Chickenpox (Varicella)

All you need to know

Chickenpox is an infection caused by the varicella virus. It cannot be treated with antibiotics. Treatment is usually to relieve the symptoms. It is easily spread by either having direct contact with (i.e. touching) the person who has chickenpox or from fluid droplets in the air when they cough.

Fever and rash are the most common signs of chickenpox. Children and adults of any age can get chickenpox but it is more common in children.

Rarely chickenpox causes complication like inflammation of brain, inflammation of the lungs and superadded bacterial infection of the skin.

Signs and symptoms

• A mild fever
• Feeling tired and irritable
• Itching

Rash (The rash usually first appears on the chest, back or face. It then can move to other area of the body including inside the mouth. At first, the rash looks like small pimples. These later become blisters full of fluid)

How is it spread?

Chickenpox is highly contagious which means it is very easy to catch. It can be spread by either having direct contact with the person, who has chickenpox from coughed fluids from their chest or by touching the liquid from the blisters. Children with chickenpox are infectious from one to two days before the rash first appears until the last blisters.

What to expect

The rash usually appears from 10 to 21 days after being exposed to someone who has chickenpox. This time between exposures to getting the rash is called the ‘incubation period’

Children with a severe infection or with underlying serious medical conditions may be given anti-viral medication. Most children with chickenpox are unwell for about five to seven days. Only a few will need to be admitted to hospital.

Treatment is about controlling the itching from the rash and other symptoms related to the viral illness. There are many medications and creams that you can buy from your local pharmacy to help with the itching. Chickenpox is a virus and it cannot be treated with antibiotics.

If your child gets large, sore, red area around the rash or become more unwell, see your family doctor in case a secondary bacterial infection has developed.

At home care

It can be difficult to make sure children drink enough when they are unwell. Give sips of drinks, jellies, water based frozen snacks, soups and other fluids often. Cold drinks and soft bland foods can help but avoid giving the child anything too salty or acidic. This helps prevent dehydration and controls the fever. Children with chickenpox can feel tired and irritable.

Children with chicken pox may have reduced appetite but ensure that your child takes enough fluids so that so that he/she is able to pass urine at least 4 times in a day try to keep the child cool as heat and sweating makes the itching worse.

It is always a good idea to use a separate towel for the child with chicken pox, although if the child has siblings this is unlikely to prevent them from catching it.

Efforts should be made to stop the child scratching the blisters, as this will make them sore and open to infection. The blisters are also more likely to leave a scar if the scabs are scratched off.

The scratching can be reduced by cutting the child’s nails short and persuading them to wear cotton gloves. Calamine lotion will help to reduce the itching but it needs to be reapplied regularly. If the itching is so bad that the child has trouble sleeping, a doctor can prescribe an antihistamine.

Taking paracetamol can help but do not give your child aspirin.

Children with chickenpox should not go to school or kindergarten until the last blister has dried. A dry blister scab is not infectious. You should tell the school if your child gets chickenpox as there may be other children who need to be immunized or treated.

It is infectious until all the blisters have formed scabs (usually about seven days). People sometimesthink that the scabs have to fall off before the risk of infection has gone, but this is not the case.

The spots, and then blisters, can develop in several phases, so check the child all over to make sure thatscabs have formed on all the blisters before sending him or her back to nursery or school.

Some members of the family may need to stay away from the child during this infectious stage. Thisincludes people who are on chemotherapy or long-term oral steroids, newborn babies and pregnantwomen who have not had chickenpox before. Most people cannot get chicken pox again if they havealready had it. Children with chickenpox can usually be cared for at home and do not need hospitaladmission.

Special considerations

• Anyone who is taking long term oral steroids and anyone who is immune compromised (eg. onchemotherapy or after an organ transplant)
• Pregnant women or newborns should see their doctor if they think have been exposed tochickenpox, as they may need treatment to prevent the virus.
• People with skin problems like eczema may also need to speak to a health professional foradvice on which creams they can use for rash
• Children with chickenpox should not be given aspirin

Key points to remember

• Chickenpox is very easy to catch
• Antibiotics will not cure chickenpox
• Treatment is usually for the symptoms, such as the rash, not the infection itself
• The rash usually starts between 10 to 21 days after the first exposure to chickenpox
• Chickenpox is infectious for one to two days before the rash starts until the last blister has dried

When should see a doctor

• You should consult your doctor if
• If child seems drowsy, irritable than usual, more sleepy than usual. If your child is not drinkingenough due to lesions in the mouth and not passing urine regularly
• If the skin lesions look very angry, red, very sore to touch
• If you feel anyway that your child is not right