by R. M. Ziegler

Created on: May 07, 2008   Last Updated: May 12, 2008

Before the varicella vaccine was introduced, chickenpox was one of the most common childhood illnesses afflicting children under the age of twelve. Until 2006 there were four million reported cases a year in the United States. Chickenpox is caused by the varicella zoster virus, which in its latent stage can cause shingles (herpes zoster). The incubation period lasts from thirteen to seventeen days. It is contagious from day one, before lesions erupt, and six days after vesicles from. It is at its highest contagiousness when skin lesions form.

The most notable symptom of chickenpox is an itchy rash. The illness usually begins with a low grade fever, fatigue and loss of appetite. Within twenty-four hours of onset, a rash develops on the trunk or scalp. The red bumps progress to clear vesicles which look like a "dewdrop on a rose petal." The vesicles fill with a cloudy fluid, and at this stage, they break easily. They spread to the face. Eventually the vesicles (or chickenpox blisters) crust over and turn into scabs. For three or four days new blisters will appear and scab over. Chickenpox blisters are usually no more than one-fourth inch wide. Less frequently, chickenpox can produce ulcers on the mucous membranes.

Chickenpox is contagious, so it is not unlikely that if one sibling contracts it, all of them will. Children should be kept out of school for a week or until all the blisters have dried up. The virus is not generally serious, but those who are at high risk for serious diseasesuch as pregnant women, those with leukemia or immune deficiencies, should not be exposed to chickenpox. Other rare complications include bacterial skin infections, septicemia, toxic shock syndrome, pneumonia and bleeding problems.

Chickenpox usually does not require medical treatment. Because it is a virus, a doctor will not prescribe antibiotics, unless an infection occurs, such as when the blisters are scratched open and become infected. If the patient is at a high risk for developing complications, the doctor may prescribe acyclovir, an antiviral medicine. However, it is only effective if taken within twenty-four hours of the onset of the rash. Otherwise, treatment is mainly to alleviate the discomfort that accompanies chickenpox. It may include:
Calamine lotion on itchy areas (except on face)
Cool compresses or oatmeal baths
Acetaminophen for pain and fever. Never give a child aspirin, as it can cause Reye Syndrome, a serious illness that can cause liver failure and death.
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