CHICKENPOX

Chickenpox is an infection caused by the varicella-zoster virus.

Chickenpox usually causes an itchy rash with small, fluid-filled blisters.

Chickenpox is highly contagious to people who haven’t had the disease or been vaccinated against it.

Symptoms of Chickenpox

The itchy blister rash caused by chickenpox infection appears 10 to 21 days after exposure to the virus and usually lasts about five to 10 days.

Other signs and symptoms, which may appear one to two days before the rash, include:

• Fever
• Loss of appetite
• Headache
• Tiredness and a general feeling of being unwell

Once the chickenpox rash appears, it goes through various phases- papules , vesicles, then crusts and scabs.

New bumps continue to appear for several days, so you may have all three stages of the rash — bumps, blisters and scabbed lesions — at the same time.

A child with chickenpox can spread the virus to other people for up to 48 hours before the rash appears; and the virus remains contagious until all broken blisters have crusted over.

The disease is generally mild in healthy children. In severe cases, the rash can cover the entire body, and lesions may form in the throat, eyes, anus and vagina.

Transmission

Chickenpox infection is a viral infection. It can spread through direct contact with the rash. It can also spread when a person with the chickenpox coughs or sneezes and you inhale the air droplets.

Risk of becoming infected with the varicella-zoster virus that causes chickenpox is higher if you haven’t already had chickenpox or if you haven’t had the chickenpox vaccine.

Treatment

Chickenpox in children is usually a mild illness, but can make the child miserable and irritable while they have it.

There is no specific treatment or cure for chickenpox.  The virus usually clears up by itself without any treatment. Treatment is mainly symptomatic to ease the itch and discomfort, reduce fever and it is also important to reduce the spread of chickenpox.

• Children having fever should be given paracetamol to relieve fever. This should be given every 6 hours till fever subsides.
• Calamine lotion and cooling gels are very helpful to ease itching. If the itching is very severe, the doctor can recommend antihistamine medications e.g. piriton in addition to the calamine lotion.
• The child should also drink lot of water to keep well hydrated.

In most children, the blisters crust up and fall off naturally within one to two weeks.

Complications

Complications of chickenpox include dehydration, sepsis, blindness and even death.

If the child’s fever is not going down and the child appears to be very ill, refusing to eat or having convulsions; you should take the child to the hospital.

Chickenpox in newborns, pregnant women and people with weak immune system are usually severe and such should be taken to the hospital for treatment.

At the hospital, doctors may introduce more treatment including antiviral medications eg acyclovir.

Prevention

Chickenpox can be prevented by the chickenpox (varicella) vaccine which is the best way to prevent chickenpox. The chickenpox vaccine (Varivax) is especially recommended for:

• Young children.(12mths to 15mths)
• Unvaccinated older children. Children ages 7 to 12 years who haven’t been vaccinated
• Unvaccinated adults who’ve never had chickenpox and are at high risk of exposure.

This article was extracted from the Group Discussion on Ask The Paediatricians Facebook group facilitated by Dr. Tochi Alex-Okoro