Chickenpox (Varicella)
Chickenpox is a highly contagious childhood disease. About 95 percent of all children have been infected with it before adolescence, most commonly between ages three and nine.
The disease is caused by the varicella zoster virus, which is transmitted by direct contact with an infected person. It is contagious a day or two before its characteristic itchy rash appears, so a child may catch it horn another before signs of infection are apparent. Clusters of small red bumps progress to blisters and scabs within 24 hours, but new clusters continue forming for four or five days. The disease remains contagious until the final crop of blisters forms scabs. The virus then becomes dormant in the body, but may reappear years later as shingles. A person who lacks immunity to the varicella virus can contract chickenpox if exposed to someone with a shingles rash.
Diagnostic Studies and Procedures
Pediatricians usually diagnose chickenpox over the phone, to avoid having infected children in the office where they may give it to others. The parent's description of symptoms is the essential diagnostic tool. A fever and the typical rash are the key signs.
Medical Treatments
A pediatrician's care is not usually required, unless the patient has a weakened immune system or develops severe complications. In such cases, acyclovir, an antiviral drug, may be administered intravenously.
Common complications of chickenpox are skin infections from scratching the blisters. These are usually treated with antibiotics. If itching is intense and the child cannot be prevented from scratching, the doctor may prescribe an antihistamine pill or ointment.
The disease is much more serious in adults than in children; complications may include pneumonia, hepatitis, and even encephalitis, a brain inflammation. Any adult who contracts chickenpox should seek prompt medical care.
Alternative Therapies
Herbal Medicine. Some practitioners recommend adding essences of ginger or elecampane to bath water to alleviate itchy skin. Others advocate drinking mild catnip tea to reduce fever and promote sleep. Some herbal books suggest drinking an infusion of yarrow leaves and flower tops to reduce fever, but this may cause an upset stomach. Also, yarrow contains derivatives of salicylic acid, the major ingredient in aspirin, which is contraindicated for children with chickenpox.
Hydrotherapy. Soothing baths often relieve itching, at least temporarily. Use lukewarm water and add to it 4 to 8 ounces of baking soda, or 1 to 2 cups of finely ground oatmeal. You can grind the oatmeal in a coffee grinder or blender, or purchase preground colloidal oatmeal at a pharmacy.
Nutrition Therapy. No special diet is required, but the child should be encouraged to drink plenty of fluids, especially if there is fever. Some naturopaths advise giving soy or almond milk instead of cow's milk until the infection clears up. Drinking diluted grape juice and eating grapes is sometimes suggested to reduce fever, but no evidence exists to support this advice.
Self-Treatment
Scratching the blisters can lead to infection and scarring. Cut the child's nails short and wash his hands often with antibacterial soap. Put a pair of light mittens or socks on a baby's hands.
Give the sick child a lukewarm sponge bath with mild soap several times a day. Do not rub the skin, but pat it dry instead, to reduce the chances of infection. Apply calamine lotion or a mild antihistamine lotion to alleviate itching and dry the blisters. For blisters in the mouth, have the child gargle with salt water.
Give acetaminophen for fever and general achiness, but never give aspirin to a child or adolescent with chickenpox. When taken during a viral infection, aspirin increases the risk of Reye's syndrome, a potentially fatal illness.
Other Causes of Childhood Rashes
In a young child, herpes, heat rash, or impetigo may look like chickenpox. Also, some children develop very mild cases, with little or no rash, and their chickenpox may be mistaken for a cold or other mild viral infection.