Chickenpox

Chickenpox is a highly infectious disease, which mostly affects children. It is generally a mild disease, which does not last long in healthy children, but may cause serious illness or death in people who have lowered immunity. Adults who develop chickenpox generally become unwell and chickenpox in adults may have more serious complications such as pneumonia.

Chickenpox is caused by the varicella-zoster virus. The same virus also causes herpes zoster (shingles). This virus is present in large numbers in and behind the nose, and is spread from child to child by sneezing and coughing. It usually takes 2 to 3 weeks for the symptoms to appear after infection with the virus.

child with chickenpox

Symptoms of chickenpox

Initially, the child (or adult) may have flu-like symptoms, including a fever, headache, backache and loss of appetite. This is quickly followed by a red and spotty rash, which soon develops into blisters. The rash normally starts on the chest and back and then spreads to other parts of the body including the face, scalp, arms and legs. The rash is usually very itchy. After a day or 2 the blisters form a crust or a scab and this peels off in 5 to 20 days. Some children develop only a few spots and others have them all over their bodies — including their vagina, mouth and up their nose.

Treatment of chickenpox

For some children, the rash may be no more than a passing inconvenience, but for others it can be very unpleasant. Treatment is therefore aimed at controlling the symptoms.

Asking your child not to scratch will probably fall on deaf ears, however it is worth trying to distract them as much as you can. Cut their fingernails very short and make sure that their hands and fingernails are kept clean. If the rash or sores are very itchy, bathe the child in a warm (but not too hot) bath with half a cup of baking soda. Your pharmacist or doctor will also be able to recommend some anti-itch preparations if your child is distressed. Calamine lotion can also be useful.

Paracetamol (but not aspirin) should be given as directed to reduce the fever and ease headaches. Ask your child to drink plenty of fluids. Don't worry if they don't eat as much as usual while they are sick — this will be fine for a day or 2.

As chickenpox is caused by a virus, no antibiotics will be prescribed, however, they may be offered if your child develops a bacterial infection as a result of having chickenpox.

Antiviral medicine can be used to treat people with complicated or severe chickenpox, or those with lowered immunity.

Preventing infection

Vaccines for the prevention of chickenpox are available in Australia. Chickenpox vaccine is recommended by the National Health and Medical Research Council (NHMRC) for all children at 18 months as part of the Australian Standard Vaccination Schedule. An additional dose may be given to children under 14 years to increase protection, but this second dose is currently not funded on the Schedule.

Vaccination is also recommended for adolescents aged 14 years and over and adults who have not had chickenpox or who have not had the chickenpox vaccine previously. Two doses of vaccine are required in adolescents and adults for adequate protection.

When can my child go back to school?

People often ask "When can my child go back to school or child-care?" Chickenpox is most infectious from 2 days before the rash is present until after scabs have formed on the blisters — this takes about 7 days. Do not send your child to school or pre-school during this time. Your child can return to school, preschool or day care 7 days after the first spots appear, as long as all of the blisters have scabbed over.

For children who have not really been sick with chickenpox this can be a bit annoying. Remember, however, for some children and adults, chickenpox can be a very serious illness.

Last Reviewed: 12 December 2012
Your Doctor. Dr Michael Jones, Medical Editor.

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References

1. Varicella (chicken pox) (revised June 2010). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 Nov. http://online.tg.org.au/complete/ (accessed Feb 2013).
2. Royal Children’s Hospital Melbourne. Clinical Practice Guidelines: Chickenpox (varicella). http://www.rch.org.au/clinicalguide/guideline_index/Chickenpox_varicella/# (accessed Feb 2013).
3. National Health and Medical Research Council. The Australian Immunisation Handbook, 9th Edition, 2008. Chapter 3.24 Varicella. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-hepatitisa (accessed Feb 2013)
Dr Michael Jones

Dr Michael Jones

Medical Editor, Your Doctor.