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Chicken Pox - Chicken Pox Symptoms and Treatments

Chicken Pox Basics

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Updated May 16, 2014

Sleeping child with chickenpox
Mieke Dalle/Photographer's Choice/Getty Images

Chicken pox (varicella) is a common childhood infection, although not as common as it once was since the chicken pox vaccine was added to the childhood immunization schedule in 1995.

Chicken Pox Symptoms

Chicken pox symptoms are well known by most parents and include:

  • an itchy rash that is usually concentrated over the child's chest, abdomen, back, face, and upper arms and legs
  • fever, which may be high and up to 104 or 105° F
  • headache
  • malaise
  • anorexia (no appetite)

Although many viral infections can cause a fever and rash, chicken pox classically causes a rash with red bumps that turn into fluid-filled blister and then scab or crust over. Kids with chicken pox usually get new crops of these red bumps over the first three days of being sick, so that they will have a rash in many different stages of development -- some simple bumps, some blisters, and some scabs, etc.

Children are usually not considered to be contagious once all of the lesions have crusted over.

It is important to note that a child can get the chicken pox rash almost anywhere, including inside their mouth or on their scalp.

Chicken Pox Diagnosis

The diagnosis of chicken pox is usually easy if children have the classic rash and fever, especially if they have had recent exposure to someone else with chicken pox within 10 to 21 days (incubation period).

Milder cases can be much more difficult to make, particularly if the child has had the chicken pox vaccine, which typically leads to the child having a very mild course of chicken pox. These children have few bumps and usually don't have a fever.

Chicken pox is sometimes misdiagnosed as:

Chicken Pox Treatments

Chicken pox treatments can include:

  • acetaminophen (Tylenol) in age-appropriate doses to treat fever, although it is very important to avoid aspirin and aspirin containing products because of the risk of Reye's syndrome
  • anti-itch treatments, such as an oral antihistamine like Benadryl (diphenhydramine hydrochloride) and topical medications, such as Calamine lotion

Acyclovir, an antiviral drug that can be used to treat chicken pox, is usually reserved for older teens or other children who are thought to be at risk for severe complications of chicken pox. The main concern is that even when started early in the course of a chicken pox infection and when it is given four times a day, acyclovir only shortens symptoms by about a day or so.

Chicken Pox Complications

Chicken pox is often thought of as a mild childhood illness. That is why even in this day of a chicken pox vaccine, some parents refuse the vaccine and instead take their kids to "chicken pox parties" so that they can get infected and develop natural immunity.

Unfortunately, chicken pox infections aren't aren't always so mild. Although not common, complications can include pneumonia, encephalitis, Reye's syndrome, hospitalization, and death.

Secondary skin infections are a more common complication of chicken pox, and can include infection with S. aureus, MRSA, or group A beta-hemolytic streptococci.

Kids are especially at risk for complications from chicken pox if they have problems with their immune system, like if they are on chemotherapy or have HIV. Congenital chicken pox and neonatal chicken pox can also be serious infections.

Chicken Pox Vaccine

Varivax, the chicken pox vaccine, has been available since 1995 to prevent chicken pox vaccines.

It is a live vaccine that is given to children beginning when they are 12 months old. A booster dose of the chicken pox vaccine is also recommended when children are four years old to prevent the mild cases of chicken pox that sometimes occur when kids only get one dose of the vaccine. Older children should get a chicken pox booster too if they didn't get it when they were four years old.

What You Need To Know

  • Chicken pox is very contagious and is caused by an infection with the varicella-zoster virus, a member of the herpes family of viruses.

  • The average unvaccinated child with chicken pox can have up to 300 skin vesicles.

  • After a chicken pox infection, the chicken pox virus can stay dormant in your child's body and then later become reactivated, causing a varicella zoster (shingles) infection. You can also less commonly get shingles after getting the chicken pox vaccine.

  • Chicken pox scabs can take anywhere from five to 20 days to heal up and go away. It is important that your child not pick off these scabs, as that can lead to scarring and a secondary bacterial infection.

  • Although most children become immune to chicken pox once they get infected, it is rarely possible to get chicken pox more than once, especially if they got their first infection at a very young age.



Sources:

Gershon: Krugman's Infectious Diseases of Children, 11th ed.

Liese JG. The burden of varicella complications before the introduction of routine varicella vaccination in Germany. Pediatr Infect Dis J - 01-FEB-2008; 27(2): 119-24

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