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Post by AlleyRose on Thu Jun 19, 2014 9:14 am

Key points

  • Chickenpox is caused by a herpes virus (varicella-zoster virus).
  • Symptoms include a mild fever, feeling unwell, coughing and sneezing, followed by a rash.
  • The rash begins as red, itchy spots, before blistering and rupturing. Most complications are a result of scratching the blisters.

Chickenpox is a very contagious viral infection caused by a herpes virus, varicella-zoster virus (the disease is known medically as varicella). It is very common in childhood, although it can affect you at any age. The symptoms are often more severe in adults.

Signs and symptoms

  • a mild fever
  • feeling unwell
  • coughing and sneezing
  • a rash follows, which often starts on the chest and back and then spreads across the body and to the head.

Course and duration
The rash begins as red, itchy spots. These spots increase in number, become blistered, then usually rupture, scab and dry over in around one week. The spots tend to occur in crops, new spots appearing ast the previous ones are crusting. They may also involve the inner mouth, palate and inside the eyelids. Most people also feel unwell for a week.

Spread of infection
A person with chickenpox can pass it on to others – from a few days before the rash appears – by droplets that are spread when they sneeze or cough.
You can also catch chickenpox if you come into direct contact with the fluid that is contained in the blisters.
Infectious period
From one to two days prior to the rash until the last blister has dried. Having been in contact with someone with chickenpox, there may be a delay of 10 to 21 days before the illness appears in you. During the incubation period you are not infectious until you develop symptoms.

Most complications are a result of scratching the blisters, these include:

  • secondary skin infection
  • scarring
  • severe bacterial infection mainly of the lung (this is very rare)

Uncommonly, chickenpox may affect the brain (encephalitis), the heart (myocarditis) and the joints (arthritis).

  • drink plenty of fluids
  • rest
  • paracetamol (be sure to give the correct dose-for-age)

It's important to avoid scratching the blisters as this can lead to infection and scarring. This can be extremely difficult as these blisters are often extremeley itchy, and young children in particular find it hard not to scratch
Keeping your child's finger nails short and having a baby wear mittens may help.
Avoid giving aspirin to anyone with chickenpox as it has been associated with a rare severe condition – Reye's Syndrome – which may be fatal.
Antibiotics will not help if you have chickenpox as it is a virus. However, antiviral drugs may be used for children with eczema or for people on drugs that suppress the immune system, for example leukaemia treatment.
Most chidren are given the chicken pox vaccine when they are 18 months old, as part of the normal vaccination schedule.
Medical intervention
You should see your family doctor if:

  • your child has eczema or a complicated medical history
  • you are concerned that the illness is more than mild.

Special notes
Children with eczema or on immunosuppressant drugs (as in treatment for cancer or after an organ transplant) are at a higher risk of complications, and may require antiviral drugs. These children should be under medical care and if they have contact with a person with chickenpox, they should notify their doctor immediately
The babies of non-immune women who contract chickenpox, particularly between eight and 20 weeks have a small risk (1-2%) of birth defects. If you are pregnant and have not had chickenpox or the vaccination, then you should contact your doctor immediately if you are exposed to the virus. Herpes zoster is also the virus that causes shingles, a painful condition that is thought to occur when the virus from childhood reactivates in later life.

Reviewed by Dr Peter Vine. A former rural paediatrician with more than 20 years experience, Dr Vine is head of campus and senior lecturer, UNSW Rural Clinical School, Albury Wodonga.

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