What New Parents Need to Know about Chickenpox

Kids seem to get rashes all the time, but a chickenpox rash isn't as common as it used to be. Still, it can happen occasionally, especially if your child is exposed and hasn't been vaccinated.

Because of vaccines, children don't get chickenpox at the rate they used to. The Centers for Disease Control and Prevention (CDC) states that since the chickenpox vaccine program started in the United States, the number of people with chickenpox has decreased by over 97%.

We spoke with experts to give us the scoop on what parents should know about chicken pox—recognizing symptoms early and the importance of vaccinating your kids.

What is chickenpox?

The varicella-zoster virus causes chickenpox. "It's usually a mild-self-limiting illness but can cause serious complications," explains Robert Klug, an urgent care doctor at MedStar Health in Maryland. It's very contagious—About 90% of people who aren't immune to chickenpox and are exposed will get it.

Chickenpox spreads by respiratory droplets, such as when you cough and from touching the fluid inside the blisters. You're usually contagious 1 to 2 days before getting the rash and until the lesions have scabbed over.

Dr. Ruth Kanthula, a pediatric infectious disease specialist with MedStar Health in Washington, DC, explains that the incubation period for chickenpox can range from 10 to 21 days. This means if you're exposed to chickenpox or come in direct contact with the shingles rash, it may take 21 days before you start seeing symptoms."

It's rare to get chickenpox more than once. Your body makes chickenpox antibodies after you have the virus, which stays in your body for the rest of your life.

What are the symptoms of chickenpox?

According to Dr. Klug and Dr. Kanthula, chickenpox symptoms can start within 15 days of being exposed and usually include:

• Fever one to two days before the rash—generally around 100 F to 102 F, and goes away in about four days
• Itching rash that looks like small flat red spots, progressing to small fluid-filled bumps
• Stomach pain
• Headache
• Fatigue
• Loss of appetite
• Respiratory symptoms such as cough, runny nose and sore throat

"The rash first appears on the chest, back and face before spreading to the rest of the body," says Dr. Kanthula. Eventually, those small fluid-filled bumps crust over. "The whole process typically lasts 4 to 7 days."

What are the complications of chickenpox?

Complications don't happen often, but when they do, they can cause:

• Bacterial skin infections, which can be serious
• Pneumonia, which can occur in children under a year
• Encephalitis, which is inflammation in the brain, can lead to seizures and a coma if not treated

There are some people at a higher risk of complications, including those who are pregnant, newborns and those who have a weakened immune system.

Since the virus stays in the body, about 10% to 20% of people who have had chickenpox will get shingles, known as herpes zoster, usually after age 50.

How do you treat chickenpox?

Keep children home from school and activities until the rash disappears and the blisters are crusted and dried, which should take about seven to ten days.

Some things that help treat chickenpox or its symptoms include:

Home remedies

• Give over-the-counter pain relievers for fever, such as acetaminophen (Tylenol). Don't give your child aspirin or ibuprofen because they can cause more harm while your child has chickenpox, according to the CDC.
• Use cool, wet cloths over the rashes, and don't let your child get too warm, as this can make the itching worse. You can also try oatmeal baths or cool baths.
• Antihistamine lotion on the rash.
• Prevent scratching as much as possible, or clip your child's nails short.

Antiviral medications

Dr. Klug explains that healthy children under age 12 usually don't need to take prescription medication. However, some kids who have a compromised immune system, are on steroids or have certain skin or lung conditions might use antiviral medications such as acyclovir and valacyclovir.

Call your child's healthcare provider if you notice:

• Severe stomach pain or a severe cough
• A stiff neck
• Trouble walking
• Fever that lasts more than four days or is above 102 F
• The rash becomes very red, painful or warm or leaks pus—this might mean a bacterial infection

How do you prevent chickenpox?

Dr. Klug says the chickenpox vaccine is safe and highly effective. Approved in 1995, it's 88% to 98% effective with two doses.

"After the first dose at 12 to 15 months, the second should be given at four to six years. All persons who have received one dose at any time should be offered a second dose," says Dr. Klug.

The best way to prevent chickenpox is by getting your child vaccinated. "Vaccines are one of the greatest public health interventions because they allow kids to live healthier lives with fewer infections than their grandparents and great-grandparents," says Dr. Kanthula.

Experts

• Robert Klug, MD, MedStar Health Urgent Care
• Ruth Kanthula, MD, board-certified pediatric infectious disease specialist with MedStar Health