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Infant and Child Health

Chickenpox

Prevention - Home Treatment - When to Call a Health Professional

Chickenpox (varicella) is usually a relatively minor illness. For the first couple of days, your child will feel ill, with cold-like symptoms, cough, fever, and abdominal pain. Then a rash of red, pimple-like spots will appear. A child may have as few as 30 spots, or the rash may cover the child's entire body, including the throat, mouth, ears, groin, and scalp.

The spots turn into clear blisters that become cloudy, break open, and crust over. The rash itches a lot. Spots continue to appear for 1 to 5 days and subside over 1 to 2 weeks.

Chickenpox is very contagious. After exposure to the chickenpox virus, symptoms appear in 11 to 20 days. The contagious period starts 1 to 2 days before the rash appears and lasts until all the spots have crusted over. Children can usually return to school or day care after the sixth day of the rash as long as any blisters that have not crusted over are covered with clothing. Encephalitis (See Encephalitis and Meningitis) is a rare complication of chickenpox.

Prevention

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The chickenpox vaccine can be given to children age 12 months and older and to teens and adults who have not had the illness. See Chickenpox (Varicella). It is especially important to immunize teens and adults who have not had chickenpox, because the disease is more severe in adulthood.

Adults who have not been vaccinated and who have not had chickenpox should avoid exposure to children who have it and avoid exposure to people who have shingles (See Shingles). Pregnant women who have never had chickenpox and have not been vaccinated should also avoid exposure, since the illness can harm the developing fetus. The vaccine cannot be given during pregnancy.

Home Treatment

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  • Use acetaminophen to relieve fever. Do not give aspirin to anyone younger than 20 who may have chickenpox because aspirin use is related to Reye syndrome (See Reye Syndrome).

  • Control itching (See Relief From Itching). Oral Benadryl and warm baths with baking soda or Aveeno colloidal oatmeal added to the water will help. Avoid Benadryl creams because it is difficult to control the dosage when the medicine is applied to the skin.

  • Cut your child's fingernails to prevent scratching. If scabs are scratched off too early, the sores may become infected.

When to Call a Health Professional

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  • If the child is at risk for complications from chickenpox (is taking steroid medications or receiving cancer chemotherapy, or has a weakened immune system).

    Reye Syndrome

    Reye syndrome is a rare, serious disease that can occur at any age, but most often affects people younger than 20. The cause of Reye syndrome is unknown. It usually occurs after aspirin is given to a child who has a viral illness such as chickenpox or flu. Reye syndrome is not contagious.

    Reye syndrome causes changes in the body that affect all the organs but are most harmful to the brain and liver.

    Symptoms of Reye syndrome include:

    • Sudden onset of persistent vomiting that is not related to having flu

    • Drowsiness, lack of energy

    • Rapid, deep breathing (hyperventilation)

    • Behaviour changes such as extreme irritability, aggressiveness, or confusion

    If Reye syndrome is not treated immediately, it can lead to seizures, coma and, in severe cases, death.

    Early treatment of Reye syndrome increases the chance for full recovery. Most people have no long-lasting complications and gradually get better after a few weeks. However, some people may have permanent brain damage.

    To prevent Reye syndrome, never give aspirin to anyone younger than 20. Give ibuprofen or acetaminophen instead.

  • If a child age 3 months to 3 years has a fever of 38.9°C (102°F) or higher for 24 hours. See Fever on See Fever.

  • If severe itching cannot be controlled by oral Benadryl and warm baths.

  • If bruising appears without injury.

  • If sores appear in a child's eyes.

  • If you notice signs of encephalitis (See Encephalitis and Meningitis):

    • Fever, severe headache, and stiff neck

    • Unusual sleepiness or lethargy

    • Persistent vomiting

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