Chickenpox in children is usually a very mild disease. It occurs less frequently in older children and adults, but if they get the disease, it is more extensive and causes a lot of discomfort to the patient.
Chickenpox is a viral infection and highly infectious. If one child gets the infection at home or in the school, those in contract with him are likely to contact the disease after a period of 2 to 3 weeks. As the disease usually confers lifelong immunity, you are safe if you have had it before.
Onset and Course:
Often, the first thing you will notice one or two tiny blisters on the back or chest. The child is otherwise normal. New blisters appear rapidly. The blisters form crusts or scabs. Some children, specially older ones, may get high fever and look quite ill, while younger ones may have low fever or no fever at all. The rash of chickenpox usually begins within a day of the onset of fever, in the form of red spots that itchy. Within a few hours, they turn first into small pimple and then into blisters on a red surface (almost like a dew drop on a red leaf). The spots are very itchy. The blisters with clear fluid become cloudy within a day and then become crusted. While this is happening, new red spots or blisters may be noted in the nearby area. Typically, in a small portion of the body, you may notice the rash in different stages- the red spot, the clear blister, the cloudy blister and the crusted one- at the same time.
The rash is mostly confined to the chest, back, face and head. The legs and hand are generally not involved. Spots may also appear in the mouth and vagina. Small glands often develop at the back of the neck and the armpits. The total period of the illness is about a week to 10days. While the disease may initially be confused with insect bites or pimples, the rash of chicken pox keeps changing its characteristics very fast, while insect bites or pimples do not follow this pattern.
Once all the spots become crusted and no new crops appear, the patient is no longer infectious. He can infect others from a day before the spots are first noticed to the day all the spots are crusted. Once that happens, the child should be ready to go to school and play with other children. Unfortunately, in some schools, the child is not allowed to join for 3 weeks till all the scabs or crusts have fallen off. Please note that only in the case of smallpox, which is now eradicated, the scabs could infect others. Interested parents may consider meeting the school authorities in this connection so that children are not unnecessarily kept away from school.
The spots of chickenpox are very itchy. A daily bath helps because sweating increases the itching. Keep the child's nails short. Explain to an older child that he should avoid scratching because it may leave behind scars. For smaller children, mittens may be used at night. If itching is severe, apply cool packs of cloth soaked in water from boiled and strained neem leaves. Plain calamine lotion applied to the spot also reduces itching. It is not advisable to use calamine mixed with other ingredients. Neem leaves may also be spread on the bed sheet. If the itching is very severe, your doctor may prescribe an antihistamine preparation to be give by mouth. If the fever does not bother the child, avoid using any drugs. If required, a paracetamol preparation may be used to lower the temperature. Never give aspirin to a child suffering from chicken pox or influenza because it may lead to a serious disease called Reye's Syndrome. No diet restrictions are required. The child should be allowed to eat his usual healthy nutritious food. If he does not feel hungry, make sure he has enough of liquids including fruits juices, coconut water and plain water.
Source: Dr R K Anand's Guide to Child Care
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