Fevers, pain, widespread vesicular rash, tears and missed days from creche…….there must be Chickenpox doing the rounds!
We have seen a number of cases of Chickenpox recently and whilst this common condition is rarely a cause for significant concern, there are a few things worth knowing about it. 90% of us will get Chickenpox at some stage in our lives (the vast majority before the age of 7) so it probably helps to know a little bit about this common condition!
Who gets Chickenpox?
Mainly younger children or those in creches and in school. Sometimes older patients on steroids or strong immunosuppressant medications as well as those who have active cancer or who are on chemotherapy.
How does it present?
The virus is usually spread by sneezing and coughing or close contact to the spots themselves. The incubation period can be up to 21 days after initial exposure so it can be difficult to know where the infection has come from! A rash develops over 3-5 days and is seen on the face, arms, legs and torso mainly. It is highly infectious and so commonly seen in younger children who interact more closely than adults do.
It usually fades over the course of 7-10 days and you are no longer infectious once all the spots have crusted over.
Any other symptoms?
Sufferers will usually have a temperature, be off form with aches or chills and of course have a rash. Presentation can be very variable and it can be difficult for us doctors to be definitive about the rash in the early stages.
What investigations are needed?
None usually-it is a clinical diagnosis though as mentioned it can be difficult to tell it apart from other causes of viruses in the early stages of the illness.
Should I always come to the doctor with a suspected Chickenpox?
Usually no, a visit to the doctor is not necessary and not generally advised as it could mean spreading the disease to other people, including sick people.
You should visit a doctor however if :
- You are unsure that it is Chickenpox you are suffering with or are worried that it may be something more serious than Chickenpox
- You have an underlying condition such as a cancer or are on chemotherapy
- You are worried that the sufferer is not able to eat or drink or if you are having difficulty controlling their temperature
- You are pregnant or think you might be pregnant
- You have spots on your eyes or penis/vaginal area or are having a lot of pain or difficulty going to the toilet because of the rash
What medicines should I take for it?
Chickepox is a virus so antibiotics do nothing to prevent or treat Chickenpox. They are only needed if the skin around the spots themselves become infected. Treatment focuses on staying hydrated and keeping your temperature down with Paracetamol, unless you are in the cohort of people mentioned above.
What about Chickenpox in pregnancy?
As mentioned above, if you are pregnant or think you might be, have been exposed to Chickenpox and are unsure as to whether or not you have had this infection in the past, then you should seek medical help. You can read more about this here.
Is there any way to prevent Chickenpox?
There is a vaccine against Chickenpox and it is available here in Portmarnock GP Clinic. It is called Varivax and it is administered after 13 months of age. It is a ‘live’ vaccine so it cannot be given at 12 months as children will be receiving the MMR at this age which is also a live vaccine. Two doses of Varivax are needed and are given a month apart. If you are considering this vaccine then the earlier it is administered the better and it is probably best administered before attending creche, Montessori or school.
Any long term effects?
As the rash fades you may notice a white depigmented area of skin where the Chickenpox spot had been. These usually recover completely over time and aren’t a cause for concern. If you are unlucky enough to have complications involving infected spots or if you have Chicken Pox in your eye then these may take longer to recover from.
Should I keep my child out of school or creche?
Most schools and creches will have their own protocols, generally we advise excluding the child for 5 days after the rash started. For more information you can check this link.
What about Shingles? Isn’t it linked to Chickenpox?
Shingles is the reawakened form of Chickenpox. The usual course of things is that somebody contracts Chickenpox and recovers fully. Then in later life the rash reappears as Shingles. We don’t fully know why this happens though it tends to occur at times of high stress, physical fatigue or illness such as cancer. Sometimes being on medicines such as those for rare neurological conditions, bowel conditions or chemotherapy can trigger the rash. The Shingles rash is more of a cluster and confined to one part of the body only.
Thanks for reading. Remember, the bulk of those with Chickenpox do not need to see a doctor and are best advised to stay at home, ensure they are hydrated and have any temperature under control.
To find out more about vaccination for Shingles or Chickenpox please contact us on 01-8461335 or 01-8038881. If you prefer you can e-mail us on firstname.lastname@example.org. We can facilitate vaccination for you or a loved one and vaccination may reduce the need to take a week or more off work!
(Featured Image-Tesco Ireland)
This post was by Dr Niall