What You Need to Know About Chicken Pox
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How can I tell it's chickenpox?
The telltale sign of chickenpox is a very itchy rash made up of small, fluid-filled blisters surrounded by an area of redness. Chickenpox is a highly contagious viral disease that children get mostly from other children. If you know that chickenpox is "going around" at school or day care, it's a pretty good bet that your child’s itchy rash is chickenpox, too. The rash appears about ten to 21 days after a person is exposed.
How does chickenpox progress?
The rash usually starts with small red bumps on the trunk, but it may start on the face or under the hair. Over the first 24 hours, the bumps turn into clear blisters, which then become cloudy. The blisters can appear anywhere on the skin and mucous membranes---inside the mouth, nose, and throat, for example. They appear in crops, with some drying up and forming a crust at the same time that new ones are popping out somewhere else. The blisters generally spread outward from ,the trunk to the extremities. Between 200 and 400 blisters may eventually appear, although the number varies greatly from one child to another. Children who have chickenpox usually have a fever and often have a mild sore throat and swollen lymph nodes in the neck or other areas.
What should I do about it?
In most children, chickenpox can be left alone to run its course, which usually takes about a week. You can give your child oral antihistamines such as diphenhydramine (Benadryl) to relieve the itch and make it easier to sleep, or you can apply antihistamine cream directly to the rash. The combination of oral and cream antihistamines can produce a dangerous overdose. Do not use them together without carefully reviewing the dosage with our office, Lukewarm baths with baking soda or colloidal oatmeal (Aveeno, Nutra-Soothe) may also help. Do not give aspirin. Giving aspirin to children with chickenpox has been connected with a very dangerous condition called Reye syndrome. It your child has a fever, use Tylenol or other acetaminophen preparations instead.
What about school?
A person with chickenpox remains infectious until all of the blisters have crusted over. Keep your child out of school or day care until all the blisters have crusted over and the crusts start to drop off. This usually takes about six days from the time the rash first appears, although it may happen sooner in those with very mild disease or later in those withmore severe disease.
When should I call the doctor?
When your child has chickenpox, call our office immediately if
- Your child vomits persistently or vomiting continues for longer than four hours
- Your child is extremely sleepy or becomes confused or disoriented
- Your child has difficulty walking or breathing, chest pain or severe cough. Severe abdominal pain, or fever over 104 °F
- You are worried or frightened about your child's condition.
- Call during regular office hours if:
- Redness, pain, or swelling occur over an area of the rash.
- Fever persists for more than one week.
- Blisters continue to develop after the first seven days.
People at special risk
Anyone whose immune System is not working normally can develop serious complications from chickenpox. These people need to be protected from exposure if at all possible. Those who need protection include:
- People with leukemia or other forms of cancer, especially if they are undergoing chemotherapy;
- People taking steroid medications (prednisone, for example) or other drugs that weaken the immune system;
- People who have diseases that damage the immune system, including AIDS.
If a child or adult is in one of these high-risk groups and is exposed to chickenpox, call our office within 24 hours of exposure. We may need to give protective treatment with a special immune globulin for the virus (Varicella zoster).
If someone in the family has chickenpox and exposes another relative or a visitor in a high-risk group. Advise the person at risk to consult his other physician
To protect other children from this highly contagious disease, notify the staff immediately when you bring a child with chickenpox to a physician's off ice, an urgent care center. or an emergency room, so that your child can go directly to an examining room away from other patients.
Revised February 9th, 2006
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