Varicella Zoster Test Price in Pakistan: Rs 2,940 at Marham Lab

A varicella zoster IgM test looks for antibodies indicating a recent infection with the virus that causes chickenpox. MedlinePlus explains that chickenpox is caused by the varicella-zoster virus, that it is a member of the herpesvirus family, and that the same virus also causes shingles in adults. At Marham Lab the test costs Rs 2,940, reduced from Rs 4,200.

MedlinePlus states that your provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history, and that small blisters on the scalp confirm the diagnosis in most cases. It then notes that lab tests can help confirm the diagnosis if needed.

So a child with the classic rash does not need this test. Where it earns its cost is the uncertain case, and MedlinePlus names exactly where that arises: some children who have had the vaccine will still develop a mild case with fewer than 30 poxes, and these cases are often harder to diagnose. It adds that those children can still spread chickenpox to others.

MedlinePlus states that women who get chickenpox during pregnancy can pass the infection to the developing baby, and newborns are at risk for severe infection.

It also describes who else gets badly ill: adults and older children get sicker than younger children in most cases, severe symptoms are more common in children whose immune system does not work well, and children under 1 year old whose mothers have not had chickenpox or the vaccine can get severe chickenpox. Children whose mothers have had chickenpox or the vaccine are protected early on by antibodies from their mothers' blood.

If someone pregnant, newborn or immunosuppressed has been exposed, that is a same-day call to a doctor, not a wait-and-watch. MedlinePlus says to talk to your provider if you think your child might be at high risk for complications and might have been exposed, because taking preventive steps right away may be important, and giving the vaccine early after exposure may still reduce the severity.

MedlinePlus states chickenpox spreads very easily from 1 to 2 days before blisters appear until all the blisters have crusted over, by touching fluid from a blister or if an infected person coughs or sneezes nearby.

On returning to normal life it is specific: a child with chickenpox should not return to school or play with other children until all chickenpox sores have crusted over or dried out, and adults should follow the same rule for work.

MedlinePlus states most children have fever, headache and stomach ache before the rash appears, and that the rash occurs 10 to 21 days after coming into contact with someone who had the disease. In most cases a child develops 250 to 500 small, itchy, fluid-filled blisters over red spots.

• Blisters are most often first seen on the face, middle of the body, or scalp
• After a day or two they become cloudy and then scab, while new blisters form in groups
• They often appear in the mouth, in the vagina, and on the eyelids
• Children with skin problems such as eczema may get thousands of blisters

It notes most pox will not leave scars unless they become infected with bacteria, which scratching makes more likely.

This is the most important practical warning on the page, and both drugs are sold over the counter here.

MedlinePlus states: do not give aspirin or ibuprofen to someone who may have chickenpox. Aspirin has been associated with a serious condition called Reye syndrome, and ibuprofen has been associated with more severe secondary infections. It says paracetamol may be used.

Brufen is a reflex purchase for fever in Pakistan. In chickenpox it is the wrong choice.

MedlinePlus suggests keeping fingernails short to avoid damaging the skin, wearing cool light loose clothing and avoiding rough fabric such as wool, lukewarm baths using little soap with thorough rinsing, trying an oatmeal or cornstarch bath, applying a soothing moisturiser after bathing, avoiding prolonged heat and humidity, and considering over-the-counter oral antihistamines or hydrocortisone cream, while noting antihistamines can cause drowsiness.

On antiviral medicine it states these are available and not given to everyone, that to work well the medicine should be started within the first 24 hours of the rash, that it is not often prescribed to otherwise healthy children without severe symptoms, and that adults and teens, who are at risk of more severe symptoms, may benefit if it is given early. It flags antiviral treatment as potentially very important for those with skin conditions such as eczema or recent sunburn, lung conditions such as asthma, or recent steroid use.

MedlinePlus states that in most cases a person recovers without complications, that once you have had chickenpox the virus often remains dormant in your body for your lifetime, and that about 1 in 10 adults will have shingles when the virus re-emerges during a period of stress.

Complications it lists are rare infection of the brain, Reye syndrome, infection of the heart muscle, pneumonia, joint pain or swelling, and cerebellar ataxia which involves a very unsteady walk and may appear during recovery or later.