Chickenpox in children is usually a very mild disease.
It occurs less frequently in older children and adults, but
if they get the disease, it is more extensive and causes a lot
of discomfort to the patient.
Chickenpox is a viral infection and highly infectious.
If one child gets the infection at home or in the school, those
in contact with him are likely to contract the disease
after a period of 2 to 3 weeks. As the disease usually confers lifelong immunity, you are safe if you have had it before.
ONSET AND COURSE: Often, the first thing you will notice are one or two tiny blisters on the back or
chest. The child is otherwise normal. New blisters appear rapidly.
The blisters form crusts or scabs. Some children, specially
older ones, may get high fever and look quite ill, while
younger ones may have low fever or no fever at all. The rash of chickenpox usually begins within a day of the onset of
fever, in the form of red spots that itch. Within a few hours, they turn first into small pimples and then into blisters on
a red surface (almost like a dew drop on a red leaf). The spots are very itchy. The blisters with clear fluid become cloudy
within a day and then become crusted. While this is happening,
new red spots or blisters may be noted in the nearby area. Typically, in a small portion of the body, you
may
notice the rash in different stages — the red spot, the clear
blister, the cloudy blister and the crusted one — at the same time.
The rash is mostly confined to the chest, back, face and head. The legs and hands are generally not involved.
Spots may also appear in the mouth and vagina. Small glands
often develop at the back of the neck and the armpits. The
total period of the illness is about a week to 10 days. While
the disease may initially be confused with insect bites or pimples, the rash of chickenpox keeps changing its
characteristics very fast, while insect bites or pimples do not follow this
pattern.
Once all the spots become crusted and no new crops appear, the patient is no longer infectious.
He can
infect others from a day before the spots are first noticed to
the day all the spots are crusted. Once that happens, the child
should be ready to go to school and play with other children. Unfortunately, in some schools, the child is not allowed
to join till all the scabs or crusts have fallen off. It is to
be noted that whereas the scabs of smallpox, which is now eradicated,
could infect others, those of chickenpox cannot. Interested
parents may consider meeting the school authorities in this connection so that children are not unnecessarily kept
away from school.
TREATMENT: The spots of chickenpox are very itchy. A daily bath helps because sweating increases the
itching. Keep the child’s nails short. Explain to an older
child that he should avoid scratching because it may leave behind
scars. For smaller children, mittens may be used at night. If
itching is severe, apply cool packs of cloth soaked in water
from boiled and strained neem leaves. Plain calamine lotion
applied to the spot also reduces itching. It is not advisable to use calamine mixed with other ingredients. Neem leaves may
also be spread on the bed sheet. If the itching is very severe, your doctor may prescribe an antihistamine preparation to be
given by mouth. If the fever does not bother the child, avoid
using any drug. If required, a paracetamol preparation may be
used to lower the temperature. Never give aspirin to a child suffering from chickenpox or influenza, because it may
lead to a serious disease called Reye’s Syndrome. No diet
restrictions are required. The child should be allowed to eat his
usual healthy nutritious food. If he does not feel hungry,
make sure he has enough of liquids including fruit juices, coconut
water and plain water.
Complications In Children And During Pregnancy
While chickenpox is not a serious disease, complications
like pneumonia and encephalitis can sometimes occur.
If a pregnant woman gets the disease in the first three months of pregnancy, there are 2% to 3% chances of her
baby suffering a birth defect. A newborn is protected from
getting chickenpox if his mother has had chickenpox in the past.
But the risk of a newborn getting the disease are quite high
(about 50%) if the mother develops chickenpox within 5 days
before or 2 days after the delivery. A baby whose mother
develops chickenpox after delivery may be given chickenpox immunogobulin,
if available. These babies should be kept away from other children for 3
weeks. If the mother has had chickenpox, her newborn is protected for
about 6 months. Such a newborn can be brought home if the older children
are having chickenpox. If the mother is not sure if she has already had
chickenpox, the newborn should be kept away from the older children for
about 2 weeks.
A particular drug for the treatment of chickenpox is reserved for special situations to be decided upon by
your doctor. In any case, it is really effective only if the
drug is started within 24 hours of the onset of the disease.
Antibiotics are also of no use in this viral infection except in
rare cases where secondary bacterial infection might have
supervened.
