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Baby with chickenpox

Chickenpox is a highly contagious virus.

What are the symptoms?

The symptoms and signs of chickenpox include general flu-like symptoms, with a classic blister-like rash occurring after the onset of other symptoms. Watch out for:

  • Fever over 38°C
  • Nausea
  • Sore muscles and limbs
  • Headache
  • Feeling unwell
  • Not wanting to eat
  • Blister-like rash

What causes it?

Chickenpox is caused by a virus called varicella zoster. It’s transmitted by direct contact with chickenpox blisters or by an infected person coughing or sneezing on you. Chickenpox is so contagious some infection specialists estimate that if a contagious patient is in the same room (say, watching a school play) for an hour or so with 100 non-immune children, over 80 of them would become infected!

Chickenpox has an incubation period of 8-21 days, which means that a child can develop it between eight and 21 days after coming into contact with a carrier. Children are contagious before they even develop the rash, so it’s almost impossible to know if someone is incubating the virus.

Who usually gets chickenpox?

It usually occurs in children under 10 years. In fact, 90% of adults in the UK are immune to the condition because they had it when they were kids.

Is there a vaccine for it?

There is a safe, live-attenuated vaccine (a live but weakened version of chickenpox that allows the body to manufacture antibodies that will protect against the full virus) that was first used in Japan in the 1980s. These days several countries vaccinate children against chickenpox, including the USA, Canada, Australia and Japan, where chickenpox has greatly reduced. The vaccine is considered safer than chickenpox itself, and fully vaccinated people are less likely to get shingles in later life. The chickenpox vaccine is not part of the routine childhood vaccination schedule in Ireland.

Where does the rash appear?

Sometimes there will be only a few spots, but sometimes the pox can cover the entire body. The spots are most likely to appear on the face, ears and scalp, under the arms, on the chest and belly and on the arms and legs.

Some really unfortunate children get the blisters in their mouth, throat, in their urethra and bottom.

Do I need to protect others from chickenpox?

A child with chickenpox will infect others very easily. This is a significant problem for vulnerable individuals such as pregnant women, newborn babies and people with weakened immune systems. So do be careful and respectful about it. Some people think it’s fine to take their kids out, say to the park, when they have chickenpox, taking the view that “every kid will get it eventually, so why not get it over with?” But other mothers may not take that view. They may be pregnant or their own children may suffer from immune disorders, etc – so it’s best to think of others and put their protection first. The unborn babies of pregnant women are particularly at risk of birth defects if their mother contracts chickenpox.

So on the whole, the advice is to keep your child home from the time you suspect chickenpox, and then at least until the spots have crusted over.

What’s the treatment for chickenpox?

Chickenpox in children isn’t usually considered serious, but you can expect your child to feel pretty miserable from the fever and irritable from the itching while they have it. Sometimes babies and children with chickenpox can become very ill, so do not be complacent if you think your baby or child is extremely sick, and speak to a doctor urgently.

There is no specific treatment for chickenpox, but paracetamol can help to relieve fever, and calamine lotion can soothe itching. It needs to be applied regularly. If your child is scratching a lot, cut her nails short and try to get her to wear cotton gloves. If the itching is so bad that she has trouble sleeping, a doctor can prescribe an antihistamine.

The spots sometimes scar, so try baby-safe soothing oils such as Vitamin E oil (no nut oils). In most children, the blisters on the skin crust up and fall off naturally within one to two weeks.

If your child has blisters inside her mouth, this can make her feel really miserable and not feel like eating or drinking. Try to tempt her with soft and easy-to-eat food that won’t sting the blisters. If feeding and drinking is a real problem, watch her carefully for any signs of floppiness or dehydration, and seek advice from your doctor if you are worried.

Should I take my child to the doctor?

For most children, chickenpox isn’t serious and they’ll get better on their own. However, contact your GP straight away (don’t just turn up at the surgery as you may put others at risk) if your child develops any of the following symptoms or complications:

  • If the chickenpox blisters become infected, ie parts of the rash get red, warm or tender, indicating a possible secondary bacterial skin infection
  • If your child has a pain in her chest or has trouble breathing
  • If the rash spreads to one or both eyes
  • If the rash is accompanied by dizziness, disorientation, rapid heartbeat, shortness of breath, tremors, loss of muscle coordination, worsening cough, vomiting, stiff neck or a fever higher than 39.4°C

You need to tell your doctor immediately if anyone you are in contact with is pregnant, is immunosuppressed (eg, on chemotherapy or has cancer) or is younger than six months old.

Can I get chickenpox as an adult?

It’s unlikely you’ll get chickenpox as an adult if you’ve already had it as a child – but it’s not impossible. It’s usually much more serious in adults, and there’s a higher risk of developing complications as well. The treatment is usually the same as for children – ie stay away from work and other people, and wait for the blisters to scab.

Chickenpox in pregnancy

Chickenpox occurs in approximately three in every 1,000 pregnancies. It can cause serious complications for both the mother-to-be and her baby. If you are pregnant and you come in contact with someone with chickenpox you should see your doctor quickly. You should also avoid other mums-to-be and babies.

Although pregnant women often worry about passing the virus on to their unborn child, this is actually quite rare and depends on which stage of the pregnancy the virus was contracted. Ideally, there should be seven days between the onset of the rash and the delivery of the baby, but this is not a hard-and-fast rule and is different for every woman. Also, mothers with chickenpox can breastfeed if they want to and are well enough to do so.

Can you get chickenpox more than once?

Yes you can! Usually people who’ve had it once build up immunity to it, but around 13% (or one in eight) of people who’ve had it go on to get it again or develop shingles.

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