The youngest of the family has finally had chicken pox…, phew…, and “Pickin’ chocs” is what he called it, by way of explanation! Everyone else in the family has had it and it was getting a bit of a worry that the youngest hadn’t had it yet.
Why do you want to get it?
As we all know, chicken pox is a common childhood illness. Most children are exposed to it and get it. It is caused by the Varicella zoster virus and is highly contagious. When caught in childhood it is mild.
What symptoms do you have?
Children will generally be unwell with possibly a fever. They may have a headache, feel ache-y and be off their food. The rash usually starts shortly after with red spots which are itchy. These develop into a blister (fluid-filled spot) around 12-14 hours later and these are intensely itchy.
After several days, the blisters dry up and develop a crusty top and these fall off over the ensuing week or so, leaving a little pink crateriform depression in the skin.
Pink crateriform depression in the skin
New waves of spots do develop for several days after the onset of the rash and therefore, there may be spots at different stages (spot, blister, crust) at any one time.
What happens if you catch it as an adult?
It tends to be more severe in adults and there is a higher risk of developing complications. The rash is usually more widespread and a small number of adults can develop chicken pox pneumonia. This risk increases if you are also a smoker. A family member caught chicken pox as a young adult and was severely unwell with it for a week or so.
I’ve heard there are dangers to pregnant women?
Yes, pregnant women who have not had chicken pox before and also people with weakened immune systems and newborn babies. They are all at an increased risk of complications if they get chicken pox.
Pregnant women are at an increased risk of developing pneumonia and the further along you are in the pregnancy, the more serious the risk of developing pneumonia. Again, the risk is higher if you smoke aswell.
If you catch chicken pox whilst pregnant there is also a risk to the unborn baby. If this happens within the first 28 weeks of pregnancy, there is a risk that the baby may be born with something called foetal varicella syndrome (FVS).
What is foetal varicella syndrome?
This is thankfully rare with the risk of developing it between 1-2% if you get chicken pox within the first 28 weeks of pregnancy. The serious complications of FVS are eye defects such as cataracts, scarring, shortened limbs and brain damage.
Are there any other risks?
You are at also increased risk of premature birth (before 37 weeks of pregnancy) and if you get chicken pox either 7 days before or 7 days after giving birth, the newborn baby may develop a more severe and serious type of chicken pox which in some cases can be fatal.
What about people with weakened immune systems?
These are people, for example those on steroid tablets, taking immunosuppressive tablets for rheumatoid arthritis or lupus, transplant patients or patients receiving chemotherapy, as they are less able to fight infections. They are at increased risk of developing chicken pox pneumonia, blood poisoning (or septicaemia), hepatitis, meningitis and encephalitis.
What do I do if my child gets chicken pox?
They should be kept off school or nursery for five days or at least until they are no longer infectious. This is when the last blister has burst and crusted over. The fluid in the vesicle contains a large amount of the virus but chicken pox is also spread by droplet infection from the nose and mouth. The most infectious period is from about 2 days before and 5 days after the onset of the rash.
Regular paracetamol to treat the fever, making sure your child has plenty of water to drink and keep hydrated and trying to stop your child scratching are all helpful.
Is there no tablet I can give my child?
There is an antiviral medicine called aciclovir available. This doesn’t cure the chicken pox, it just shortens the duration of the episode and makes the symptoms less severe. It is usually reserved for those at risk of developing severe complications, ie pregnant women, newborn babies and those with weakened immune systems.
There is also varicella-zoster immunoglobulin (VZIG) which contains antibodies to the chicken pox virus obtained from healthy donors. This is given by injection to protect people at high risk developing a severe chicken pox infection, as listed above, if they have had significant exposure to chicken pox and have blood test proof that they haven’t had chicken pox before. Also, in the case of pregnant women, it can also reduce the risk of the unborn baby becoming infected.
Is there a vaccination against chicken pox?
There is but it is not part of the routine childhood vaccination schedule in the UK. It is only currently offered on the NHS to people without chicken pox immunity in close contact with someone who has a weakened immune system. It is given as 2 injections and is more effective in children than in teenagers.
Kind regards,
Sandy
Dr Sandy Flann, Consultant dermatologist
