Chickenpox

Chickenpox is a common illness among kids, particularly those under age 12. An itchy rash of spots that look like blisters can appear all over the body and may be accompanied by flu-like symptoms. Symptoms usually go away without treatment. This is a very communicable disease and a member of the herpes virus family which only infects people. Chickenpox may typically develop two to three weeks after contact. Most children have chickenpox at some stage. The immune system makes antibodies during the infection. These fight the virus and then provide lifelong immunity. A person who has caught chickenpox is very rarely can catch it again.

Vaccination

The best way to protect children from chickenpox is to have them vaccinated. If your child is not yet vaccinated and comes in contact with another child who has chickenpox, he may still be protected if he is vaccinated right away. If one of your children has chickenpox, it will probably spread to other members of the household who are not already immune. If someone else catches the infection, it will appear two to three weeks after the first family member got it. Vaccination can be done usually between the ages of 12 to 15 months. It is also recommended a booster shot at 4 to 6 years old for further protection, people 13 years of age and older who have never had chickenpox or received chickenpox vaccine get two doses of the vaccine at least 28 days apart. Older children and adults who have previously had chickenpox do not need to be vaccinated. Contact your doctor or local health department for further information about the chickenpox vaccine.

The vaccine is about 70% to 85% effective at preventing mild infection, and more than 95% effective in preventing moderate to severe forms of the infection. Healthy children who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness. Although the vaccine works pretty well, some kids who are immunized still will get chickenpox with much milder symptoms than those who haven't had the vaccine and become infected.

The symptoms

The incubation period (from exposure to onset of symptoms) is 14 to 24 days. Chickenpox begins with a fever, followed in a day or two by a rash that can be very itchy. Dry cough and sore throat are also common. The rash starts with red spots that soon turn into fluid-filled blisters. Some people have only a few blisters. Others can have as many as 500. These blisters dry and form scabs in 4 or 5 days. The rash usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body, including the scalp, mouth, nose, ears, and genitals. The rash begins as multiple small, red bumps that look like pimples or insect bites. They develop into thin-walled blisters filled with clear fluid, which becomes cloudy. The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs. Chickenpox blisters are usually less than a quarter of an inch wide, a reddish base, and appear in about 2 to 4 days. Typically, chickenpox is a mild illness, but can affect some infants, teens, adults, and people with weak immune systems more severely.

A person usually has only one episode of chickenpox, but this virus can lie dormant within the body and cause a different type of skin eruption later in life called shingles (or herpes zoster). Getting the chickenpox vaccine significantly lowers your child's chances of getting chickenpox, but he or she may still develop shingles later.


Contagiousness

Chickenpox is very contagious — most kids with a sibling who's been infected will get it as well, showing symptoms about 2 weeks after the first child does. To help keep the virus from spreading, make sure your kids wash their hands frequently, particularly before eating and after using the bathroom. And keep a child with chickenpox away from unvaccinated siblings as much as possible. People who haven't had chickenpox also can catch it from someone with shingles, but they cannot catch shingles itself. That's because shingles can only develop from a reactivation of VZV in someone who has previously had chickenpox.

Chickenpox is contagious from about 2 days before the rash appears and lasts until all the blisters are crusted over. Chickenpox is transmitted to others by direct person-to-person contact with the virus, by droplet or airborne spread of discharges from an infected person's nose and throat or indirectly by contact with articles freshly soiled by discharges from the infected person's lesions. The virus enters the body by the nose or mouth. It can also spread through the air, if you are near someone with chickenpox who is coughing or sneezing. A pregnant woman with chickenpox can pass it on to her baby before birth. Mothers with chickenpox can also give it to their newborn babies after birth. The virus travels in the air and then settles on clothes, bedding, etc. A child with chickenpox is likely to pass it on to most classmates and household members who have not already had it. It takes 14 to 24 days to develop symptoms after catching the virus (known as the 'incubation period'). A child with chickenpox should be kept out of school until all blisters have dried, usually about 1 week. If you're unsure about whether your child is ready to return to school, ask your doctor.

The only way to stop the spread of the virus from person to person is to prevent infected people from sharing the same room or house, which isn't practical. Chickenpox cannot be spread through indirect contact. A person with chickenpox is infectious from 2-4 days before the rash first appears until all the spots have crusted over (commonly about 5-6 days after onset of the illness).

Treating Chickenpox

The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. The drug, which can make the infection less severe, must be given within the first 24 hours after the rash appears. Acyclovir can have significant side effects, so it is only given when necessary. Your doctor can tell you if the medication is right for your child. However, because chickenpox tends to be mild in healthy children, most physicians do not feel that it is necessary to prescribe acyclovir. One important note is that do not give aspirin [acetylsalicylic acid (ASA)] or any products that contain aspirin. Taking aspirin increases the risk of getting Reye's syndrome, which can damage the liver and brain. Taking good care of the skin and not itching may prevent infections that can be caused by bacteria that get into the skin. Your doctor may recommend a cream to help reduce the itch.

Give pain-relieving syrup and plenty of fluids. Calamine lotion and antihistamine medicines may relieve the itching. Keep your child's hands clean and their fingernails short. Try to discourage them from scratching the spots, as they can scar. Give plenty to drink to avoid dehydration. Give paracetamol or ibuprofen to ease fever, headaches, and aches and pains. Crotamiton lotion or cream put on the spots may ease itching. Antihistamine tablets or liquid medicine may help with sleep if itch is a problem. Give a dose at bedtime. You can buy these at pharmacies or get them on prescription.

Here are some tips on treating chickenpox: using cool wet compresses or giving baths in cool or lukewarm water every 3 to 4 hours for the first few days. Oatmeal baths, available at the supermarket or pharmacy, can help to relieve itching. (Baths do not spread chickenpox.) Patting (not rubbing) the body dry. Putting calamine lotion on itchy areas (but don't use it on the face, especially near the eyes).
Give your child foods that are cold, soft, and bland because chickenpox in the mouth may make drinking or eating difficult. Avoid feeding your child anything highly acidic or especially salty, like orange juice or pretzels. Ask your doctor or pharmacist about pain-relieving creams to apply to sores in the genital area. Give your child acetaminophen regularly to help relieve pain if your child has mouth blisters. Ask the doctor about using over-the-counter medication for itching.
Talk to your doctor if you're unsure of the diagnosis or if your child seems particularly unwell, have a cough, headache, if the skin is particularly inflamed or infected, or there are other worrying symptoms. For young babies or children with immunity problems, always seek medical advice.

Note: All information on this site is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.