Learn how to prevent and treat this common childhood disease.


What Is Chickenpox?

Chickenpox is one of the most common childhood illnesses. Before the vaccine was approved in March, 1995, there were 4 million cases of it appearing in the United States every year. In fact, 95 percent of adults in America today had chickenpox before the age of 18. It occurs most often in the late winter/early spring and in children between the ages of 6 and 10.

Chickenpox is caused by Varicella zoster virus and is highly contagious. About 90 percent of people who never had chickenpox (or the vaccine) will catch it if a family member has it. A person with chickenpox is contagious from one to two days before the rash starts until about five days after the rash appears. It can be spread by direct contact (through lesions or sores) or through the air. Children with chickenpox have to stay home from childcare or school until they are no longer contagious.

A child who catches chickenpox may not show symptoms for 10 to 21 days after being exposed to the virus. At that point, the characteristic symptom usually appears -- an itchy rash, which usually develops first on a child's scalp and body, and then spreads to his face, arms, and legs over the next three to four days. In total, a child with chickenpox will have 250 to 500 itchy blisters that dry up into scabs two to four days later.

While the rash is the most well-known symptom of chickenpox, it's not the only one. Here are some other symptoms that often accompany chickenpox:

  • A mild fever for one or two days before the rash appears
  • General malaise
  • Coughing
  • Fussiness
  • Lack of appetite

Once someone has had chickenpox, the virus stays in her body permanently. This is usually a form of immunity -- she will probably never suffer from chickenpox again. But in about 10 to 20 percent of the population, the virus will reappear later in life (usually over the age of 50) and cause shingles. Shingles typically causes numbness and itching or severe pain in various areas of the skin. Within three to four days, clusters of blister-like sores develop and last for two to three weeks.

How Is It Treated?

When a child comes down with chickenpox, it's usually more uncomfortable than it is dangerous. Here are some things you can do to ease the discomfort:

  • Give your child oatmeal baths. This can relieve some of the itchiness.
  • Apply calamine lotion. Just like oatmeal baths, this can dull some of the discomfort.
  • Have your child take acetaminophen tablets. These tablets can help reduce the fever and general malaise. However, DO NOT give your child aspirin or salicylate (a compound found in aspirin) -- they can lead to Reye's syndrome, a disease that affects the liver and brain.
  • Ask your pediatrician about acyclovir. This is a medication that can make a case of chickenpox less severe if it's taken in the first 24 hours after the onset of the rash. However, it's usually only used for patients who are at risk of developing severe chickenpox, such as older children (and adults), kids with certain skin or lung diseases, or children taking other prescribed medications.
  • Don't let your child scratch! Scratching can pop the blisters before they heal and leave them prone to infection. Scratching also increases the possibility of scarring.

When Should I Worry?

Most healthy children who get chickenpox won't have any complications from the illness. But there are rare cases in which chickenpox leads to more than just itchiness. According to the American Academy of Pediatrics (AAP), about 9,000 people are hospitalized for chickenpox and about 90 people die from the disease each year. This occurs most often in adults and older children, but your child may be at greater risk if he:

  • Has a weakened immune system
  • Is under 1 year of age
  • Suffers from eczema
  • Takes a medication called salicylate
  • Was born prematurely

Or if you:

  • Came down with chickenpox around the time of delivery
  • Never had chickenpox

If your child fits into one of these categories, contact your pediatrician to discuss more aggressive treatment options. Also call the doctor if your child:

  • Has a fever that lasts longer than four days
  • Has a fever that rises above 102 after the third day
  • Becomes dehydrated
  • Has a rash that gets very red, warm, or tender

Should I Get My Child Vaccinated?

Because there is a small possibility of skin infection, scarring, pneumonia, brain damage, or even death as a result of chickenpox, the AAP recommends that all babies receive a chickenpox vaccine between 12 and 18 months of age -- or any time after that if they've never had the illness.

This vaccine is highly effective in protecting against severe chickenpox. Children who have had the vaccination will probably never get chickenpox. Even if they do, it will probably be a very mild form with little to no possibility of complications.

However, as with any vaccine, there are slight risks involved. These risks are very small, but it's important that you are informed of them before deciding whether or not to get your child vaccinated. Mild complications include:

  • Soreness or swelling where the shot was given
  • A slight fever
  • A mild rash that resembles chickenpox

More severe complications, though they occur in less than one baby per 1,000 receiving the vaccination, include:

  • An allergic reaction
  • A high fever
  • A seizure
  • Pneumonia

Keep your eyes open for signs of an allergic reaction in the hours after your child gets a shot. These signs can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat, or dizziness. A high fever or seizure, if it occurs, would happen one to six weeks after the shot.

If your child shows any of these symptoms, contact a doctor right away.

There are also some children who should not receive the vaccination at all. These include kids who:

  • Have a disease or are taking medications that weaken the immune system
  • Have any kind of cancer
  • Are undergoing cancer treatment with x-rays or drugs
  • Have ever had a life-threatening allergic reaction to gelatin
  • Recently received a blood transfusion

For the healthy child, however, the chickenpox vaccine may be a life saver.

Sources: American Academy of Pediatrics; Centers for Disease Control and Prevention

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

American Baby