15 things to know about chickenpox
Chickenpox is a common childhood illness - most children catch it at some point. It’s a mild condition, though all too often, a deeply uncomfortable one. Our reporter talks to Dr Suzanne Cotter, specialist in public health medicine, about the progress of the disease and how to manage an outbreak in your home
Published 30/08/2016 | 02:30
A recent case in Britain of chickenpox which went undiagnosed - to near fatal effect - left the parents of the infected child calling for routine public vaccination against the disease. While some countries do offer vaccination under their health services, it is not part of Ireland’s public vaccination programme. So what is chickenpox, and should we be lobbying for change? Here are 15 things you should know.
1 Know all the Symptoms
Although the most common chickenpox symptom is a red rash on the body, your child may actually feel unwell for some days beforehand. He or she may complain of flu-like symptoms such as feeling generally unwell, having a high temperature of 38ºC (100.4ºF) or over, headache, painful muscles and loss of appetite.
“Children can feel unwell for about two days before the rash appears, so if the parent knows there has been chickenpox in the community, or that the child has been in contact with it, there may be a heightened suspicion that their child has come down with it,” says Dr Suzanne Cotter.
However, she adds, it’s often only when parents see the rash that they realise a child has chickenpox.
“The other symptoms can mimic other illnesses,” Dr Cotter says, adding that the flu-like symptoms, especially the fever, tend to be worse in adults than in children.
2 Recognise the Rash
Some children and adults may only have a few spots, but others are covered from head to toe. Spots normally appear in clusters and are often found behind the ears, on the scalp, under the arms and on the chest, stomach, arms and legs. They can also be found inside the ears and mouth, on the palms of the hands, soles of the feet and inside the nappy area.
The rash begins as small, itchy red spots. After about 12-14 hours the spots develop a blister on top and become very itchy. After another day or two, the fluid in the blisters gets cloudy and they begin to dry out and crust over. After one to two weeks, these crusts will fall off naturally.
Remember, however, that new spots can keep appearing in waves for three to five days after the rash begins. Therefore different clusters of spots may be at different stages of blistering or drying out.
There is no cure for chickenpox, and the virus usually clears up by itself without any treatment.
However, if your child is in pain or has a high temperature, you can give them paracetamol. Always read the manufacturer’s instructions. Paracetamol is the preferred painkiller for treating symptoms of chickenpox, because there is a small risk of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, causing a skin reaction. “If a child with chickenpox were to develop this, it might be masked by the chickenpox rash,” Dr Cotter says.
4 Stay hydrated
It is important for anyone with chickenpox to drink plenty of water to avoid dehydration. Sugar-free ice-lollies are a good way of getting fluids into children — and they can also help to soothe a sore mouth that has chickenpox spots in it. Avoid any food that may make the mouth sore, such as salty foods. Soup is easy to swallow so long as it is not too hot.
5 When To See the Doctor
Contact your GP straight away if you or your child develop/s any abnormal symptoms, for example if the blisters become infected, if the skin surrounding the blisters becomes red and painful or if the patient experiences pain in the chest, has difficulty breathing or becomes unwell to the point where you are concerned. In such cases, prescription medicine, and possibly hospital treatment, may be needed.
6 Prevent scratching
Chickenpox can be incredibly itchy, but it’s important for children and adults to not scratch the spots. “Scratching can cause scarring and infection,” warns Dr Cotter.
One way to avoid this is to keep fingernails clean and short. You can also put socks over your child’s hands at night to stop him or her scratching the rash while sleeping. If your child’s skin is very itchy or sore, try using calamine lotion, oatmeal or cooling gels. These have a cooling, soothing effect, are available in pharmacies and are very safe to use.
A stronger medicine called chlorphenamine can be prescribed by your GP to relieve itching. It’s taken by mouth and is suitable for children over one year old.
7 Dress in Cool Clothing
If your child has a fever, or if their skin is sore and aggravated, it’s best to dress them in loose-fitting, smooth, cotton fabrics. Avoid sponging down with cool water as this can make the child too cold.
8 What Causes Chickenpox?
Chickenpox is caused by the varicella-zoster virus. You catch it by coming into contact with someone who is infected with the virus. It’s a contagious infection, as about 90pc of people who have not previously had chickenpox will become infected when they come into contact with the virus. “The source of infection can be someone who has chickenpox or shingles, because it is the same virus,” explains Dr Cotter.
9 How You Catch Chickenpox
The chickenpox virus is spread in the same way as colds and flu — through the respiratory system. It’s contained in the millions of tiny droplets that come out of the nose and mouth when an infected person sneezes or coughs.
You can then become infected with the virus by breathing in these droplets from the air or by handling a surface or object on which the droplets have landed on, then transferring the virus to yourself by touching your face.
Once you have come into contact with the virus, it takes between 10 and 21 days for the symptoms of chickenpox to show. A person with chickenpox is most infectious from one to two days before the rash appears until all the blisters have crusted over, which usually takes five to six days from the start of the rash.
10 What To Do if You or Your Child has Chickenpox
Inform the school or nursery and keep the child at home while they remain infectious. If you have chickenpox, stay off work and at home until you’re no longer infectious.
Avoid contact with pregnant women, newborn babies or infants under one-year-old, as well as anyone who has a weak immune system, such as people who are having chemotherapy or taking steroid tablets.
Remember that if you or your child have recently been exposed to the chickenpox virus, you may not be able to visit friends or relatives in hospital. Telephone the ward to check first.
11 Stop the Spread
Chickenpox can sometimes be spread through contact with objects that have been infected with the virus, such as children’s toys, bedding or clothing. “The virus will not last forever,” explains Dr Cotter, adding that the virus can remain alive and contagious on a surface, for example, in a crèche.
So if someone in your household has chickenpox, wipe down any objects or surfaces with a sterilising solution and make sure that any infected clothing or bedding is washed regularly.
“However, normally the route for transmission is through the respiratory system,” Dr Cotter says.
If you have not had chickenpox before, you can also catch chickenpox from someone with shingles, which is an infection caused by the same virus. However, it’s not possible to catch shingles from someone who has chickenpox.
“The primary infection is chickenpox, but the virus can stay dormant in the nerve endings and later appear as shingles. Shingles is infectious to people who come into contact with it and who are not immune to the chickenpox virus,” says Dr Cotter.
There is a chickenpox vaccine which is used to protect people who are most at risk of a serious chickenpox infection or of passing the infection on to someone who is at risk.
People who may be considered for chickenpox vaccination include healthcare workers who are not already immune — for example, a nurse who has never had chickenpox and who may pass it to someone they are treating if they become infected, as well as people living with someone who has a weakened immune system such as the child of a parent receiving chemotherapy.
“The vaccine can be given to a child but it is not part of the routine primary childhood immunisation programme,” says Dr Cotter. “It’s not part of the HSE programme but people can go to their GP and request it, though they have to get it administered privately.”
The vaccine is not suitable for pregnant women. Avoid getting pregnant for three months after having the vaccine. The vaccine is also not suitable for people with weakened immune systems.
14 Chickenpox is a Notifiable Disease
Chickenpox is a notifiable disease since 2012. “This means that hospital cases of chickenpox must be notified to the medical officer of health at the local Department of Public Health,” explains Dr Cotter.
15 If you travel to Ireland from a warm climate
Chickenpox is a common childhood illness in northern climate and temperate zones of the world, and is less common in tropical regions. Therefore, adults who originate in the tropics are often more susceptible to chickenpox than indigenous Irish people because they have not been exposed in childhood, explains Dr Cotter. A study cited in the Journal of Infectious Diseases showed 96pc of urban adults were immune to chickenpox by the age of 25, compared with 42pc of people living in a rural Tropics group.
Health & Living