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Varicella, more commonly known as chickenpox is caused by the virus varicella-zoster. The incubation period of varicella-zoster virus is about 2 weeks, that means you may develop symptoms within 2 weeks of catching the virus.
The virus spreads very easily from person to person usually via close contact such as respiratory droplets, saliva and the fluid within the vesicles of a chickenpox rash.
If the child has caught the virus, up to 90% of the people close to the child who are not immune will also become infected. The patient is infectious about 1-2 days before the onset of the rash all the way till when all the rash has dried up.
What are some of the symptoms you may expect?
- fever and lethargy
- headache and body ache
- loss of appetite
Thereafter, they may develop a classical rash all over the whole body. These rashes may first present as a few itchy red bumps but spreads rapidly over the next few days to the entire body including scalp and head and face. The bumps will then become fluid filled bubbles It may take 1-2 weeks before these bubbles dry up to form scabs.
Some of the complications that may occur from chickenpox includes
- bacterial skin infection which may require oral antibiotics
- viral spread to internal organs like the brain and the lungs
- infection spreading within the blood stream
In serious cases, even death. Fortunately, complications from chickenpox are very rare and most of the time, the body recovers by itself.
Treatment of chickenpox is usually symptomatic.
If the child develops fever, control the fever via
- cool fluid hydration
- sponging and water bath
- anti fever medications like paracetamol
If the child is scratching excessively due to itch
- you can consider over the counter oral antihistamines like Zyrtec or telfast
- calamine lotion or moisturiser
- wearing clothing with long sleeves and pants
- keeping their fingernails trimmed
Some of the red flag symptoms to watch out for includes
- fever lasting more than 5 days
- fever higher than 39-40 degree celcius
- drowsiness or lethargy
- persistent vomiting and inability to feed or drink
- severe abdominal pain
- difficulty breathing
- swelling, tenderness or pus discharge from the skin
If you see any of these symptoms and signs - do seek medical consultation immediately.
Chickenpox is very contagious. It can spread very quickly amongst children and even to adults who are not immune. To prevent the transmission to others, adopt these few steps
1) Isolate your child. Avoid contact with others as the virus usually spread via touch and through their oral and respiratory droplets.
2) Clean and disinfect frequently touched surfaces and shared items, including toys and door knobs.
3) For caregivers who are not immune, do not hug or kiss the child. Wash your hands with soap and water often.
4) No sharing of drinking cups, utensils, personal items like towels and brushes.
Now there are vaccines available to protect your child from chickenpox. In Singapore, the chickenpox vaccine, known as varicella zoster vaccine is already part of our national immunization childhood schedule. All children should receive 2 doses of chickenpox vaccine from age 12 months onwards, 3 months apart. This is usually given together with the Mumps, measles and rubella vaccine. The vaccine is subsidised and all eligible children can get it for free at polyclinics or CHAS-accredited private GP clinics in Singapore.
For adults 18 years and above who are not immunised yet, it is also recommended to receive two doses of the vaccination 1-2 months apart. Please consult your family doctor for more information on the vaccine. Now some people who are vaccinated may still get chickenpox. However, the symptoms are much less severe and they may only develop a few small bumps and vesicles, typically less than 50 red bumps.
They are also less likely to spread the virus to others.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)