Are they the cause of your child’s rash?
Chickenpox used to be a common childhood illness. With the invention of the vaccine for it, the frequency of cases has diminished significantly. However, it’s still out there and poses a risk to some individuals. Do you fall into that category? Why is it important to prevent chickenpox? What can happen if you don’t?
Chickenpox is an infection that is caused by a virus, varicella-zoster. It’s generally a mild disease, but is highly contagious. Its spread through coming into contact with the rash or when an infected person coughs or sneezes and someone else inhales those droplets. Symptoms usually begin 10 – 21 days after exposure and last about 5 – 10 days. The most common symptom is an itchy, blister rash. It has three phases. The first is raised pink/red bumps, which appear over several days. The second is the formation of small, fluid-filled blisters that form in roughly one day. These blisters break open and leak. The third phase is when the blisters crust and scab over. Once this happens, it takes several days for them to heal. Since new bumps will keep appearing for several days, the person will be experiencing all three stages at once. You can spread the virus to others starting 48 hours before the rash appears and continue spreading it until all the blisters have crusted over. Other symptoms include fever, loss of appetite, headache and tiredness. Some individuals can have chickenpox more than once, but this is rare.
Sometimes, chickenpox can be severe with the rash covering the person’s entire body, including in the throat, eyes and mucous membranes of the urethra, anus and vagina. Other times, it can cause complications, like dehydration, pneumonia, encephalitis (inflammation of the brain), toxic shock syndrome, Reye’s syndrome (can occur if children under 16 take aspirin), bacterial infections of the skin/soft tissues/bones/joints/bloodstream and death. Some individuals are at a higher risk for developing complications. Those that fall into this group are newborns/infants whose mothers never had chickenpox or the vaccine, pregnant women who haven’t had the chickenpox, smokers, those with weakened immune systems and those who uses steroid medications long-term. If a woman has a chickenpox infection early in her pregnancy, the baby is at risk for being born with a low birth weight and limb abnormalities. If a pregnant woman is infected in the week or few days before delivery, the baby has a high chance of developing a serious, life-threatening infection.
If you’ve had chickenpox, you’re at risk for developing a complication later in life called shingles. After you’ve recovered from a chickenpox infection, the varicella-zoster virus remains in your nerve cells until something reactivates it. When this happens, it reappears on your skin in a painful-cluster of blisters. This is more likely to occur in older adults and those with weakened immune systems. The blisters don’t usually last long, but the pain that’s associated with them often does. This is known as postherpetic neuralgia and, for some, it’s very intense.
The goal of chickenpox treatment is to provide relief of the symptoms since it typically doesn’t require medical intervention. It’s key to avoid scratching because this can result in scarring, slow the healing time and increase the likelihood of a secondary skin infection. Obviously, for children it can be incredibly hard to get them to not scratch. There are things that you can do to help them, like putting gloves on their hands (especially at night), trimming their fingernails and finding ways to help relieve the itching. One method to do this is to have them take a cool bath that has baking soda, aluminum acetate, uncooked oatmeal or colloidal oatmeal (a finely ground oatmeal that is designed to be used for soaking) added to it. You can also apply calamine lotion to the spots. If your child has lesions in their mouth, offer them foods that are bland and soft. Some over-the-counter antihistamines, such as diphenhydramine, are helpful at controlling the itching. If your child has a fever, use acetaminophen to reduce it. Don’t use aspirin since this increases the risk for developing Reye’s syndrome (a potentially life-threatening condition). Also, consult with your child’s doctor before giving ibuprofen or any other non-steroidal anti-inflammatory (NSAIDs). For individuals with chickenpox, they’re thought to lead to skin infections or tissue damage. If your child’s fever doesn’t go away after four days or at any point is higher than 102°F, you should call their doctor.
For individuals who are at high risk of developing complications, doctors might prescribe antiviral medications, like acyclovir, or immune globulin intravenous to decrease the severity of the infection. In order to be effective, the medicines must be given within 24 hours of the rash’s appearance. Other antiviral drugs, valacyclovir or famciclovir, could also lessen the severity, but they’re not appropriate for everyone to take. Another thing your doctor may recommend is receiving the chickenpox vaccine after you’ve been exposed because this can help prevent or lessen the severity of the disease. If you do have complications, your doctor will decide the best course of action to help you recover. Often, it involves being hospitalized in order to receive the appropriate treatment.
The best way to prevent chickenpox is to receive the vaccine. According to the Centers for Disease Control and Prevention (CDC), the vaccine is able to completely prevent cases in 98% of the people who receive. For those it doesn’t protect completely, they become infected, but the symptoms are less severe and don’t last as long as someone who hasn’t been vaccinated. Typically, the vaccine is given in two doses with the first being between 12 -15 months and the second between 4 – 6 years. Often, it’s given with the MMR (measles, mumps and rubella) vaccine. If you haven’t been vaccinated or exposed to virus, you should receive two catch-up doses. This is especially important for women of childbearing age. The time frame between the two doses depends on your age. You should not receive the vaccine if your pregnant, have a weak immune system or are allergic to gelatin or neomycin (antibiotic). If you’re planning on becoming pregnant, be sure to talk to your doctor about making sure you’re up-to-date on all of your vaccinations.
For individuals at risk of developing shingles, there are two vaccines available to reduce the chances of it occurring. Zostavax is for those over the age of 60. Shingrix can be taken by anyone over the age of 50 and who have already received Zostavax. For these reasons, it’s the preferred vaccine.
Even though most cases aren’t severe, chickenpox can be a miserable thing to experience. The good news is that with the vaccine, you and your children don’t have to. If you have any questions or concerns about chickenpox, please speak with your or your child’s doctor. If you would like more information, please visit KidsHealth.org’s Chickenpox page at https://kidshealth.org/en/parents/chicken-pox.html