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Chicken Pox in Children

Chicken pox is caused by the Herpes Zoster virus. It is very infectious. A child with chicken pox is likely to pass it on to most classmates and household members who have not previously had it. The immune system makes antibodies during the infection. These fight off the virus and then provide lifelong immunity. It is therefore very rare to have more than one bout of chicken pox.

What are the symptoms of chicken pox?

Like other virus infections a child may feel unwell with a fever (temperature) and headache. This often starts a day or so before the rash appears. Spots appear in crops. The spots develop into small blisters and are itchy. The spots can be anywhere on the body and sometimes also in the mouth. Several crops may develop over several days. Some children may be covered in spots, others have only a few or even none (a sub-clinical illness). Commonly there is a dry cough and a sore throat. Some children feel quite unwell for a few days, others appear only mildly off colour. The child is usually much better within a week. The blisters dry up and scab. They gradually fade but may take up to two weeks to go completely.

What is the treatment for chicken pox?

Treatment aims to make the child as comfortable as possible whilst the immune system fights off the virus.

• Give plenty to drink to avoid dehydration.
• Give paracetamol (Calpol, Disprol, etc) to ease fever, headaches, aches and pains.
• Calamine lotion or cream applied to the spots may ease itching.
• Antihistamine tablets or medicine may be advised at bedtime to help with sleep if itch is a problem. These are available from pharmacies or on prescription.
• Make sure the nails are cut short to stop deep scratching.

Are there any complications?

The spots do not usually scar unless they are badly scratched. One or more spots become infected with bacteria in about 1 in 10 children with chicken pox. If a spot becomes infected with bacteria the surrounding skin becomes red and sore. Antibiotics may then be needed. An ear infection develops in about 1 in 20 children with chicken pox. Pneumonia and inflammation of the brain (encephalitis) are rare complications.

To isolate or to mix?

A child is infectious from 48 hours before the rash appears until all the spots have scabbed (about 6 days). It takes 14-20 days to develop symptoms after being in contact with an infected person. Most children will have chicken pox at some time but the illness is often mild. In adults it can be more serious. In particular it can be serious and cause problems during pregnancy. Therefore, many people believe it is best to have chicken pox as a child. Some parents will encourage their school age children to mix with infected children. If they catch it they will be immune as adults. In practice, schools usually ban children with chicken pox even if the child feels well enough to go to school. Parents and teachers may have different views on this issue.

However, there are two groups of people who should avoid people with chicken pox.

• Pregnant women who have not previously had chicken pox and so are not immune.
• People with poor immune systems. For example, people with leukaemia, people who are HIV positive or those on high dose steroid medication or chemotherapy.

An anti-virus serum may be advised if such people come in contact with chicken pox.