Chickenpox

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What causes it?

Chickenpox is caused by the Varicella zoster virus. It can be spread either through person-to-person contact, or via sneezing and coughing. It is contagious from a few days before the rash appears, until all the existing lesions or blisters have formed scabs and are no longer weeping. This usually takes around a week.

What are the symptoms

The incubation period for chickenpox is 2-3 weeks after contact. Symptoms tend to be much milder in children than in adults. The illness usually starts with a general feeling of tiredness and lethargy, which is soon followed by the outbreak of a characteristic rash. At first, this rash appears as red spots, which develop into crops of small blisters over the trunk. These soon begin to appear on the rest of the body, and may occur even in the mouth, ears or genitals. The blisters are extremely itchy, and new ones keep forming as older ones are scabbing over and drying up. Your child remains contagious until the last blister has scabbed over and the blisters are all dry. The scabs may take several weeks to fall off. The rash does not leave any scars unless your child scratches the blisters or scabs, or the lesions become infected. The rash may be accompanied by a fever, which is usually more marked in adults.

In healthy children complications of chickenpox are unlikely, although they do occasionally occur. These include pneumonia and encephalitis. Children who have reduced immunity, such as those with cancer or those taking immunosuppressant medication, can suffer severe attacks of chickenpox and need to be kept away from those who have it or who may be incubating it. Elderly people cannot get shingles from chickenpox, but children can develop chickenpox after contact with someone who has shingles.

How is it treated?

There is no cure or specific treatment for chickenpox. Treatment is geared towards relieving the symptoms. Gauze pads soaked in bicarbonate of soda and water and then placed over the lesions can calm the itch for a while. If the itching is intolerable, your doctor may prescribe an antihistamine medicine or tablets. Keep your child’s nails short so that if they do scratch, infection is less likely to occur. Alternatively, put mittens on younger children. Give paracetamol according to directions to help lower the fever. Keep your child away from daycare or school until the last blister has scabbed over.

In very severe cases an anti-viral medication called acyclovir may be recommended.

How can I prevent it?

The best way to avoid chickenpox is to have your child immunised. Chickenpox vaccine is now given free as part of the government immunisation program. If your child is vaccinated and still gets chickenpox, the disease will be much milder.

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