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Chickenpox

The Chickenpox Vaccine

Children who have never had chicken pox can be vaccinated at 12 months and 4 to 6 years of age. Adolescents and adults who have never had chickenpox can also get the vaccine. The vaccine has proven very effective in preventing severe chickenpox. The CDC Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians recommend that all children be vaccinated for chickenpox.

Many states now require vaccination prior to entry into preschool or public schools.

What is chickenpox?

Chickenpox is a highly contagious disease, usually associated with childhood. By adulthood, more than 90 percent of Americans have had chickenpox.

The disease is caused by the varicella-zoster virus (VZV). Transmission occurs from person-to-person by direct contact or through the air by coughing or sneezing.

Until 1995, chickenpox infection was a common occurrence, and almost everyone had been infected by the time he or she reached adulthood. However, the introduction of the chickenpox vaccine in 1995 has caused a decline in the incidence of chickenpox in all ages, particularly in ages one through four years. The varicella vaccine can help prevent this disease, and two doses of the vaccine are recommended for children, adolescents, and adults.

What are the symptoms of chickenpox?

Symptoms are usually mild among children, but may be life threatening to adults and people with impaired immune systems. The following are the most common symptoms of chickenpox. However, each child may experience symptoms differently. Symptoms may include:

  • fatigue and irritability one to two days before the rash begins
  • itchy rash on the trunk, face, scalp, under the armpits, on the upper arms and legs, and inside the mouth
  • feeling ill
  • decreased appetite

The symptoms of chickenpox may resemble other skin problems. If a person who has been vaccinated against the disease is exposed, then he may get a milder illness with a less severe rash and mild or no fever. Always consult your child's physician for a diagnosis.

How is chickenpox spread?

Once exposed, the incubation period is typically 14 to 16 days, but it may take as few as 10 and as many as 21 for the chickenpox to develop. Chickenpox is contagious for one to two days before the appearance of the rash and until the blisters have dried and become scabs. The blisters usually dry and become scabs within four to five days of the onset of the rash. Children should stay home and away from other children until all of the blisters have scabbed over.

Family members who have never had chickenpox have a 90 percent chance of becoming infected when another family member in the household is infected.

How is chickenpox diagnosed?

The rash of chickenpox is unique and therefore the diagnosis can usually be made on the appearance of the rash and a history of exposure.

Treatment for chickenpox:

Specific treatment for chickenpox will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the condition
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

Treatment for chickenpox may include:

Aspirin and the Risk of Reye Syndrome in Children

Do not give aspirin to a child without first contacting the child's physician. Aspirin, when given as treatment for children, has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Therefore, pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.

  • acetaminophen or ibuprofen for fever (DO NOT GIVE ASPIRIN)
  • antibiotics for treating bacterial infections
  • calamine lotion (to relieve itching)
  • antiviral drugs (for severe cases)
  • bed rest
  • increased fluid intake (to prevent dehydration)
  • cool baths with baking soda or Aveeno (to relieve itching)

Children should not scratch the blisters, as this could lead to secondary bacterial infections. Keep your child's fingernails short to decrease the likelihood of scratching.

Immunity from chickenpox:

Most individuals who have had chickenpox will be immune to the disease for the rest of their lives. However, the virus remains dormant in nerve tissue and may reactivate, resulting in herpes zoster (shingles) later in life. Sometimes, a second case of chickenpox does occur. Blood tests can confirm immunity to chickenpox in people who are unsure if they have had the disease.

What complications are commonly associated with chickenpox?

Complications can occur from chickenpox. Those most susceptible to severe cases of chickenpox are adults and people with impaired immune systems. Complications may include:

  • secondary bacterial infections
  • pneumonia
  • encephalitis (inflammation of the brain)
  • cerebellar ataxia (defective muscular coordination)
  • transverse myelitis (inflammation along the spinal cord)
  • Reye syndrome (a serious condition which may affect all major systems or organs)
  • death

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