Let’s Talk: Chicken Pox

A few weeks ago, I’d arranged for Grace, Ethan and me to meet with a friend and her children for an afternoon.

The night before, however, I got a message from my friend – one of her daughters was getting over chicken pox and she wasn’t sure whether we should postpone the playdate.

I paused – Grace has had chicken pox but Ethan has so far escaped and I wondered whether this was an opportunity to get it over and done with.

When Grace had it, she was covered head to toe in spots, although in typical Grace fashion, she coped with it like a trooper.

Ethan, however, is a completely different kettle of fish – he does not cope well with adversity and I couldn’t bring myself to deliberately expose him to the virus, so we rearranged to a later date.

The fact is it’s unlikely that Ethan will be able to escape chicken pox forever – it’s pretty much an inescapable part of growing up.

So, I decided to speak to Dr Lisa Neligan, a GP at Kingsbridge Private Hospital in south Belfast, to find out all about chicken pox, including what to do when it hits and whether there is actually a way to avoid it altogether.

Q: What is chicken pox?

A: Chicken pox is a virus which comes from the varicella family.

You may notice that your child has become a little bit out of sorts, sometimes with a high temperature, a day or so before they develop the spots.

This will be followed by a rash of red spots, they don’t really look like blisters at this stage, and they can be confused for all sorts of viral infections.

They can be anywhere on the body – the face, head, arms and legs, and the trunk.

Usually, within 12 to 24 hours, the spots begin to fill with fluid and they will start to resemble the blisters that you associate with chicken pox.

Chicken pox blisters show up in waves, so after some begin to crust over, a new group of spots might appear.

It usually takes 10 to 14 days for all the blisters to be scabbed over and then you are no longer contagious.

Q: How do you get chicken pox?

A: Unfortunately, the virus is really contagious.

It’s airborne, so if you’re in a room with a child who has chicken pox, the likelihood is that anyone who isn’t immune will develop the infection themselves.

It is spread by coughing, sneezing and close contact with someone who is infected, which is why you shouldn’t go on a flight when you have chicken pox and also why it is passed so easily between children who are playing together and maybe hugging and coming into close proximity.

The incubation period is anything between 10 days and three weeks from becoming infected to starting to display symptoms.

Q: How can I treat my child’s chicken pox?

A: You can have a child who has a very mild case and might only need camomile lotion to deal with the itch, or you can have children who are unlucky and feel very unwell and are covered from head to toe with spots.

You want to try and control their temperature if they have one, paracetamol if required, using the recommended dosage for your child.

Avoid aspirin use in children with chicken pox as it may trigger a more serious skin condition.  

You can also use calamine lotion and anti-histamine to deal with the rash – you want to try and stop your child from scratching as that is how the spots can become infected.

There are also people who swear by putting oatmeal in a lukewarm bath to soothe itching, and certainly children with chicken pox do like being in a lukewarm bath anyway.

Q: Do I need to take my child to the GP if they have chicken pox?

A: Most cases of chicken pox are minor and self-limiting and can be managed with over-the-counter medication, so a GP consultation isn’t necessary.

There are, of course, occasions when it is necessary to seek medical advice.

Complications may occasionally occur, including pneumonia, inflammation of the brain and bacterial skin infections, so speak to your GP if you are worried about your child.

If your child becomes very unwell, for example if they consistently have a fever – a temperature of more than 38.5 degrees for more than two or three days – despite you giving them paracetamol to manage their temperature, I would advise contacting your GP.

If your child develops blisters in their mouth, they can become dehydrated as it is so painful for them to eat and drink, so it’s advised to contact your GP.

It’s also important to seek medical advice if any of the sores become infected as your child might need an antibiotic.

You can spot if the spots are becoming infected if they start to ooze or there is pus present.

I would recommend ringing ahead to speak to the GP rather than just turned up – you don’t really want to take someone with chicken pox into a GP waiting room where there may be people with a weakened immune system.

Q: Should I keep my child inside when they have chicken pox?

A: Because the virus is so infectious and it can be very dangerous for certain groups of people, it is recommended that you limit contact with other people until the last spot has crusted over.

Chicken pox can be very dangerous for pregnant women in particular – it can result in a baby becoming very unwell or even lead to miscarriage.

If you have more than one child, and one of them has the infection, it isn’t necessary to limit their siblings from going about their usual activities.

However, I would let people know that a sibling has chicken pox so they can make an informed decision to meet with you or not.

Remember, your child may be contagious for a couple of days before they develop the spots.

This obviously doesn’t matter if your child has already had chicken pox.

Q: I’m pregnant and one of my children has chicken pox. I don’t know whether I had the virus when I was younger. What should I do?

A: Don’t worry unnecessarily.

All pregnant women have a number of tests done at their 12-week booking appointment and will be tested for immunity to the varicella virus.

If you don’t have immunity, this should be flagged up by your consultant or midwife but it is also in the green notes so you can check this yourself.

If you’re exposed to chickenpox during pregnancy and you’re not immune, contact your health care provider immediately.

He or she might recommend an injection of an immune globulin product that contains antibodies to the chickenpox virus.

When given within 10 days of exposure, the immune globulin can reduce the risk of chickenpox or reduce its severity.

If you develop chickenpox during pregnancy, your health care provider might prescribe oral antiviral drugs to speed your recovery.

The medication is most effective when given within 24-hours of the rash developing.

Q: Should you take your child to a chicken pox party?

A: I’ve heard of these, they are where parents hold a party with a child with chicken pox present to deliberately expose their children to the virus.

It’s not something I ever did with any of my children and it’s certainly not something I would recommend to anyone if their child has an underlying medical condition.

 Q: Is it possible to get a chicken pox vaccination?

A: Chicken pox can be really tough and I’ve known it to ruin family holidays, with a family cancelling a trip or one parent staying at home with the sick child while the rest of the family travels.

There is a vaccination, although it isn’t part of the childhood vaccination programme, but can be given to children with HIV, for non-immune healthcare workers and those who are going through chemotherapy.

It’s also available at the likes of Kingsbridge Private Hospital.

We’re seeing more parents wanting their child to have the vaccination, particularly if there has been an outbreak at school, as they are not able to take up to 2 weeks off work while their child recovers from the illness.

If the child has been exposed and if they receive the vaccine within 72 hours to five days of being exposed, there will be a significant reduction in the chances of them developing chicken pox.

It is effective in almost 90% of cases and if it doesn’t stop the infection, it will not be as severe.

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