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Dr. Fred Piaser

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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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