Chickenpox

Chickenpox is one of the most common childhood diseases. It is usually mild and not life-threatening to healthy children. Anyone can get chickenpox at any age, but it occurs most frequently in children from ages 6 to 10.

The most obvious sign of chickenpox is a skin rash that develops on your child's scalp and body, then spreads to his face, arms, and legs over a period of 3 to 4 days. The rash forms between 250 to 500 itchy blisters that dry up into scabs 2 to 4 days later. School-age children often get a mild fever for 1 or 2 days before the rash appears. Other symptoms of chickenpox are:

• coughing
• fussiness
• loss of appetite
• headaches

Chickenpox can easily be spread in any of the following ways:

• by direct contact with an infected person, usually through fluid from broken blisters
• through the air when an infected person coughs or sneezes
• through direct contact with lesions (sores) from a person with shingles

A person with chickenpox is contagious from 1 to 2 days before the rash starts and for up to 5 days after the rash appears. Your child will have to stay home from child care or school until she is no longer contagious. An adult or child who has never had chickenpox is at risk of getting it and may not show symptoms for 10 to 21 days after being exposed to the virus. Within households, 80% to 90% of at-risk persons will develop chickenpox if they are exposed to a family member who has it.

Once someone has had chickenpox, the virus stays in the body of the infected person permanently. Later in life, the virus can reappear and cause shingles. Shingles can occur at any age, but usually occur after a person is 50 years old. About 10% to 20% of all people who have had chickenpox develop shingles. People with shingles typically feel numbness and itching or severe pain in the skin areas where the affected nerve roots are. Within 3 to 4 days, clusters of blister-like sores develop and last for 2 to 3 weeks.

Chickenpox can occur at any time of the year, but the peak times are in the winter and early spring, especially in moderate climates. Before the vaccine became available, there were about 4 million cases of chickenpox in the United States each year.

Treating Chickenpox
You may remember how itchy chickenpox was when you were a child. If your child scratches the blisters before they are able to heal, they can become infected, turn into small sores, and possibly leave scars. Discourage your child from scratching and keep his fingernails trimmed short just in case.

Oatmeal baths can help relieve itching and acetaminophen may help reduce your child's fever. Acetaminophen is a substitute for aspirin. Do not give your child aspirin or salicylate (a compound found in aspirin). They have been associated with Reye's syndrome, a disease that affects the liver and brain. If your child's fever lasts longer than 4 days, rises above 102° F after the third day of having chickenpox, or your child becomes dehydrated, call your pediatrician. Also let your pediatrician know if the rash gets very red, warm, or tender. It may mean your child has an infection and needs other treatment.

The drug acyclovir can help make a case of chickenpox less severe. Acyclovir is most often used for patients who are at risk of developing severe chickenpox, such as adolescents; children with certain skin or lung diseases; and children taking other prescribed medications, such as steroids. To be effective, acyclovir must be given within the first 24 hours of the onset of the chickenpox rash. You may want to discuss the use of acyclovir with your pediatrician.

Most healthy children who get chickenpox won't have any complications from the disease. However, each year in the United States, about 9,000 people are hospitalized for chickenpox and about 90 people die from the disease.

The most common complication from chickenpox is a bacterial infection of the skin. The next most common problems are pneumonia and encephalitis, an infection of the brain. The following groups of people are at higher risk of developing these problems:

• people who have weak immune systems or low resistance to disease
• infants under 1 year of age
• adolescents and adults
• newborns whose mothers had chickenpox around the time of delivery
• premature infants whose mothers have not had chickenpox
• children with eczema and other skin conditions
• children receiving therapy with salicylate (a compound found in aspirin)

When an adult gets chickenpox, the disease is usually more severe, often developing into pneumonia. Adults are almost 10 times more likely to be hospitalized for chickenpox than children under 14 years of age, and adults are more than 20 times more likely to die from the disease. If a pregnant woman gets chickenpox, her unborn baby may have complications.

Source: American Academy of Pediatrics