Word of the Fortnight: Varicella Zoster

Doctors often look foolish when it comes to the health of their own children.

I love having a houseful of guests, especially now most of my friends have little ones in tow and you can stick all the kids in one room to entertain themselves fight it out whilst the adults hide in another sneakily drinking wine. On one such occasion a friend commented that sprog1 had a few spots around his neck and asked if he’d had chicken pox yet. I fleetingly cast an eye in his direction and continued supping from my glass. Come bath time I looked like a prize plum as he was spottier than Mr Tumble and was undeniably in the grips of varicella zoster.giraffe

Yes – Varicella is not the newest teen pop sensation but the medical word for good old chickenpox. Most of us have suffered with the pox in childhood and are fairly familiar with it, but I thought it’s always worth a bit of a refresher.

Chickenpox is perhaps one of the most contagious childhood infections. If one of your children gets it there is a 90% chance the next one will succumb too (unless they’ve had it before obviously). Unfortunately the bug seems to worsen with each person in the household who catches it, so the first person is likely to have a much milder version of the illness than the last person. It can be passed on 1-2 days before the spots first appear until they have crusted over, usually around a week later. If you have been infected, you’ll start to show signs of illness 10-21 days later.

I’m sure most of you will have seen chickenpox spots at some point, but if you aren’t sure they look like this. chickenpoxref

The spots usually start off as small itchy blisters and then over the course of a week become more pus-filled and finally crusty. The spots tend to appear fairly quickly over a few days and often are preceded by mild temperature and generally feeling a bit ‘off colour’.

Chickenpox is a viral illness so usually no formal treatment in necessary. Some children will experience a low fever that can make then feel a bit uncomfortable. Paracetamol can help if needed. Avoid using ibuprofen or aspirin as both of these can cause complications. The itching is usually the most distressing feature of the pox. I vividly remember my mother covering me in pink, sweet smelling calamine lotion when I was beside myself with itching, and it is still something we recommend. It is thought to cool the skin, thereby easing the itch. The antihistamine Piriton is also quite helpful in alleviating itching, so worth trying if your little one is getting really bothered.

Other simple things that can help a great deal are wearing loose cotton fabrics and drinking plenty of fluids. Keeping nails girl drinking watershort will help to reduce any damaged caused by scratching, especially at night time.

For most of us chilckenpox is a bit of a rite of passage but occasionally it results in more serious illness. Fortunately this is pretty rare, with only 1 in 100,000 children developing serious complications.

Catching chicken pox in infancy or adulthood is often a different kettle of fish. Both groups are usually are more unwell with it and have a higher risk of a more serious illness ensuing. In adults there is some merit in taking antiviral medication within 24hours of the rash appearing, and the under 1’s should be closely observed to make sure they are not getting too unwell.

One of the commonest complications of chicken pox is that the spots can develop a secondary infection; often triggered by scratching. These secondary infections result in the rash becoming redder, itchier and the child feeling more unwell with high temperatures. Antibiotics usually sort this out fairly easily, but occasionally stronger treatments and monitoring in hospital is required.

The other thing to watch out for is that spots in the mouth can make it painful for little ones to eat or drink, so dehydration can be a risk. Small and regular amounts of fluids can avoid this, or sucking on a frozen lolly/ice cubes. If you are worried you child isn’t drinking enough or hasn’t passed normal amounts of urine speak to your GP.

One of the things I get asked about a lot is the risks of chickenpox in pregnancy. It usually goes along the lines of ‘I’m 14 weeks pregnant and spent the weekend with my nephew, who has since come down with chickenpox…what should I do?’ If you know that you have had chickenpox in the past, you are therefore immune from the illness and have no further need to worry. If you aren’t sure if you’ve had it or not, a simple blood test can be done to confirm either way.

If you do catch chickenpox in pregnancy there can be some risks to the baby, so your doctor will refer you urgently to the hospital obstetric team for specialist treatment and monitoring.

A vaccination for varicella does exist and is available for specific groups of people via the NHS. It isn’t currently a routine vaccination so if you are thinking of becoming pregnant and haven’t had chickenpox previously, it may be something you could consider having done privately.school sign

Lastly (phew – who knew there was so much to say about chicken pox!) the other pox-related question I get asked all the time is how long children need to be kept of school/nursery whilst infected. The answer is they can go back 5 days after the first spots appeared.

Wishing you all a healthy and pox-free week!

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