Chickenpox, also known as varicella, is a common illness among kids, particularly those under age 12. The disease has a worldwide distribution, but more in temperate climate. Lifelong immunity for chickenpox generally follows the disease. Symptoms usually go away without treatment, but because the infection is very contagious, an infected child should stay home and rest until the symptoms are gone.

The Varicella-zoster virus (VZV) causes chickenpox. Kids can be protected from VZV by getting the chickenpox (varicella) vaccine, usually between the ages of 12 to 15 months. A booster shot at 4 to 6 years old for further protection is recommended. People 13 years of age and older who have never had chickenpox or received chickenpox vaccine should get two doses of the vaccine at least 28 days apart. Getting the chickenpox vaccine significantly lowers your child's chances of getting chickenpox, but he or she may still develop shingles later.

Although the vaccine works pretty well, some kids who are immunized still will get chickenpox. Those who do, though, will have much milder symptoms than those who haven't had the vaccine and become infected.

Healthy children who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness. A person usually has only one episode of chickenpox, but VZV can lie dormant within the body.

Symptoms of Chickenpox

Approximately two weeks following exposure to VZV, healthy children generally experience one to two days of fever, sore throat, abdominal pain and malaise. Within 24 hours of these symptoms, a characteristic red itchy rash develops initially on the abdomen or back and then spreads over the next seven to 10 days everywhere else on the body, including the head, face, arms, legs and genitals.

The rash of chickenpox develops in waves or bouts over 2 to 4 days with raised red spots that look like pimples or insect bites arriving first, progressing to blisters that burst, creating open sores, which finally crust over to become dry, brown scabs.

At the peak of the disease, a patient may have over 300 skin lesions at one time. Younger kids often have milder symptoms and fewer blisters than older children or adults. Once all lesions are scabbed over, the person is no longer contagious. The lesions rarely cause permanent scarring, unless secondary infection develops.

Patients are contagious up to five days (more commonly, one to two days) before the rash appears until when all the sores have crusted over. A child with chickenpox should be kept out of school until all blisters have dried, usually about 1 week. Most kids with a sibling who's been infected are at risk of getting it as well, showing symptoms about 2 weeks after the first child does. So keep a child with chickenpox away from unvaccinated siblings as much as possible.

Chickenpox and Pregnancy

Pregnant women and anyone with immune system problems should not be near a person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth defects and she is at risk for more health complications than if she'd been infected when she wasn't pregnant. If she develops chickenpox just before or after the child is born, the newborn is at risk for serious health complications. There is no risk to the developing baby if the woman develops shingles during the pregnancy.

Those at risk for severe disease or serious complications — such as newborns whose mothers had chickenpox at the time of delivery, patients with leukemia or immune deficiencies, and kids receiving drugs that suppress the immune system — may be given varicella zoster immune globulin after exposure to chickenpox to reduce its severity.

Treating Chickenpox

A virus causes chickenpox, so the doctor won't prescribe antibiotics. However, antibiotics may be required if the sores become infected by bacteria. This is pretty common among kids because they often scratch and pick at the blisters.

The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. The drug, which can make the infection less severe, must be given within the first 24 hours after the rash appears. Acyclovir can have significant side effects, so it is only given when necessary. Your doctor can tell you if the medication is right for your child.

Self-Care at Home to prevent discomfort

Most cases of chickenpox can be managed at home. Chickenpox rash tends to be extremely itchy. Following treatments can be used at home to help a child feel better.

• Using cool wet compresses or giving baths in cool or lukewarm water every 3 to 4 hours for the first few days. Oatmeal baths can help to relieve itching. (Baths do not spread chickenpox.)
• Patting (not rubbing) the body dry.
• Putting calamine lotion on itchy areas (but don't use it on the face, especially near the eyes). Lotions containing diphenhydramine (Benadryl) should not be used -- erratic absorption through open skin lesions may occur and be associated with toxicity.
• Diphenhydramine (Benadryl), loratadine (Claritin), or citirizine (Zyrtec) taken orally also can relieve itching. These medicines are available over the counter.
• Occasionally a child will develop blisters in the mouth, making eating or drinking painful. A person should be encouraged to drink fluids to prevent dehydration. To alleviate pain, provide cold fluids (ice pops, milk shakes, and smoothies) and soft bland foods. Avoid any foods that are spicy, hot, or acidic (for instance, orange juice).
• Asking your doctor or pharmacist about pain-relieving creams to apply to sores in the genital area.
• Giving your child acetaminophen regularly to help relieve pain if your child has mouth blisters.
• Asking the doctor about using over-the-counter medication for itching.

Never use aspirin to reduce pain or fever in children with chickenpox because aspirin has been associated with the serious disease Reye syndrome, which can lead to liver failure and even death.

As much as possible, discourage kids from scratching. This can be difficult for them, so consider putting mittens or socks on your child's hands to prevent scratching during sleep. In addition, trim fingernails and keep them clean to help lessen the effects of scratching, including broken blisters and infection.

Most chickenpox infections require no special medical treatment. But sometimes, there are problems. Call the doctor if your child:

• has fever that lasts for more than 4 days or rises above 102° Fahrenheit (38.8° Celsius)
• has a severe cough or trouble breathing
• has an area of rash that leaks pus (thick, discolored fluid) or becomes red, warm, swollen, or sore
• has a severe headache
• is unusually drowsy or has trouble waking up
• has trouble looking at bright lights
• has difficulty walking
• seems confused
• seems very ill or is vomiting
• has a stiff neck

If you take your child to a doctor's office, call ahead to let the staff know that you think your child has chickenpox. They may usher you to a special waiting or treatment room to avoid exposing other children.