Chickenpox: Symptoms, Complications,
and Treatment

Varicella-Zoster Virus

Chickenpox is a highly contagious disease that is caused by the Varicella-Zoster Virus (VZV). Until 1995 there was no vaccine available against VZV.

Symptoms of chickenpox are usually mild and mostly irritating, but because it is so contagious, all children should be vaccinated against VZV.

If a person has had chickenpox once, they usually have life-long protection against the virus. However, VZV can lie dormant in a person’s body and cause Shingles later on in life.

Signs and Symptoms:

Fever and a sore throat develop about two weeks after exposure to VZV. The fever and sore throat will last about two days, after which a skin rash will develop.

The rash usually develops on the torso and then spreads to the head, arms and legs. The rash first looks like bug bites, then develop into blisters where after it will scab over. The fluid in the blisters contains highly concentrated infectious virus particles.

New spots continue to appear for up to ten days. The rash is very itchy; itchiness can range from mild to intense.

Other symptoms could include: unease and discomfort, irritability, coughing, runny nose, mild headache, abdominal pain or loss of appetite.

Contagiousness:

Children with chickenpox are contagious from two days before the rash starts until all the blisters have crusted over.

Incubation period:

It takes about two weeks from being infected with VZV to showing symptoms.

Diagnosis:

Diagnosis is usually made based on a physical exam and a medical history.

Prevention:

Children between the ages of 12-15 months should be vaccinated and they should also receive a booster shot between the ages of 4-6 years of age.

The vaccine is about 95% effective in preventing an infection. Some children who got vaccinated will still get chickenpox, but symptoms will be very mild.

The vaccine is not approved for pregnant women, people with immune deficiencies and people who are allergic to the antibiotic Neomycin.

Unvaccinated people, who have had chickenpox, are immune and need not receive the vaccine.

Always wash your hands when coming into contact with someone who has chickenpox. Unvaccinated people who are not immune should avoid contact with infected people.

Complications:

Chickenpox is a mild illness, most of the time. However, some people can be affected more severely or develop complications.

• Skin infections: The chickenpox rash is itchy and children will scratch. However, scratching could cause the blisters to become infected with bacteria. Rarely, this bacterium will spread throughout the entire body and cause life-threatening infections.

• Pneumonia: Pneumonia is an infection in the lungs. Pneumonia associated with chickenpox is relatively rare in children, but it is the primary cause of hospitalization and mortality in adults.

• Encephalitis: Encephalitis is inflammation of the brain. It rarely affects children.

• Shingles: Shingles develop because of a reaction to VZV. When a person has chickenpox and the body does not completely destroy the virus, the virus sometimes lies dormant in the skin sensory nerve cell bodies. Later in life, the virus is released down the skin nerve fiber and produces a painful rash — shingles. Approximately one in ten adults, who had childhood chickenpox, develop shingles.

• Rare complications include hepatitis, kidney disease and ulcers.

• Chickenpox and pregnancy: Contracting chickenpox early on in pregnancy poses a variety of potential problems for the newborn. These include low birth weight and birth defects. There is a greater risk to the unborn baby if the mother develops chickenpox during the last week or two of pregnancy. Infected babies have an up to 25% mortality rate, because of multiple organ failure and/or an infection of the bloodstream of the baby.

Transmission:

The chickenpox virus could be spread through tiny saliva droplets that become airborne when an infected person sneezes, coughs or laughs. The virus could also be spread via direct contact with the blisters.

Treatment:

Medical:

Chickenpox is caused by a virus, so antibiotics cannot cure it. Your body will build up anti-bodies to the virus and kill it. These anti-bodies will provide life-long protection against chickenpox, so chances are that you will not contract it again.

Treatment for chickenpox is symptomatic. Antibiotics will only be prescribed to people who develop secondary bacterial skin infections, pneumonia and encephalitis.

Ibuprofen could help lower a fever. Never administer ASPIRIN to a child with a viral infection. The combination of aspirin and viral infections, in children 16 years old and younger, has been linked to Reye-syndrome, a potentially fatal condition.

Calamine lotion could be used to relieve itching.

• Encourage children not to scratch the rash — this could lead to infection. Trim fingernails to prevent scarring.
• Add baking soda or uncooked oatmeal to a cool or lukewarm bath to reduce itching; this also creates a playful diversion.
• Pat, rather than rub, dry after a bath.
• Give your child enough fluids to prevent dehydration.
• If the child has blisters in the mouth, give him/her soft, bland foods. Cold fluids could help reduce pain.
• Infected children should be kept at home until ALL the blisters have crusted over.
• When taking your child with chickenpox to the doctor, call in advance to ensure that your child does not come into contact with other children.
• Plenty of rest is mandatory for overcoming any infection.

Who is at risk?

• Children between the ages of 5-10 years who have not been vaccinated.
• Newborns and infants whose mothers are not immune. Mothers who are immune, pass immunity on to babies through the placenta (when in the womb) and through breast milk, once born.
• Adults are more likely to develop complications.
• People who have immune deficiencies or who have leukemia.
• People who use steroid medication, such as kids with asthma.
• People who have eczema usually have a more severe rash.

When is chickenpox a medical emergency?

• The rash spreads to the eyes (one or both).
• The rash becomes warm and tender and red and leaks a thick yellow or green fluid.
• The infected person has a fever higher than 38,5ºC.
• The person has seizures of a high fever accompanied by vomiting, severe headache and dizziness.
• The person develops breathing difficulties.
• The person is confused or extremely sleepy.
• The person is unusually sensitive to light.

Author: Annemien van Staden
Copyright 2008: Remedium