Chicken Pox
Chicken Pox is a viral infection caused by
the varicella-zoster virus, a type of
herpes virus. It is contracted by
contact with actual lesions or by respiratory
secretions and there is a 10-21
day incubation period during which your child is
developing the illness but
does not show any symptoms and is not contagious
(until the very last 1 or 2
days before the pox appear.). Once the vesicles show
up there are likely to
be many more on the way for between 3 and 7 more days and
your child is
contagious throughout this whole period until there are no new
lesions for at
least 24 hours and the old lesions are dry or scabbed. This virus
is unusual
in several ways, one way being that it settles into areas of the
nervous
system and then potentially can reactivate as a localized painful rash
that
follows a nerve path. This is known as herpes zoster (also referred to
as
Shingles) and it is spread to anyone who has never had chicken pox
only by
direct contact with the lesions (not by the respiratory route like
the original
chicken pox infection). Zoster often occurs in elderly or run
down or immune
compromised people and is not the result of exposure to a
child with chicken pox
- it is a reactivation of one's own previous chicken
pox infection, usually from
as far back as childhood. This becomes important
to families when young children
with chicken pox are scheduled to visit
grandparents and parents are concerned
that their elderly parents will
"catch" pox from the grandchildren.
Chicken pox can be acquired any time
during the year but is most prevalent in
winter and spring. 90-95% of
Americans get chicken pox in childhood and often
from their own siblings. For
unclear reasons, chicken pox is less common in
tropical climates and many
adult immigrants are not protected from this
infection. Infection in adults
is typically more severe and can be life
threatening. Almost all exposed
children will develop a rash, described as
"dewdrops on rosebuds", although
some children have so few lesions
that they may go unnoticed. Many children
have a prodrome (sick period before
the actual obvious illness appears) that
included fever, malaise, headache, poor
appetite, and mild abdominal pain.
These symptoms may continue for 2-4 days
after the rash first appears.
Usually the vesicles start on the face and scalp,
moving next to the trunk
and then on to the extremities. They arrive in clumps
so that there are
clusters of lesions in various stages around the body. The
average number of
lesions is about 300 but as few as 10 and as many as 1500
lesions have been
counted on one child! They begin as itchy raised red bumps
that soon become
blister like with fluid inside and then "pop" or ooze
and then crust over.
Second cases in the home are usually worse than the
original case and
children with skin conditions such as excema are also prone to
worse
outbreaks. The lesions can appear anywhere including the mouth, the vagina
,
the anus, the eyes, and although painful, it rarely has serious outcome.
The
healing lesions are hypopigmented for many weeks but pox rarely scar
except when
badly gouged and infected secondarily with bacteria in the
fingernails of the
"scratcher". An immune globulin called VZIG
(varicella-zoster immune
globulin) is available for protection of immune
compromised children, pregnant
women, and newborn infants exposed to maternal
varicella right before or after
Chicken Pox is a viral infection caused
by the varicella-zoster virus, a type of
herpes virus. It is contracted by
contact with actual lesions or by respiratory
secretions and there is a 10-21
day incubation period during which your child is
developing the illness but
does not show any symptoms and is not contagious
(until the very last 1 or 2
days before the pox appear.). Once the vesicles show
up there are likely to
be many more on the way for between 3 and 7 more days and
your child is
contagious throughout this whole period until there are no new
lesions for at
least 24 hours and the old lesions are dry or scabbed. This virus
is unusual
in several ways, one way being that it settles into areas of the
nervous
system and then potentially can reactivate as a localized painful rash
that
follows a nerve path. This is known as herpes zoster (also referred to
as
Shingles) and it is spread to anyone who has never had chicken pox
only by
direct contact with the lesions (not by the respiratory route like
the original
chicken pox infection). Zoster often occurs in elderly or run
down or immune
compromised people and is not the result of exposure to a
child with chicken pox
- it is a reactivation of one's own previous chicken
pox infection, usually from
as far back as childhood. This becomes important
to families when young children
with chicken pox are scheduled to visit
grandparents and parents are concerned
that their elderly parents will
"catch" pox from the grandchildren.
Most children with chicken pox are at
least mildly uncomfortable from the itchy
nature of the pox. Using soothing
lotions and cool baths is helpful as is
keeping the fingernails short and
antihistamines available for the worst nights.
Many over the counter bath
solutions claim to help dry the pox and certainly
make the itching milder but
be careful to only gently pat dry the rash so as not
to irritate the skin or
spread virus particles to others. Keeping cool and clean
is very helpful for
the comfort and safety of the child with pox. Keeping
entertained is another
matter and some families have combined their sick
children to keep each other
company. The risk of increasing the exposure for
other siblings and for
spreading secondary bacterial infection between the
children make this a poor
idea in general. Besides, sick children need to rest
and be encouraged to
drink more fluids instead of becoming more active during
the illness. Staying
out of doors and away from sun exposure also decreases the
chance of severe
itching and scarring. Most children are back in school in a
week or so and
have many fellow students to compare notes with. This is a very
common and
usually manageable childhood
illness.