CHICKENPOX

Chickenpox (varicella), a viral illness characterized by a very itchy red rash, used to be one of the most common infectious diseases of childhood. But as a result of the wide use of vaccinations since the 1990s, it has become so uncommon that many doctors in practice now have never seen it.

Chickenpox is usually mild in children, but adults run the risk of serious complications, including bacterial pneumonia.

People who have had chickenpox almost always develop lifetime immunity (meaning you can’t get it again). However, the virus remains dormant in the body, and it can reactivate later in life and cause shingles.

Because the chickenpox virus can pass from a pregnant woman to her unborn child, possibly causing birth defects, doctors often advise women considering pregnancy to confirm their immunity with a blood test.

The best way to prevent chicken pox is to get vaccination against the disease.  However, even those with vaccination can still get infected, but only milder and fewer blisters.

The first symptoms of chickenpox include:

  • A fever of 100.4°F (38°C) to 103°F (39.4°C).
  • Feeling sick, tired, and sluggish.
  • Little or no appetite.
  • Headache and sore throat.

The first symptoms are usually mild in children, but they can be severe in teens and adults. These symptoms may continue throughout the illness.

About 1 or 2 days after the first symptoms of chickenpox appear, an itchy rash develops.

DIAGNOSIS

Chickenpox usually can be diagnosed based on how the chickenpox rash looks. For a healthy child, describing the rash over the phone to a doctor (rather than visiting the office) may be all you need to do.

Anyone who is over age 12, or pregnant, or has a weak immune system needs to be checked by a doctor as soon as you suspect chickenpox. When given right away, treatment can help prevent serious complications. For more information, see When to Call a Doctor.

At the doctor’s office, your doctor will ask you about your symptoms and will examine you. This usually gives your doctor enough information to find out if you have chickenpox.

Chickenpox during pregnancy

A woman who has had chickenpox early in her pregnancy may want to have her fetus checked for birth defects. This can be done with a fetal ultrasound during the second trimester.

 

RECOMMENDED MEDICATIONS

Medicines for chickenpox can:

  • Prevent chickenpox by making you immune to it.
  • Help make chickenpox less severe after you are exposed or have symptoms.
  • Help relieve chickenpox itch, pain, and fever.

If you (or your child) are not immune to chickenpox and have been exposed to the virus, call your doctor. The right medicine depends on your health, age, how long it’s been since you were exposed to the virus, and your symptoms.

Vaccination to prevent chickenpox

To prevent chickenpox, most people can get the chickenpox vaccine. To fully protect you, two doses are needed before you’re exposed to the virus.

Some people can’t get the chickenpox vaccine. They include women who are pregnant and people who have ever had an anaphylactic reaction to gelatin, neomycin, or any other substance in the vaccine.

Medicines to help reduce the severity of chickenpox

  • Chickenpox vaccine. If you are exposed to chickenpox and you get the vaccine within 3 days, you may not get sick, or your illness may be mild. If you can’t get the shot within 3 days, getting it up to 5 days after exposure may still help.2
  • Immunoglobulins. Immunoglobulins (IG) help the body’s immune system recognize and destroy harmful bacteria and viruses in the body, such as the varicella virus. Pregnant women, newborns who are at high risk for getting chickenpox, and people who have certain immune system problems can get a shot of chickenpox IG soon after they are exposed to the virus. It can help prevent infection and help them feel better sooner.
  • Antiviral medicine. Antiviral medicine, such as acyclovir, is usually used to treat adults and people who have weak immune systems. It’s used after you start to have symptoms of chickenpox. Healthy children usually don’t need this medicine when they have chickenpox. It isn’t known whether antiviral medicines reduce a person’s chances of having complications of chickenpox.

Medicines to relieve pain and discomfort

After you have symptoms of chickenpox, you can take over-the-counter medicines to help relieve discomfort. Check with your child’s doctor before giving medicine to your child.

  • Acetaminophen (such as Tylenol) or ibuprofen (such as Advil) to reduce pain and fever. Follow the package instructions carefully. If you give medicine to your baby, follow your doctor’s advice about what amount to give. People over age 20 also can take aspirin to reduce fever. Do not give aspirin to anyone younger than 20, because of the risk of Reye syndrome.
  • Oral antihistamines (such as diphenhydramine) to relieve itching. Talk to your doctor before using any antihistamine lotions or creams on yourself or your child. And check with your child’s doctor before giving antihistamine pills to your child.

Your doctor may prescribe antibiotics to you or your child if you get a skin infection from chickenpox blisters.

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