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CHICKEN POX Varicella is a highly contagious viral
infection that is common among
children between ages one and nine. Adolescents and adults are usually
immune because of past childhood infection. Those who manage to escape
chicken pox as children can get it as adults. Symptoms for an adult can
be more severe then those for a child. The chicken pox vaccine is now available
and I recommend it to my patients. With the advent of this vaccine, chicken pox
is much less common.
Chicken pox travels from child to child via particles shed from the
respiratory passages and blisters. After it enters a child’s system, the
virus incubates for 14 to 21 days before the rash appears. For 24 hours
before the rash appears the disease is contagious. Contagiousness lasts
until all the sores have crusted over - usually seven days after the first
outbreak. There’s usually no need to keep a child with chicken pox in bed.
The purpose of staying home is mainly to avoid infecting other children.
For the most part, chicken pox is a mild illness. Most children run mild
fevers for the first few days of illness. They may also complain of fatigue,
achiness, and similar generalized symptoms. A widespread rash is the most
prominent symptom of chicken pox. It starts on the trunk and spreads to the
arms, face, and scalp. The rash begins as a crop of small red spots, which
quickly become raised, fluid-filled blisters. These blisters (called
vesicles) then break and form yellowish scabs called crusts. As the initial
rash crusts over, new spots appear. At the height of the illness, spots,
vesicles, and crusts are all present on the skin.
Most complaints focus on itching. Try to discourage excessive scratching,
since prematurely broken blisters are most likely to leave scars and allow
bacteria to enter the skin. Bacterial infection is the most common
complication of chicken pox. Children who cannot help scratching should keep
their hands clean and their fingernails short. Bathing once a day with soap
and water will help keep the skin clean.
A number of over-the-counter remedies are available to soothe itching. You
can apply calamine lotion liberally and frequently. Oral anti-itch
medication can help in severe cases. Many doctors recommend baking soda and
cornstarch baths. Oatmeal bath may also be helpful. In addition, a child
can hold an ice cube against a particular itchy spot for a few minutes for
temporary relief. Drink plenty of fluids to help avoid dehydration.
Call me in the following situations. (a) An area of the skin becomes red,
swollen, and painful. This could mean infection and I may need to prescribe
an antibiotic. (b) If your child looses coordination, falls, or has trouble
moving. These signs may mean central nervous system involvement. (c) If
your child develops difficulty breathing, cough or chest pain. This may be
symptoms of pneumonia. This complication is rare in childhood but more
frequent in adults. (d) If your child begins to vomit and becomes
disoriented near the end of the illness. These are symptoms of Reyes
syndrome. This is a serious illness that follows viral infections such as
chickenpox. Aspirin used during a viral illness may be a factor causing
Reyes syndrome. Therefor, never give aspirin to children with chickenpox,
colds, or flu. Use acetaminophen instead. The virus that causes chickenpox
is also responsible for an adult illness called shingles. This illness
results in a linear rash that can be quite painful.
In conclusion, chickenpox is a common viral infection that is not usually
a serious illness. It is a very symptomatic illness that requires
symptomatic treatment. Feel free to call my office for additional
information.
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