Chickenpox in Children

Chickenpox causes a rash and can make a child feel generally unwell. Treatment aims to ease symptoms until the illness goes. Full recovery is usual in children. Serious complications are rare but are more likely to occur in children with a poor immune system such as those on chemotherapy.

What is chickenpox?

Chickenpox is an infection caused by the varicella-zoster virus. Most children have chickenpox at some stage. The immune system makes antibodies during the infection. These fight the virus and then provide lifelong immunity. Therefore, it is rare to have more than one bout of chickenpox.

What are the symptoms of chickenpox?

• Fever (temperature), aches and headache often start a day or so before a rash appears.
• Rash. Spots appear in crops. They develop into small blisters and are itchy. They can be anywhere on the body, and sometimes 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.
• Dry cough and sore throat are common.

Some children feel quite unwell for a few days. Others appear only mildly ill. Most are much better within a week. The blisters dry up and scab. They gradually fade, but may take up to two weeks to go completely.

What is the treatment for chickenpox?

Treatment aims to ease symptoms whilst the immune system fights the virus.

• Give plenty to drink to avoid dehydration.
• Give paracetamol or ibuprofen to ease fever, headaches, and aches and pains.
• Crotamiton lotion or cream put on the spots may ease itching.
• Antihistamine tablets or liquid medicine may help with sleep if itch is a problem. Give a dose at bedtime. You can buy these at pharmacies or get them on prescription.
• Keep fingernails cut short to stop deep scratching.

Antiviral medication is used in special circumstances where chickenpox can be more serious. For example, children who have a poor immune system, newborn babies, and in some cases of chickenpox in pregnant women.

Are there any complications?

• The spots do not usually scar unless they are badly scratched.
• Some spots become infected with bacteria in about 1 in 10 cases. If this occurs, the surrounding skin becomes red and sore. Antibiotics may then be needed.
• An ear infection develops in about 1 in 20 cases.
• Pneumonia and inflammation of the brain (encephalitis) are rare complications. See a doctor if your child develops any worrying symptoms such as:
  • breathing problems
  • drowsiness
  • convulsions
  • pains or headaches which become worse despite paracetamol or ibuprofen
  • becoming generally more and more unwell.

Is chickenpox infectious?

Yes, it is very infectious. The virus travels in the air and then settles on clothes, bedding, etc. A child with chickenpox is likely to pass it on to most classmates and household members who have not already had it. It takes 11-20 days to develop symptoms after catching the virus (the 'incubation period').

A person with chickenpox is infectious from 2-4 days before the rash first appears until all the spots have crusted over (commonly about 5-6 days after onset of the illness).

Protecting others

When a child is infectious keep him or her off school and also away from people who may get a severe illness if they get chickenpox. These are:

• Pregnant women who have not had chickenpox in the past. Chickenpox can be severe and cause complications during pregnancy.
• People with a poor immune system. For example, people with leukaemia, with HIV/AIDS, on high dose steroid medication, or are taking chemotherapy.

Healthy adults who have not had chickenpox may also want to avoid catching it as the illness tends to be worse in adults.

Should I let my child catch chickenpox?

Some parents encourage their children to mix with others who have chickenpox in order to catch it.

Some arguments for this:

• Chickenpox is usually a milder illness in a child than in an adult.
• The risk of serious complications is higher in adults with chickenpox. In particular, chickenpox during pregnancy can cause serious complications to both mother and baby.
• Most people get chickenpox at some stage. As the risks are less if you have it as a child, it may be better to get it over with.

Some arguments against this:

• "I could not willingly let my child develop an illness."
• Although rare, some children do have serious complications.

Different parents have different views on this issue.

© EMIS and PIP 2006   Updated: June 2006   PRODIGY Validated