Chickenpox

Chickenpox

Chickenpox (varicella) is a relatively minor illness. Almost all children will get it. The first couple of days, your child will be in generally ill health, with a cold, cough, fever, and abdominal pain; then a rash of red, pimple-like spots appears. A child may have just one or two spots, or the rash may cover the entire body, including the throat, mouth, ears, groin, and scalp.

The spots turn into clear blisters that become cloudy, break open, and crust over. This rash itches a lot. Spots continue to appear for one to five days and subside over a week or two.

Chickenpox is very contagious. After exposure, symptoms occur in 10 days to 3 weeks. It is contagious for one to two days before the rash appears and for up to five days after the spots appear. Children can generally return to school or day care when all the spots have scabbed, or on the sixth day after the rash appeared. Encephalitis is a rare complication of chickenpox.

Prevention

The chickenpox vaccine can be given to children age 12 months and older, and to teens and adults who have not had the illness. It is especially important to immunize teens and adults who have not had chickenpox, because the disease is more severe in adulthood.

Adults who have not been vaccinated and who have not had chickenpox should avoid exposure to children who have it and avoid exposure to people who have shingles. Pregnant women who have never had chickenpox and have not been vaccinated should also avoid exposure, since the illness can harm the developing fetus. The vaccine cannot be given during pregnancy.

Home Treatment

• Use acetaminophen to relieve fever. Do not give aspirin to children and teens under age 20 who may have chickenpox because aspirin use is related to Reye's syndrome.
• Control the itching. Oral Benadryl and warm baths with some baking soda or Aveeno colloidal oatmeal added to the water will help. Avoid Benadryl creams because the medication can build up to toxic levels in the body.
• Cut the child's fingernails to prevent scratching. If scabs are scratched off too early, the sores may become infected.

When to Call a Health Professional

• If your child is at risk of complications from chickenpox (is taking steroid medications or cancer chemotherapy, or has a weakened immune system).
• If a child age three months to three years has a fever of 103° or higher for 24 hours.
• If severe itching cannot be controlled by Benadryl and warm baths.
• If bruising appears without injury.
• If sores appear in the eyes.
• If you notice signs of encephalitis:
  • Fever, severe headache, and stiff neck
  • Unusual sleepiness or lethargy
  • Persistent vomiting