Chickenpox
Chickenpox is a common childhood illness. It is caused by a virus and results in a rash of blisters which are very itchy. Complications, although rare, do occur, and can be serious. Chickenpox is more common in children but can occur in adults.
Cause
Chickenpox is caused by a herpes virus, the Varicella zoster virus.
It is highly contagious, spread by droplets breathed out into the air or from the fluid of chickenpox blisters.
Signs and symptoms
* Begin between one and three weeks after infection
* First symptoms: mild headache, moderate fever, general unwell feeling
* Most younger children (<10 years) do not get these early symptoms, and symptoms are worse in adults
* Rash develops a day or so later: small flat red spots, developing quickly into itchy blisters which break down to form crusts
* Rash first appears on back and chest then spreads to face, neck, arms and legs
* New spots can continue to appear for up to five days
* The various stages of spots, blistering and crusts may be present on different parts of the body as the rash progresses
* Blisters vary from a few on the trunk, to covering the whole body. They can occur anywhere, including the scalp, eyelids and on mucous membranes in the mouth, throat, anus and vagina in severe cases
* Crusts disappear within a few weeks
* Blisters can be complicated by secondary bacterial infection and can leave scars
* Other complications include pneumonia, encephalitis, serious bacterial infections of deep tissue or the bloodstream and a bleeding tendency Infections in the first half of pregnancy can cause damage to the foetus and infections late in pregnancy can cause severe chickenpox in the newborn infant.
Important
Most people recover from chickenpox without any problems. However, you should see your doctor if:
* The blisters get very red and sore with pus
* There is high fever, severe headaches or vomiting, particularly a week or so after the chickenpox began
* Joint pain occurs
* You have a condition or are taking medication that affects your immune system e.g. chemotherapy, radiotherapy, HIV infection.
Preventing chickenpox
Vaccines are now available on prescription from doctors for immunisation of children over nine months of age and adults
* Vaccination is suggested for child-care workers, non-immune parents of young children and contacts of patients with weakened immune systems
* It is not known yet if booster doses of vaccine will be needed to ensure long-term protection. Protection after immunisation is long-lasting.
How contagious is chickenpox?
* A person with chickenpox is contagious from when symptoms first appear until the last blisters have crusted
* Children with chickenpox should not go to childcare or school until at least five days after the rash first appears
* The chickenpox virus stays dormant in the nerve roots of the spine, so generally you can not catch chickenpox again. However, the virus can reactivate in later life to cause shingles.
* Someone who has not had chickenpox or been immunised against it, can catch chickenpox following contact with a person with shingles.
Treatment
Treatment for chickenpox aims to relieve itching, fever and discomfort.
* Cold compresses
* Baths - coal tar /pine tar or oatmeal bath additives
* Hydrogels e.g. Solugel, Solosite
* Calamine lotion/creams
* Antihistamine tablets and syrups (one with a sedative action is especially useful for night-time scratching. Ask a pharmacist)
* Oral paracetamol (e.g. Panadol) for fever
* Aspirin should NOT be given to children or teenagers with chickenpox.
* In addition, keeping up plenty of fluids is important, particularly if blisters/ulcers in the mouth and throat make swallowing painful.
* In some circumstances, such as patients with complications, or in patients with compromised immune function, antiviral medication may be appropriate.
Self care
* Get as much rest as possible, with plenty of fluids
* Resist scratching - risk of infection is increased
* Children can relieve their itch by patting or gently smacking their lesions
* Keep nails short to reduce risk of infection
* Avoid contact with people who have not had chickenpox or shingles while contagious.
Contact
A doctor - (listed under ‘Medical Practitioners’ in the yellow pages of the phone book).
A Self Care pharmacy - to locate telephone 1300 369 772 and ask for the Pharmacy Self Care Field Officer.
In case of poisoning, phone the Poisons Information Centre on 131 126 from anywhere in Australia.
Pharmacists are medicines experts. Ask the pharmacist for advice when choosing a medicine.
