Home » Topic » Chicken pox

What is the cause?
What is the course of the disease?
How is it treated?
When should the doctor be called?
Can chickenpox be prevented?
What is chickenpox?
How is chicken pox spread from person to person?
What are the symptoms of chicken pox?
What if I am pregnant?
Is chicken pox more common at certain times of the year?
What can I do if my child gets chicken pox?
When should I consult a doctor?
What is the role of vaccination?
Written by : DoctorNDTV Team
Associate Director,
Internal Medicine,
Max Hospital, New Delhi
  • What is the cause?

    Chickenpox is caused by a highly contagious virus known as varicella-zoster virus. The varicella virus belongs to the Herpes group of viruses.
  • What is the course of the disease?

    The fever is usually the highest on the third or fourth day. Children start feeling better and stop having fever once they stop getting new crops. On an average, a child gets a total of 300 chickenpox sores.

    The normal chickenpox scars can take 6 to 12 months to fade. Chickenpox rarely leaves any permanent scars unless the sores become infected or the scabs are picked off repeatedly. A single attack usually gives lifelong immunity. Very rarely, a child may have a second mild attack.

    Children with chickenpox are contagious until all the sores have crusted over, usually about a week after the rash begins. To avoid exposure to other children, avoid taking the child to the doctor’s clinic. Once all the sores have crusted over (after 6 to 7 days), the child does not have to stay at home anymore even though scabs may still be there. It may take up to 2 weeks for all the scabs to fall off.

    Most adults who think they did not have chickenpox as a child probably had a mild attack. Siblings will come down with chickenpox in 7 to 21 days. The second case in a family generally has many more chickenpox sores than the first case.
  • How is it treated?

    The treatment for skin discomfort and itching is a cool bath every 3 to 4 hours for the first few days. Add 4 tablespoons of baking soda per tub of water. Bath water does not spread chickenpox. Calamine lotion can be applied on the itchy areas. The itchy areas can be massaged with an ice cube.

    Paracetamol may be given in the dose appropriate for the child's age for fever over 102°F (39°C). Do NOT give aspirin to children and adolescents with chickenpox because of the risk of Reye's syndrome, a neurological illness.

    Since chickenpox sores also occur in the mouth and throat, the child may be picky about eating. Encourage the child to drink cold fluids. For infants, use a cup rather than a bottle because the nipple can cause pain. A soft, bland diet, avoiding salty foods and citrus fruits is good.

    If urination becomes very painful due to sores in the genital area, apply 5% Xylocaine ointment to the genital ulcers every 4 hours for pain relief.

    Acyclovir is an expensive, oral anti-viral drug that can be used to treat chickenpox. It helps only if it is started within 24 hours of the appearance of the first sores. It may reduce the number of sores and the duration of illness. The complications are not reduced. Some doctors prescribe acyclovir for adults and older students. It may also be prescribed for younger children having social obligations (such as travel). Most doctors do not treat normal, healthy children with acyclovir.
  • When should the doctor be called?

    Consult the doctor immediately if some chickenpox sores look infected (yellow pus, spreading redness, red streaks), the child looks very sick, or fever lasts more than 4 days, or the itching is severe and doesn't respond to treatment.
  • Can chickenpox be prevented?

    A chickenpox vaccine is available that is recommended for all children who haven't had chickenpox. It is given at any time after 12 months of age.
  • What is chickenpox?

    Chickenpox is a viral illness that generally starts with a fever. There are multiple small, red bumps on the skin that become thin-walled blisters filled with water. These become cloudy blisters or open sores and finally dry up with brown crusts (all within 24 hours). There are repeated crops of these sores for 4 to 5 days. The rash is on all body surfaces, but usually starts on the head and back. Some sores may be in the mouth, eyelids or genital area. There may be an exposure to a case of chickenpox 2-3 weeks earlier.
  • How is chicken pox spread from person to person?

    The chicken pox virus spreads easily through the air as droplets when the patient breathes out or through contact with the fluid in a chicken pox blister. Symptoms may start as soon as 10 days or as late as 21 days after your child has been in contact with someone infected with chicken pox. One infected child quickly infects classmates and this is an important clue to diagnosis.

    The infections period starts 1-2 days prior to development of rash and lasts until the last blister has crusted or 5 days after the rash starts, whichever time is shorter. This means your child can give the virus to another child during this time.

  • What are the symptoms of chicken pox?

    Chicken pox starts with a mild fever. This is followed in a day or two by a rash that can be very itchy. The rash begins with red spots on the scalp and body that soon turn into fluid-filled blisters. New blisters may form on the face, arms and legs during the next few days. The blisters appear as crops and are described as ‘dew drops on a rose petal’ due to a red base and a water filled centre. Crusts form over the blisters. The rash may take 2-3 weeks to disappear depending on the severity of the rash.

    Other symptoms of chicken pox are chills, loss of appetite and headaches.
  • What if I am pregnant?

    Adults can develop severe chicken pox, especially pregnant women. There are 2 important times when it can cause problems for pregnant women.

    1. Chicken pox in the first 20 weeks of pregnancy can cause severe damage to the unborn baby. But this occurs in less than 3 in 100 pregnant women who have chicken pox at this time.

    2.  If a woman gets chicken pox a few days before or after delivering her baby, the baby can become very ill. The baby’s immune system is not developed enough at this point to fight the infection.
  • Is chicken pox more common at certain times of the year?

    Chicken pox can occur at any time, but happens most in the winter or early spring.
  • What can I do if my child gets chicken pox?

    Watch for symptoms if your child has recently been around a child who has chicken pox. It could take 2 to 3 weeks for your child to show signs of infections. If he or she does develop chicken pox, make sure you tell his or her school or teacher. If your child has fever, do not give acetylsalicylic acid (ASA), also known as Aspirin or any product contain ASA. Aspirin increases the risk of getting reye’s syndrome. Reye’s syndrome, an extremely rare but serious illness that can affect the brain and liver, occurs most commonly in kids recovering from a viral infection.

    It is safe to use acetaminophen.

    Try to stop your child from scratching the blisters. The blisters could become infected. Keep your child’s fingernails trimmed short.

    If one child in your home has chicken pox, do not try to keep other children in the family away from the child. It is usually impossible to stop chicken pox from spreading to other members of a family. It shall likely show up 2 or 3 weeks after the first family member became ill.
  • When should I consult a doctor?

    Tell your doctor if areas of the rash get very red, warm or tender ,appear filled with rash or if fever reappears. This may mean your child has a bacterial infection and needs other treatment. If any child in your home has an immune system disorder, call your doctor.

    If your child has a skin disease (such as eczema) or a lung disease such as asthma, and takes steroid medicine) he or she could develop severe chicken pox. A prescription medicine is available for these patients. To be effective, it must be given within 24 hours after the rash appears. Talk to your doctor about this medicine if your child is at increased risk for severe chicken pox.
  • What is the role of vaccination?

    Vaccination is administered as a single dose in children aged 12-18 months and as two doses 4-8 weeks apart in older children. It may provide 84-97% protection. Despite vaccination, some people would get the disease but it is generally  mild.

    One episode of chickenpox provides you lifelong immunity.

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