Chicken Pox

Previously, about 3 1/2 million people would contract chicken pox each year, but with the introduction of a vaccine this infection is much less common today. The highly contagious illness is most common among children between ages one and nine. Adolescents and adults are usually immune because of childhood infection, but usually have more difficulty with chicken pox if they contract it.

A widespread rash, beginning on the truck and spreading to the arms, face and scalp, is the most prominent symptom. The rash begins as a crop of small red spots, which quickly become raised, fluid filled blisters. These blisters then break and form yellowish scabs. As the initial rash crusts over, new spots appear. At the height of the illness, spots, blisters, and scabs are all present on the skin. Once all the blisters have crusted over, usually seven days after the first breakout, the disease is no longer contagious.

Chicken pox travels from child to child via airborne viral particles shed from the respiratory passages and blisters. After it enters a child’s system, the virus incubates for 14 to 21 days before the rash appears. For 24 hours before the rash appears the disease is contagious, so it is not always possible to avoid exposure.

Treatment

There is no curative treatment for chicken pox infection. Many children have symptoms so mild that no medication is needed. Most, however, will have low-grade fever, fatigue, itching and generalized discomfort.

  1.  Acetaminophen (Tempra, Tylenol) may be offered for fever and body aches. Avoid the use of aspirin and other salicylates with chicken pox due to the possibility of Reye’s Syndrome.
  2.  Oral anti-itch medication, such as diphenhydramine (Benadryl), maybe offered as needed.
  3. The child should avoid excessive scratching of the rash as this may lead to bacterial infection of the sores.
  4. Lotions, such as Calamine, may be applied to relieve itching. Baking soda or oatmeal baths (Aveeno) may also be soothing to the rash. A child may hold an ice cube against a particularly itchy spot for a few minutes for temporary relief.

Possible Complications

Chicken pox is generally a mild illness. There is usually no need to keep the child with chicken pox in bed. The purpose of staying home is mainly to avoid infection other children. Some children, however, run fevers as high as 104. Painful sores inside the mouth or in the rectum or genitals are also not uncommon.

More serious complications, while rare, do sometimes occur. Call your doctor immediately if:

  • An area of the skin becomes red, swollen, and painful. This could indicate the presence of a bacterial skin infection for which the doctor can prescribe oral antibiotics after evaluation.
  • The child develops difficulty breathing or chest pain. These are symptoms of pneumonia which rarely accompanies chicken pox in children but frequently affects adults with the disease.
  • The child begins to vomit or become disoriented during or after the illness. These are symptoms of Reye’s Syndrome, a serious disease that follows viral infections such as chicken pox. Reye’s Syndrome has been liked to aspirin use during viral illness. Therefore, never give aspirin to children with chicken pox, influenza, or other viral infections.

Chicken Pox Vaccine

The chicken pox vaccine (Varivax) is recommended for children over 12 months of age. It is 85% effective in preventing the infection and it reduces the severity of the disease in those immunized individuals who get chicken pox. Life long immunity is promising, but uncertain at this time.

Posted in: Pediatric Topics