem. If you feel acute pain while exercising, you should:

* Stop exercising immediately.
* Wrap the injured part in a compression bandage.
* Apply ice to the injured part.
* Elevate the injured part to reduce swelling.
* Get to a physician for a proper diagnosis of any serious injury.

What should I do if I get injured?

Obviously a serious trauma injury, such as a broken bone or ruptured ligaments, will require immediate medical attention, but most injuries are not so dramatic, and some may even respond simply to rest.

When you get injured, there is typically swelling, redness, tenderness and increased temperature. This inflammatory response is how the body tries to heal itself – it is the body's attempt to dispose of blood (from torn tissue) and damaged cells.

Excessive swelling (oedema) can interfere with the initial healing process, so it's important in the early first aid treatment of sports injury to help limit this swelling. The acronym NICER is a useful reminder:

* N = non-steroidal anti-inflammatory drugs, such as ibuprofen, which reduce inflammation and swelling, and alleviate pain (remember to check the label for contraindications).
* I = ice, or cold therapy, since this decreases pain and limits the extent of the swelling. Ice should never be placed directly against the skin. The time for which a tissue should be cooled depends upon the site and severity of the injury.
* C = compression, usually in the form of a compression bandage. This mechanically limits the amount of swelling by restricting the amount of space in and around the injury.
* E = elevation. This also helps control swelling since fluid is drained more effectively from the injury.
* R = restricted activity. To allow the healing process to proceed, the injured area must be rested initially.


Who's the best person to treat my injury?

If your injury is minor – not much more than a little stiffness or soreness – it may be that you have simply been doing a little too much too soon and the affected area just needs rest.

However, there may be underlying reason for the soreness, extrinsic or intrinsic, and it never pays to ignore an injury, especially when it may be very easy to locate its cause.

Start with a sports physiotherapist if the problem seems to be related to sport, or you've had it before, or with your GP, who may then suggest you see one or more of various therapists. You could be referred for:

* Physiotherapy - this covers a well-established group of treatments or techniques, frequently involving physical manipulation of the affected area. It's offered in hospitals, on the high street, in doctors' surgeries, and often in gyms and sports centres. Physiotherapy is a very broad term and many physiotherapists specialise in a particular area of the body, so you may need some guidance in choosing the right therapist for you. Physiotherapy is available on the NHS, but these days you usually have to wait weeks and months. If you can decide to see a physio privately, you can refer yourself directly.

* Podiatry - podiatrists specialise in diagnosis and treatment of disorders affecting the foot and lower limb. They can provide relief of painful symptoms and also preventive care for people with conditions that may affect the health of their feet. A podiatrist might prescribe and manufacture orthoses - specialist insoles that can address problems like pronation by holding the foot in a stable position and preventing it rolling inwards. Podiatry is rarely offered on the NHS, so you'll probably have to pay to see a podiatrist privately.

* Osteopathy - this is a complementary therapy that focuses on musculo-skeletal problems. It concentrates primarily on problems with muscles, joints and nerves and employs a range of physical and manual techniques. In the UK it's considered a complementary therapy, so access to osteopathy on the NHS is limited, but some osteopaths work alongside GPs, and GPs are permitted to refer patients to them. You can also go to see them privately without referral.

* Chiropractic - chiropractors use physical manipulation to treat problems with joints, bones and muscles, and the effects they have on the nervous system. Chiropractors place particular emphasis on the spine, which is why they tend to be associated with treating bad backs. Like osteopathy, chiropractic is only available as an NHS treatment in some areas, depending on the policy of the local primary care trust, or you can see them privately without referral.