Chickenpox is a highly contagious disease caused by a virus called varicella zoster. Before the vaccine that protects against chickenpox became available in 1995, it was one of the most comon disease of childhood, affecting almost all children before the age of 9 years.
Signs and Symptoms
Most children with chickenpox have relatively mild symptoms. They commonly develop a very itchy, blister-like rash that appears 10 to 21 days after exposure and infection with the virus. The blisters usually appear first on the torso and scalp, often surrounded by a reddened area. They may spread to other parts of the body, including the face, arms, and legs. In time, the blisters become crusty before finally healing. Most children develop a mild fever during the course of the infection.
What You Can Do
If your child has chickenpox and is feverish or uncomfortable, you may choose to give him appropriate doses of acetaminophen (keep in mind, however, that a fever helps the body fight off an infection). Never give aspirin to a child with a fever.
Try to prevent your child from scratching the rash, or the rash itself could become infected with bacteria and may leave small scars. Keep his fingernails trimmed. Bathe him with soap and water or, if you choose, oatmeal baths sold in pharmacies. An antihistamine is useful to decrease itch.
Keep your youngster away from other children who have never had chickenpox or the chickenpox vaccine, especially children with weakened immune systems. The contagious period begins 1 to 2 days prior to the first appearance of the rash and continues for another 5 to 7 days (or 24 hours after the last new blister develops). Children with chickenpox should be kept home from school until the rash has crusted over.
When to Call Your Pediatrician
Most children with chickenpox do not need to be seen by a pediatrician. However, contact your pediatrician if your child has a high fever (temperature greater than 102°F or 38.9°C) or if the fever lasts for more than 4 days.
Also, notify your pediatrician if your child has any signs of a bacterial infection, such as part of the rash becoming extremely red, tender, and warm, or if your child’s symptoms seem much worse.
Treatment
Your pediatrician can prescribe an antiviral medication called acyclovir that can reduce the symptoms of chickenpox. However, to be most effective, it must be given within 24 hours after the disease begins. This medicine is most often prescribed for teenagers and for children with asthma or a skin condition called eczema rather than otherwise healthy young children.
What Is the Prognosis?
As uncomfortable as chickenpox may be, the disease clears up completely without complications in most children. Bacterial infections do occur in some children. These are usually mild skin infections, but at times the infection can be more severe and involve the tissues under the skin and the muscles. In these cases, antibiotics and surgery are needed to control the bacteria.
A few children will have a more severe disease affecting the brain during the rash or a few weeks after the rash. Although most of these children recover, some will be left with damage to the brain.
Prevention
The AAP recommends a first dose of the chickenpox vaccine at 12 to 15 months of age for all healthy youngsters who have never had the disease. A second dose should be given at 4-6 years of age (but may be given earlier, if at least 3 months after the first dose). Until your child reaches his first birthday, the best way to protect him from chickenpox is to keep him away from children with the active disease. Keep in mind that an infant will have immunity during the first few months of life if his mother has had chickenpox or the chickenpox vaccine at some point in her life.