Chickenpox in children -cause symptoms,signs,complications,treatment and prevention

Chickenpox is a disease caused by a virus. It continues to affect people in all parts of the world but the incidence has come down after the introduction of a vaccine. Chickenpox in children is usually less severe than in adults and is one of the causes of fever with rash.

The virus spreads through air and is quite contagious.

Clinical features:The disease starts with some reddish spots on the skin which quickly become filled with fluid causing small blister like rash.

The lesions are mostly seen on the trunk and face but limbs are also affected. The small blisters (vesicles) rupture leading to crusted lesions. The lesions are formed by the drying of the fluid.

A characteristic feature of chickenpox is the presence of different types of lesions at the same time. This is called pleomorphic rash-macules-areas of small red spots not elevated above the skin level, papules-elevated small swellings, vesicles-swellings filled with fluid and crusted lesions. The vesicles can get infected with bacteria when they are called pustules.

Some children may have fever. Itching is very common. Usually no other symptoms will be present and the general condition of the child will be good. Complications are not common.

Treatment: Acyclovir is the drug of choice and is given is a dose of 20 mg per kg body weight per dose every six hours for a total of five days. The drug is generally will tolerated.

For fever paracetamol may be given is a dose of 15mg per kg body weight of the child. It may be repeated every 6 hours if needed. Aspirin should never be given to control fever as it is known to cause a serious disease called Reye’s syndrome.

If the lesions are infected a topical antibacterial drug may be used. If secondary bacterial infection is severe systemic antibiotics may be required.For itching on antihistaminic-diphenhydramine or hydroxyzine may be used.

Complications: The virus can cause herpes zoster (shingles) in later life.

Varicella pneumonia can occur especially in those suffering from some immunodeficiency disorder. It causes cough and breathlessness.

Encephalitis is rare. The features are vomiting, drowsiness or irritability. Complete recovery is common.

Some children may develop a severe form of chickenpox associated with bleeding into the lesions. This is called hemorrhagic chickenpox.

Chickenpox in pregnancy

Varicella infection occurring in the first 20 weeks of pregnancy can cause serious infection in the developing baby leading to congenital anomalies and brain damage. If a woman develops chickenpox in the period 5 days before delivery to 2 days after delivery the newborn baby can suffer from severe or even fatal infection. Such babies should be given Varicella-Zoster Immunoglobulin.

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