Chickenpox causes spots (a rash) and can make a child feel generally unwell. Treatment aims to ease symptoms until the illness goes. Full recovery is usual in children aged under 12 years. Serious complications are rare but are more likely to occur in children with a poor immune system, such as those on chemotherapy.
Chickenpox is an infection caused by the varicella-zoster virus. Most children have chickenpox at some stage. Most commonly, children get chickenpox before the age of 10 years. The immune system makes proteins called antibodies during the infection. These fight the virus and then provide lifelong protection against it (immunity). Therefore, it is uncommon to have more than one bout of chickenpox in your lifetime.
Chickenpox symptoms
- High temperature (fever), aches and headache often start a day or so before a rash appears.
- Spots (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. The rash starts off looking like red spots, which then blister, and then scab over.
- Loss of appetite or feeding problems.
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?
Most of the time, children with chickenpox recover fully and have no complications. Uncommonly, one or more of the following complications can occur.
- The spots do not usually scar unless they are badly scratched.
- Some spots become infected with germs (bacteria) in some cases. This is the most common complication in children. If this occurs, the surrounding skin becomes red and sore. Antibiotics in the form of creams or medicine may then be needed.
- Inflammation of the lung (pneumonia) and inflammation of the brain (encephalitis) are rare complications.
- Vary rarely, other serious complications develop. For example:
- Reye’s syndrome. (a very rare condition with brain and liver problems).
- Inflammation of the heart muscle (myocarditis).
- Kidney inflammation (glomerulonephritis).
- Appendicitis.
- Ataxia (problems co-ordinating movements).
- Inflammation of the pancreas (pancreatitis).
- Henoch–Schönlein purpura (a condition that can affect the kidneys).
- Inflammation of the testes (orchitis).
- Inflammation of the joints (arthritis).
- Inflammation of various parts of the eye.
Therefore, although serious complications are rare, it is best to be watchful. See a doctor if your child develops any worrying symptoms that you are unsure about such as:
- Breathing problems.
- Weakness such as a child becoming wobbly on his/her feet.
- Drowsiness.
- Fits (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.
What is the treatment for chickenpox?
For most children
Treatment is mainly aimed at easing symptoms and trying to make your child as comfortable as possible whilst the immune system deals with the virus.
- Advice on dealing with a high temperature (fever) is detailed below.
- A soothing cream or lotion(emollient) may help the itch. Ask us about our Chicken Pox Lotion.
- A sedating antihistamine (in a tablet or liquid medicine) may help with sleep if itch is a problem. Give the dose at bedtime. It can also be helpful for itch during the daytime but may cause some sleepiness as a side-effect.
- Keep fingernails cut short to stop deep scratching.
- Dress children comfortably so they are not cold or overheated. Use cool smooth fabrics such as cotton.
Dealing with a fever. A fever commonly occurs with chickenpox, and may make your child feel uncomfortable and irritable. The following are things that you can do that may bring the temperature down and make your child feel more comfortable:
- You can give paracetamol to lower a temperature. You can buy paracetamol in liquid form, or as melt-in-the-mouth tablets, for children. The dose for each age is given with the medicine packet.
Note: paracetamol does not treat the cause of the fever. It merely helps to ease discomfort. It also eases headaches, and aches and pains. You do not need to use paracetamol if your child is comfortable and not distressed by the fever, aches or pains.
Note: ibuprofen has been used with paracetamol in the past. Recent research has recommended that ibuprofen no longer be used for chickenpox. This is because some studies suggested that there may be an association with more severe skin reactions if ibuprofen is used for chickenpox. While more evidence is awaited, the advice is to avoid ibuprofen in this situation. - Take extra layers of 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. This helps to prevent a lack of fluid in the body (dehydration). You might find that a child is more willing to have a good drink if they are not so irritable. So, if they are not keen to drink, it may help to give some paracetamol first. Then, try the child with drinks half an hour or so later when his/her temperature is likely to have come down.
Do not cold-sponge a child who has a fever. This used to be popular, but it is now not advised. This is because the blood vessels under the skin become narrower (constrict) if the water is too cold. This reduces heat loss and can trap heat in deeper parts of the body. The child may then get worse. Many children also find cold-sponging uncomfortable.
Some people use a fan to cool a child. Again, this may not be a good idea if the fanned air is too cold. However, a gentle flow of air in a room which is room temperature may be helpful. Perhaps just open the window or use a fan on the other side of the room to keep the air circulating.
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.
Nine in ten people who have not had chickenpox would catch it after being exposed in this way.
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 spots first appear until they have all 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 and until all the lesions have crusted. Also, whilst infectious, they should keep away from at-risk people who may develop a severe illness if they get chickenpox. These include:
- Pregnant women who have not had chickenpox in the past. Chickenpox can be severe and cause complications during pregnancy.
- People with a poorly functioning immune system. For example, people with leukaemia, with HIV/AIDS, on steroid medication, or who are having chemotherapy.
- The at-risk children listed earlier.
Healthy adults who have not had chickenpox may also want to avoid catching it, as the illness tends to be worse in adults.
Note: people with chickenpox should not travel by air until all the spots have crusted over.
Should I let my child catch chickenpox?
Some parents encourage their children to mix with others who have chickenpox in order to catch it.
Some arguments for this
- Chickenpox is usually a milder illness in a child than in an adult.
- The risk of serious complications is higher in adults. In particular, chickenpox during pregnancy can cause serious complications to both mother and baby.
- Most people get chickenpox at some stage. As the risks are fewer if you have it as a child, it may be better to get it over with.
Some arguments against this
- “I could not willingly let my child develop an illness.”
- Although rare, some children do have serious complications.
Different parents have different views on this issue. And remember, children who develop chickenpox spots (the rash) today will have been just as infectious over the previous two days when they were well, but were incubating the virus.
Inverell Pharmacy – your locally owned and operated pharmacy at 132 Byron Street (next to Telstra). Phone 0267 223146.