Chickenpox

Chickenpox is a viral infection caused by a herpes virus called varicella-zoster (VZV).

An airborne disease, chickenpox spreads easily via the coughs and sneezes of an infected person.

The incubation period – the time from infection to the first symptom – is usually 10-20 days. Therefore, it is difficult to stop the disease from spreading and it is common for entire preschool departments or school classes to get chickenpox at the same time. 

The contagion period starts from the end of the incubation period (10-21 days) until all rashes are covered with a crust (7-10 days). Contagiousness of chickenpox is 100% – everyone who has not previously encountered the virus gets sick. When all the rashes have dried and become wound crusts, you are no longer infected.

You can only get chickenpox once. But just like other herpes viruses, the virus is latent in the body after the infection and can be reactivated later in life in the form of shingles.

The first symptoms of chickenpox are usually fever, fatigue and headache. After a day or two, small, red rashes begin to emerge, which soon turn into watery, itchy blisters. The blisters dry after a couple of days and become sores that then fall off.

Common symptoms:

• fever and fatigue
• headache
• red, itchy rash that turns into liquid blisters.

The first rashes usually appear on the chest, abdomen or back and can then spread throughout the body. This can range from a few rashes to several hundred sitting in the face, arms, legs, scalp or mouth, for example. Sometimes rashes and blisters can also occur in the mucous membranes of the ears, rectum or genitals. Mostly, chicken pox heals well, but it can produce small scars.

Children usually get healthy after a week or two, but adults who get chickenpox can be sick for a long time.

Hand, foot, and mouth disease, like chickenpox, can cause fever and fatigue with itchy blisters. The blisters usually sit in the mouth, but can also occur on the hands, palms, feet, soles of the feet. Sometimes impetigo is mistaken for chickenpox.

Hygiene measures

The spread of chickenpox can be prevented by isolating affected individuals. Contagion is by exposure to respiratory droplets, or direct contact with lesions, within a period lasting from three days before the onset of the rash, to four days after the onset of the rash. The chickenpox virus is susceptible to disinfectants, notably chlorine bleach (i.e., sodium hypochlorite). Like all enveloped viruses, it is sensitive to desiccation, heat and detergents.

Vaccine

The varicella vaccine is recommended in many countries. Some countries require the varicella vaccination or an exemption before entering primary school. A second dose is recommended five years after the initial immunization. A vaccinated person is likely to have a milder case of chickenpox if they become infected. Immunization within three days following household contact reduces infection rates and severity in children.

Important to know about Reye’s syndrome

Reye’s syndrome is a very rare disorder that affects children and teens that have been treated with Aspirin (acetylsalicylic acid).

A few days after a viral infection, such as a cold, flu or chickenpox, there may be inflammatory effects on the brain and liver. The symptoms of Reye’s syndrome are cramps, abdominal pain and vomiting, fits and losing consciousness. Sometimes Reye’s syndrome has a fatal outcome.

Because the use of aspirin in children has been linked to Reye’s syndrome, children and adolescents under 18 years of age should not use Aspirin without a doctor’s recommendation. 

Most children get a mild form of chickenpox and do not need treatment. The disease usually heals itself within two weeks and the itching can be alleviated with the help of unscented lotion and allergy tablets. 

Adults and children in their upper teens are recommended treatment with antiviral drugs. In order to have the best effect, treatment should be started within a day of the first rash appearing.

If you are pregnant, you may need treatment for chickenpox – contact your maternity care provider or talk to your doctor.

Sometimes it may be appropriate to treat chicken pox with antiviral drugs. This applies to newborn children or people with a reduced immune system.

Here’s how you can relieve the symptoms:

• do not itch the blisters – chickenpox can become infected if bacteria enters the wounds
• relieve itching – bathing with cold water and allergy tablets can also help
• sleep in a cool room – this relieves itching and body temperature drops
• cut the baby’s nails to reduce the risk of scratching
• drink water if there is fever, to prevent dehydration.
• Children with chickenpox should stay at home until the fever has disappeared and all the blisters have dried.

Chickenpox is very contagious. So if you suspect you or your child has chickenpox you must call the doctor before coming in – avoid waiting rooms where other people can easily become infected.

If your child gets a cough, prolonged fever and has many infected rashes with sore, red skin or severe itching, you should get medical help.

Children who get chickenpox before the age of six months should always see a doctor.

Children in their upper teens and adults should always get medical help for suspected chickenpox. This is especially important if you have a reduced immune system.

Children and adults who have just had chickenpox and have a fever and cough again should be checked to rule out complications.

If you are pregnant, didn’t have chickenpox before and think you may have been infected with chickenpox or shingles, you should contact your doctor.

You should contact your doctor urgently if, after having a cold, flu or chickenpox, your child is:

• repeatedly being sick 
• unusually tired
• displaying personality or behavioural changes 

Although it’s unlikely these symptoms will be caused by Reye’s syndrome, they still need to be checked by a doctor. (Remember to alert your doctor if your child has taken Aspirin.)

APPOTEK can help with chickenpox. A nurse or doctor will make an individual assessment in the online consultation. You may then be prescribed treatment or referred for further examination. 

If your child has any of the symptoms of Reye’s syndrome you should seek urgent care.