Chicken Pox In Children

Chicken pox is caused by the Herpes Zoster virus. It is very infectious. A child with chicken pox is likely to pass it on to most classmates and household members who have not previously had it. A person will usually have chicken pox only once as antibodies are produced in the body which protect from further infection.

What are the symptoms?

Like other virus infections a child may feel unwell with a fever (temperature) and headache. This often starts a day or so before the rash appears. Spots appear in crops. The spots develop into small blisters and are itchy. The spots can be anywhere on the body and sometimes also in the mouth. Several crops may develop over several days. Some children may be covered in spots, others have only a few or even none (a sub-clinical illness). Commonly there is a dry cough and a sore throat. Some children feel quite unwell for a few days, others appear only mildly off colour. The child is usually much better within a week. The blisters dry up and scab. They gradually fade but may take up to two weeks to go completely.

Treatments

Give plenty to drink. Paracetamol (Calpol, Disprol, etc) will help with fever, aches and pains. Calamine lotion applied to the spots may ease itch. Antihistamine medicine may be advised at bedtime for a few days. This is available from pharmacies or on prescription. It may help with sleep if itch is a problem. Make sure the nails are cut short to stop deep scratching.

Complications

The spots do not usually scar unless they are badly scratched. One or more spots become infected with bacteria in about 1 in 10 children with chicken pox. If a spot becomes infected with bacteria the surrounding skin becomes red and sore. Antibiotics may then be needed. An ear infection develops in about 1 in 20 children with chicken pox. Pneumonia and inflammation of the brain (encephalitis) are rare complications.

To isolate or to mix?

A child is infectious from 48 hours before the rash appears until all the spots have scabbed (about 6 days). It takes 14-20 days to develop symptoms after being in contact with an infected person. Most children will have chicken pox at some time but the illness is usually minor. In adults it can be more serious. In particular it can be serious and cause problems during pregnancy. Therefore, many people believe it is best to have chicken pox as a child. Some parents will encourage their school age children to mix with infected children. If they catch it they will be immune as adults. In practice, some schools ban children with chicken pox even if the child feels well enough to go to school. Parents and teachers may have different views on this issue. However, there are two groups of people who should avoid people with chicken pox.

• Pregnant women who have not previously had chicken pox and so are not immune.
• People with poor immune systems. For example, people with leukaemia, people who are HIV positive or those on high dose steroid medication or chemotherapy.
  
  An anti-virus serum may be advised if such people come in contact with chicken pox.

Extract from Mentor Plus copyright OUP, EMIS and Authors 1999


Chicken Pox In Adults

Chicken pox is caused by the Herpes Zoster virus. It is very infectious. A person will usually have chicken pox only once as antibodies are produced in the body which protect from further infection. Most people catch chicken pox as a child. About 9 out of 10 people have had chicken pox by the age of 15. A small number of people catch chicken pox as an adult.

What are the symptoms?

Symptoms are usually more severe in adults than in children. A few uncomfortable days can be expected. Like other virus infections there is usually a fever (high temperature). There may be a dry cough, sore throat, feeling sick, headache and general aches and pains. These symptoms often start a day or so before the rash appears. Spots then appear in crops. The spots develop into small blisters and are itchy. The spots can be anywhere on the body and sometimes also in the mouth. Several crops may develop over several days. The blisters gradually dry up and scab. They slowly fade over a week or so but may take 2-3 weeks to go completely.

Treatments

Have plenty to drink to avoid dehydration.
Paracetamol or aspirin taken regularly will help with fever, headaches, aches and pains.
Gargling with soluble aspirin is useful to relieve a sore throat.
Calamine lotion or cream applied to the spots may ease itching.
Antihistamine tablets or medicine may be advised at bedtime to help with sleep if itch is a problem. These are available from pharmacies or on prescription.
Complications

Complications are uncommon. The spots do not usually scar unless they are badly scratched. Sometimes bacteria can infect one ore more spots. If a spot becomes infected with bacteria the surrounding skin becomes red and sore. Antibiotics may then be needed. Inflammation of the lung (pneumonia) is a rare complication affecting about 1 in 100 adults with chicken pox. Inflammation of the brain is a very rare complication. Seek medical advice urgently if there is breathlessness, confusion or if there are any unusual or severe symptoms.

Can it be passed on?

Yes, it is very infectious. Household members and close contacts who have not previously had chicken pox are likely to catch it. However, most adult contacts will be immune from a previous childhood infection and are unlikely to become ill. Also, many parents prefer their children to have chicken pox as a child. It is usually a milder illness in children and complications are less likely. A person is infectious from about 48 hours before the rash appears until all the spots have scabbed (about 6 days). It takes about 14-20 days to develop chicken pox after being in contact with an infected person. However, two groups of people in particular should not mix with anyone with chicken pox.

• Pregnant women who have not previously had chicken pox and so are not immune.
• People with poor immune systems. For example, people with leukaemia, people who are HIV positive, those on high dose steroid medication or on chemotherapy.
  
  An anti-virus serum may be advised if such people come in contact with chicken pox.

Extract from Mentor Plus copyright OUP, EMIS and Authors 1999

Chicken Pox Contact And Pregnancy

Chicken pox is caused by the Herpes Zoster virus. It is very infectious and causes a typical blistering rash. There may also be a cough, sore throat, feeling sick and general aches and pains. Symptoms are usually mild in children. It is often more severe and complications more likely in adults, particularly pregnant women. A person will usually have chicken pox only once as antibodies are produced in the body which protect from further infection. Most people catch chicken pox as a child. Only a small number of people catch chicken pox when adult.

What should I do if I am pregnant?

About 17 out of 20 women of childbearing age have already had chicken pox as a child. Sometimes they cannot remember it or it was so mild it was not noticed. These women are immune and will not catch chicken pox again. So, only about 3 women in 20 are at risk. If you are pregnant and come into contact with a person with chicken pox:

If you have had chicken pox in the past, you are safe and there is nothing further to do.

If you have not previously had chicken pox or you are unsure, see a doctor as soon as possible. A blood test may be advised which can detect chicken pox antibodies.

Blood tests and treatment

A blood test can check for antibodies to the chicken pox virus. If antibodies are present in the blood, this means that chicken pox has occurred in the past. No further action is then needed. If there are no antibodies, chicken pox may develop. In this situation a special anti-serum (antidote) may be advised to stop chicken pox developing. This is best given within 4 days of coming into contact with the virus. However, there may be some protection even if anti-serum is given up to 10 days after contact with chicken pox. (It takes about 14-20 days for the chicken pox illness to develop after coming in contact with an infected person).

What are the complications to be prevented?

For the pregnant woman - chicken pox even without complications can be a severe and uncomfortable illness in pregnant women. In addition, about 1 in 10 pregnant women who have chicken pox develop inflamed lungs (pneumonia or pneumonitis). This can sometimes be serious. Inflammation of the brain (encephalitis) is an uncommon but serious complication.

For the unborn child - there is about a 1 in 50 chance of the baby having an abnormality if the mother has chicken pox within the first 20 weeks of pregnancy. The most unfavourable time is between the 13th and 20th week of pregnancy. If the mother has chicken pox after the 20th week of pregnancy there does not appear to be any risk to the baby unless it occurs just near the time of birth. If a mother has chicken pox a few days before or after a birth, the new-born baby may develop a severe form of chicken pox.

Extract from Mentor Plus copyright OUP, EMIS and Authors 1999