I have three children aged seven, five and two. My youngest is in a creche and I was recently told that there have been cases of chicken pox in children attending there. We are due to visit my in-laws over the next few weeks. My sister-in-law is pregnant. She said she had chicken pox before, but we are worried about her catching shingles. Should we stay away? Can my older children get sick again also?
I'm delighted you brought up the issue of chicken pox and shingles as these are two conditions about which there is a lot of confusion.
Both are cause by a virus called Varicella. Chicken pox is one of the few childhood viral illnesses that we still see regularly. It causes an extensive intensely itchy blistering rash that can occur all over the body. Shingles causes a painful blistering rash that usually occurs in a localised area.
Chicken pox occurs most commonly in young children. It is highly contagious. Most people have fever and a flu-like illness for several days before the rash appears. The rash starts as small, red, slightly raised spots which then blister and crust. A person will develop the illness about seven to 21 days after being exposed to the virus.
It is contagious from 48 hours before the rash appears and until 24 hours after the last spot has crusted. It is necessary to stay out of work, school or creche for this time.
In most children, Varicella causes discomfort but passes off with no serious problems. It is not always necessary to see a doctor.
However, in adults or in children with other illnesses there can be more severe complications. The most dangerous of these are brain inflammation, pneumonia or infection of the skin from scratching.
If the fever is not settling or if there is associated headaches, drowsiness, shortness of breath or ooze from the blisters, it is important to see a doctor.
Treatment isn't always necessary but paracetamol and ibuprofen can be used to treat fever and discomfort. Antihistamines can be used to treat the itch. Calamine lotion is nearly always used but in my opinion doesn't really help. Lukewarm baths with bread soda or oatmeal can be much more soothing.
Your sister-in-law should be fine if she had the illness previously. However, if she is not immune and she is more than 28 weeks' pregnant she should see a doctor urgently as treatment is important to prevent risk to the baby.
Shingles occurs when the chicken pox virus reactivates.
The virus breaks out of the root, travels along the nerve and shows itself on the skin, causing a painful blistering rash. The rash usually resolves over a period of two to four weeks.
Medication, if started within 72 hours of the rash, can be helpful, especially in those over 50, with weakened immune systems or other illnesses. Over-the-counter painkillers work for many.
In answer to your question, you cannot catch shingles from someone with chicken pox.
Shingles is only contagious on direct contact with the fluid in the blisters and will cause chicken pox in those who have not had this before.
It is likely that your two-year-old will get chicken pox if he or she has not had them but it sounds like your older children are immune.