Chickenpox is an extremely contagious disease caused by a varicella-zoster virus. It is characterized by a rash of small, widely scattered, individual red bite-like spots which usually blister within 24 hours. These then rupture and form a crusted lesion. The blisters vary from the size of a pinpoint to that of a pencil eraser.
Chickenpox can erupt over the entire body including the ears, mouth, throat, scalp, vagina and anus. New lesions appear daily for four to seven days. Day four or five tends to be the worst. A fever of 101° F to 103° F may be present as well as a sore throat and often a headache. Severe complications do occur. As the skin breaks down from the pox, it is the set up for a very rapid invasion of streptococcal infection.
If your child develops a very high fever, a rapid redness or swelling and tenderness around any of the lesions, your child should be seen immediately.
Other complications including pneumonia and encephalitis can occur, either during the active phase or sometimes after the disease has subsided.
Chickenpox is spread by direct contact from an infected individual. The incubation period is 10 to 21 days (but usually 17 days) from the date of exposure.
Chickenpox is contagious from 24 hours before the rash appears until the lesions are all crusted over (roughly one week).
Fever and discomfort can be treated with acetaminophen or ibuprofen. AVOID ASPIRIN due to its association with Reye's Syndrome.
The itching can be helped by applications of calamine lotion applied to the lesions, or a tub bath with tepid water to which a cup of baking soda has been added. Benadryl Elixir can be purchased over the counter. This usually gives relief from the itching. The dose is approximately one teaspoon for every 15 pounds of body weight, given three or four times daily. If this fails to control the itching, there are prescriptions available.
Keep fingernails clipped to avoid injury from intense scratching. Try to dress your child in light cotton clothing.
When to Call the Doctor's Office
- Fever over 104° F
- Fever that recurs after the fifth day of the disease
- Persistent severe cough
- Severe headache
- Hallucination or disorientation
- Frequent vomiting
- Chickenpox on the eyeball
- A chickenpox becomes infected. This will appear as an enlarged, pustular pox, surrounded by a red ring.
An anti-viral medication called acyclovir is sometimes used to treat chickenpox. It can reduce the number of pox that develop and shorten the disease's time course. To be effective it needs to be started within 24 hours of developing the pox. This drug is not used routinely.
Chickenpox vaccine is now required. The use of the vaccine has reduced the mortality rate of chickenpox more than 85 percent.