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Antiviral drug could cut chicken pox short.

Each year another 3.5 million children in the United States develop the short-lived but intense itching and blistering rash that signals chicken pox. A new research report indicates, however, that immediate drug treatment can free many of these youngsters from traditional therapies -- oatmeal baths and those messy applications of calamine lotion -- up to three days earlier than usual.

The double-blind study, conducted at 10 university health centers, involved 815 otherwise healthy 2- to 12-year-olds infected with varicella-zoster, the herpesvirus responsible for chicken pox. The reserarchers, led by Lisa M. Dunkle of St. Louis University, randomly assigned half the children to five days of treatment with oral acyclovir, an anti-viral drug best known for its use against genital herpes. The remaining children received a placebo.

Compared with the placebo group, the children on acyclovir developed briefer rashes and fewer chicken pox lesions, the team reports in the Nov. 28 NEW ENGLAND JOURNAL OF MEDICINE. In more than 95 percent of the children treated with acyclovir, the last spots erupted by day 3; all of these youngsters "had completely healed lesions by day 4," the researchers note. In contrast, 80 percent of the children receiving the placebo finished breaking out by day 3, and new spots continued to erupt on most of the remaining 20 percent through day 6. Moreover, fewer of the rash spots ever blistered in the drug-treated group. These children also suffered less fever, malaise, respiratory symptoms and itching than their counterparts in the control group.

Acyclovir may prove useful for early treatment and for treating other children in the family, especially if it becomes available over the counter, asserts Philip A. Brunell of Cedars-Sinai Medical Center in Los Angeles. "Untreated, a second child is expected to have a more severe illness than the first child," he notes in an editorial accompanying the research report.

The Food and Drug Administration is now considering whether to permit acyclovir's maker to add chicken pox to the drug's recommended uses -- a review undertaken "largely in response to our data," says study coauthor Ann M. Arvin of Standford University.

The new findings also indicate that children treated promptly with acyclovir may be well enough to return to school several days earlier than the American Academy of Pediatrics (APA) recommends, notes Dale A. More of Pennsylvania State University. On a national scale, such early returns could spell big economic savings, Brunell adds.

At present, the APA advises parents to keep a child home for six days after the initial rash emerges. With the majority of U.S. parents working outside the home, that can translate into significant wage losses for a parent who stays home to nurse the sick child. More than 95 percent of chicken pox's economic burden in the United States -- some $400 million annually -- "is attributable to parents' loss of income from work," Brunell says.

Nor should a child's early return aggravate the infection's spread, Moore says. In the June 1 AMERICAN JOURNAL OF EPIDEMIOLOGY, she presented results showing that nearly all transmission of chicken pox--probably through coughing--occurs before the rash breaks out.
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Title Annotation:oral acyclovir
Author:Raloff, Janet
Publication:Science News
Date:Nov 30, 1991
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