Chickenpox (also known as varicella) is a very contagious, easy-to-spread infection caused by the varicella-zoster virus. Chickenpox is a very common childhood infection. Most children by the age of nine will have had chickenpox.
This virus is spread from one person to another in one of two ways:
By direct contact with the actual rash; or through the air by coughing or sneezing, just like with a cold.
The symptoms of chickenpox vary from child to child. Some children develop such a mild form of chickenpox that their parents do not even realize that they have had it. However, in typical cases, the disease starts with one or more of the following symptoms:
- Cold-like symptoms
Within a day or so, the typical chickenpox rash develops, which is a very characteristic one and usually easy to identify. The rash begins as a round or oval red spot that develops a blister-like center full of a yellowish fluid containing the varicella virus. The rash, which can be quite itchy, may occur anywhere on the body. Some children develop very few blisters while others seem to have their whole body covered.
When is chickenpox contagious?
A child developing chickenpox is considered to be contagious a couple of days before the rash breaks out. This is why the disease spreads so easily, as children are contagious before the rash comes out and generally are still attending school or daycare. Once the rash appears, the child is contagious for about three to five days, or until all the blisters have dried and crusted off. Only when all the lesions are crusted can a child return to school or daycare.
Parents often wonder how long it takes to develop the illness after being exposed to a child with chickenpox. This period—known as the incubation period—ranges between eleven and twenty days, although for most children it develops within fourteen days. If a child does not develop chickenpox after this period, then he or she has not been infected this time.
Fortunately, most children do not suffer any serious consequences from chickenpox infections. From a community and societal point of view, chickenpox can be expensive and inconvenient. Because children have to miss school, parents have to miss work, causing inconvenience and a loss of productivity all around. However, approximately one in two thousand children may develop more serious complications requiring hospitalization. These complications include:
- Bacterial infection of the rash, and, rarely, flesh-eating disease
- Brain inflammation or encephalitis
- Balance problems related to infection of a specific part of the brain (cerebellitis) and
- Death (very rare)
Who is particularly susceptible to chickenpox?
Varicella zoster infections are more serious or dangerous in the following groups of high-risk individuals:
-Very young children
-Adults or children with weak immune systems (such as those with AIDS or cancer)
-People on medications that weaken their immune systems (such as oral cortisone)
There is no specific recommended treatment or medicine for healthy children who develop chickenpox. The general approach to uncomplicated chickenpox infections includes the following:
-Applications of calamine lotion;
-Soothing baths of oatmeal, baking soda, or cornstarch to help relieve the itch;
-Cool compresses may also help;
-Make sure children have short nails so they don’t scratch and infect the rash; young babies may need mittens;
-For temperature control, acetaminophen can be given as needed for age and weight;
ASA or aspirin should never be given to children with chickenpox. When given certain viral infections including chickenpox and influenza, ASA has been associated with a sometimes fatal condition called Reye’s syndrome that can result in liver and brain damage.
-Make sure they are drinking well (and enough);
-If a child is having difficulty eating because of chickenpox in the mouth, offer him cold fluids (avoid acid drinks like an apple or orange juice) and a soft diet.
-For high-risk individuals who either develop or are exposed to varicella infection, there are certain antiviral medications and other treatments that may need to be given to protect their weakened bodies. In many cases, they will require hospitalization.
When to seek medical attention?
You should see a healthcare provider if:
- Signs of infection such as redness or swelling develop around the blisters
- There is a very high fever
- The child vomits more than three times
- The child is confused, difficult to awaken, or has trouble walking
- You are worried that your child is not following the typical course of chickenpox (as compared with another child)
Can chickenpox be prevented by a vaccine?
Yes, there is a vaccine that protects children from chickenpox. The vaccine has been proven to be 85 percent effective in preventing the disease and almost 100 percent effective in preventing severe disease. This results in a decrease in potential complications.
Chicken pox and shingles (also known as Zoster or Zona) are caused by the same virus. However, there are differences in the way the infection develops and spreads. Also, the chicken pox form of the infection is far more common in children than in the shingles form. It is known that after a chickenpox infection, the varicella virus remains in our bodies forever. The virus remains “asleep” in our nerves.
For a variety of reasons, usually in older people or those with weakened immune systems, the virus appears on the skin again. However, this time it only comes out in an area fed by one or more nerves called a dermatome. It looks like a localized “patch of varicella blisters.” This is called Herpes Zoster or shingles. While we usually see shingles in the elderly, or individuals with weakened immune systems, it can occur in otherwise normal children too, but much less frequently.
People who have not yet had chickenpox or the varicella vaccination can contract the virus and develop a typical chickenpox infection from someone who has shingles. More specifically, if they come into contact with the little blisters that contain the varicella-zoster virus. A person with a zoster is considered contagious until the blisters (vesicles) have dried and crusted. Persons who have had chicken pox in the past or have been vaccinated will be protected, whether they come into contact with active typical chickenpox or shingles. For more information on shingles click here.
Sometimes people do not remember if they have had chickenpox. This may be especially important in persons who work with children. There is a blood test that can confirm whether or not a person has been infected by chickenpox in the past. In many cases, the test is usually positive signifying that they have had a varicella virus infection but it was so mild that they didn’t realize they had it.
Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.