Chickenpox

Chickenpox is a highly contagious illness that should become much less a part of childhood as more children are given the Varivax vaccine. Chickenpox is caused by the varicella zoster virus and occurs most commonly in late winter or early spring. Unvaccinated children usually develop symptoms about ten to twenty-one days after being exposed to someone with chickenpox (incubation period).

Since the introduction of the chickenpox vaccine, cases of chickenpox in children have decreased almost 70-90%. The vaccine has also decreased the number of missed school days that children have.

Symptoms begin with a low grade fever, loss of appetite and decreased activity. About two days later, your child will develop an itchy rash consisting of small red bumps that start on the scalp, face and trunk and then spread to the arms and legs (but may also occur in the mouth and genitalia). The bumps then become blisters with clear and then cloudy fluid, and then become open sores and finally crust over within about twenty four hours, but your child will continue to get new bumps for about four more days.

All of the chickenpox lesions should be crusted over after about six days at which time your child will no longer be contagious. It may take another one to two weeks before all of the scabs finally heal. Once your child has had chickenpox he should have lifelong immunity.

There is no effective treatment for children who develop uncomplicated chickenpox, but if your child is given the Varivax vaccine within 72 hours of being exposed to someone with chickenpox, it may help prevent him from becoming infected. The only treatments are aimed at making your child more comfortable, and can include pain relievers, plenty of fluids, oatmeal baths, calamine lotion, and oral Benadryl for severe itchiness. Also keep your child's fingernails cut short and allow him to wear loose fitting clothing.

Treatment with acyclovir, an antiviral medication that can help to decrease the symptoms of chickenpox, should be considered for children at risk of developing a severe case of chickenpox. This includes children with pulmonary disorders, on steroid medications, or with immune system problems.

Another medication, Varicella Zoster Immune Globulin (VZIG), can be given as a preventative medication to children at high risk for developing a severe case of chickenpox as soon as they are exposed to someone with chickenpox (and within 96 hours) to help prevent them from getting infected. High risk children who are considered candidates for VZIG include those with immune system problems, pregnant women who have never had chickenpox and newborns whose mother developed chickenpox within 5 days before delivery or two days after delivery.

You should call your doctor if your child has chickenpox and the blisters become very red and tender, drain pus, if your child has high fever for more than 3-4 days or is unconsolable, has swollen and tender glands or if he is unable to drink and is becoming dehydrated.

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After having chickenpox, the chickenpox virus stays dormant in your body. In some children, it can become reactivated and cause shingles. The main symptoms of shingles is a rash on one side of the body that begins as a cluster of red bumps. These bumps then change into small blisters or vesicles that soon crust over. Your child may also feel itchy, but will otherwise be well. The rash usually continues to develop for a few days and then completely crust over and go away in about seven to ten days without treatment.

Children with shingles are contagious and can transmit chickenpox to others who aren't immune. Direct contact with the rash is necessary to be contagious, so he does not need to stay home from school if you can keep the rash completely covered.