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Chickenpox in Children

chicken pox child

Chickenpox is an infection caused by the varicella-zoster virus. Most children have chickenpox at some stage. The immune system makes antibodies during the infection. These fight the virus and then provide lifelong immunity. Therefore, it is rare to have more than one bout of chickenpox in your lifetime.

Chickenpox symptoms

  • Fever , aches and headache often start a day or so before a rash appears.
  • Rash. Spots appear in crops. They develop into small blisters and are itchy. They can be anywhere on the body. Several crops may develop over several days. Some children may be covered in spots; others have only a few or even none.
  • Dry cough and sore throat are common.
  • Some children feel quite unwell for a few days. Others appear only mildly ill. Most are much better within a week. The blisters dry up and scab. They gradually fade, but may take up to two weeks to go completely.

What are the possible complications?

The spots do not usually scar unless they are badly scratched. Some spots become infected with bacteria in about 1 in 10 cases. If this occurs, the surrounding skin becomes red and sore. Antibiotics may then be needed. An ear infection develops in about 1 in 20 cases.

  • Pneumonia and inflammation of the brain (encephalitis) are rare complications.
  • Reye's syndrome.
  • Myocarditis (inflammation of the heart muscle).
  • Glomerulonephritis (kidney inflammation).
  • Appendicitis.
  • Hepatitis (inflammation of the liver).
  • Pancreatitis (inflammation of the pancreas).
  • Henoch-Schönlein purpura (a condition that can affect the kidneys).
  • Orchitis (inflammation of the testes).
  • Arthritis.
  • Inflammation of various parts of the eye.

Therefore, although serious complications are rare, it is best to be vigilant. See a doctor if your child develops any worrying symptoms that you are unsure about such as:

  • Breathing problems.
  • Weakness.
  • Drowsiness.
  • Convulsions.
  • Pains or headaches which become worse despite paracetamol.
  • Being unable to take fluids, due to a severe rash in the mouth.
  • A severe rash, or a rash which bruises or bleeds into the skin (haemorrhagic rash).
  • Becoming generally more and more unwell.

Shingles

Shingles is caused by the same virus that causes chickenpox Shingles is an infection of a nerve and the area of skin supplied by the nerve. It causes a rash and pain in a local band-like area along the affected nerve. About 1 in 5 people has shingles at some time in their life. It can occur at any age, but it is most common in people over the age of 50.

The reason why shingles may occur is because the virus does not completely go after you have chickenpox. Some virus particles remain inactive in the nerve roots next to your spinal cord. They do no harm there, and cause no symptoms. For reasons that are not clear, the virus may begin to multiply again (reactivate).

What is the treatment for chickenpox?

For most children
A soothing cream (emollient) may help the itch.
A sedating antihistamine tablet or liquid medicine for children over one year old may help with sleep if itch is a problem..
Keep fingernails cut short to stop deep scratching.
You can give paracetamol (not ibuprofen).

  • This is because some research has shown that ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) may increase the risk of developing serious skin infection complications in children with chickenpox.

Take the clothes off your child if the room is normal room temperature. It is wrong to wrap up a feverish child. The aim is to prevent overheating or shivering.
Give lots to drink.
Do not cold-sponge a child who has a fever.

Special at-risk groups

  • Children (babies) less than one month old.
  • Children with a poor immune system. For example, children with leukaemia, immune diseases or HIV/AIDS.
  • Children taking certain medication such as steroids, immune suppressing medication or chemotherapy.
  • Children with severe heart or lung disease.
  • Children with severe skin conditions.

These children can be treated with antiviral medicine acyclovir.

Is chickenpox infectious?

A person with chickenpox is very infectious. The virus spreads in the air from person to person. For example, if you have not already had chickenpox, you stand a good chance of catching it if:

  • You are in the same room as someone with chickenpox for more than 15 minutes; or
  • You have any face-to-face contact with someone with chickenpox, such as a conversation.
  • It takes between 7 and 21 days (most commonly 10-14 days) to develop symptoms after catching the virus (the incubation period).

Protecting others

A person with chickenpox is infectious from two days before the rash first appears until all the spots have crusted over (commonly about five days after onset of the rash). A child with chickenpox should stay off school or nursery for five days from the onset of the rash.

Is there a vaccine against chickenpox?

Yes, there is a vaccine that protects against the virus that causes chickenpox. It is part of the routine childhood immunization programme in certain countries such as the USA, Canada and Australia.


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