Children

Chickenpox in children: contagion, symptoms, incubation, complications and vaccinations

Chickenpox is a particularly contagious exanthematous disease , caused by the Varicella Zoster Virus , which is transmitted by direct contact with skin lesions or by the respiratory route.

Mode of transmission and contagiousness

Varicellase enters through the airways (through saliva) and through the conjunctiva (membrane lining the inside of the eyelids) or wounds.

The person is contagious from 1-2 days before the blisters appear until all the blisters have turned into scabs.

There is possibility of transmission of the virus between the pregnant mother and the fetus.

First signs

The first signs of incoming chickenpox can be represented by a general malaise and fever, symptoms that can last 1-2 days.

The typical rash

The spots appear quite quickly, first on the chest and abdomen, then on the face, arms and legs.

The spots are pink and itchy, they gradually fill with milky liquid, then turn into vesicles which then dry up, giving rise to the typical crusts of chickenpox.

Usually the rash consists of 250-500 lesions all over the body.

Incubation and healing

From the moment of infection to the manifestation of the disease, 10-21 days can pass.

Healing occurs in 7-10 days, with the progressive disappearance of the scabs, scars rarely remain.

Treatment

The child should be kept at home for up to 5 days after the rash appears or in any case until the vesicles have all dried up.

The pediatrician will prescribe any medications to treat the symptoms (fever and/or itching).

Complications of chickenpox

Chickenpox is generally a mild disease, but it can lead to some complications. In particular it can cause secondary bacterial infections with Staphylococcus or Streptococcus  being the most common cause of hospitalization and outpatient doctor visits. Secondary infection with invasive group A streptococci can cause serious illness and lead to hospitalization and in some cases death. The pneumonia that follows chickenpox is usually viral but can be bacterial. Secondary bacterial pneumonia is most common in children younger than 1 year.

Nervous system complications range from aseptic meningitis to encephalitis. Involvement of the cerebellum, resulting in cerebellar ataxia, is the most common central nervous system manifestation and is usually successful. Encephalitis is a rare complication of chickenpox (estimated to be 1.8 in 10,000) and can lead to seizures and coma Diffuse brain involvement is more common in adults than in children. Reye’s syndromeit is an unusual complication of chickenpox and influenza and occurs almost exclusively in children who take aspirin during acute illness. The etiology of Reye’s syndrome is unknown. There has been a dramatic decrease in the incidence of Reye’s syndrome, presumably related to a decrease in children’s aspirin use.

Rare complications of chickenpox include: aseptic meningitis, transverse myelitis, Guillain-Barré syndrome, thrombocytopenia, hemorrhagic varicella, purpura fulminans, glomerulonephritis, myocarditis, arthritis, orchitis, uveitis , iritis and hepatitis.

People at greatest risk of chickenpox complications are:

  • Persons over 15 years of age
  • Infants under 1 year old
  • Immunocompromised people
  • Newborns of women with rash onset within 5 days before to 2 days after delivery

Chickenpox vaccination

The chickenpox vaccine is a live attenuated virus that can be administered after the child is 12 months of age. It is a well-tolerated vaccine whose protection appears to be long-lasting.

The vaccine has an estimated efficacy of 95%, in the prevention of moderate or severe forms; by 70-85% in the prevention of mild forms. The vaccination should be carried out with a single dose for children between 12 months and 12 years, and with two doses for those over 12 years old.

The vaccine should be postponed when:

  • the child has an acute illness with fever or other symptoms considered important
  • the child has had a recent administration of immunoglobulins, blood or plasma, which can hinder a good immune response to the vaccine
  • the child has had a recent administration of another live attenuated virus vaccine

The child cannot be vaccinated if

  • has a serious defect of the immune system due to diseases or therapies (e.g. chemotherapy)
  • have severe allergic reactions to constituents of the vaccine or to previous administrations of the same vaccine.

Vaccine Side Effects:

The varicella vaccine is generally well tolerated.

The reactions attributable to the vaccine are mild (swelling and redness at the injection site).

6-12 days after the administration of the vaccine, the child may have a fever of modest entity and duration which in 5-15% of vaccinated children can reach 39°C.

In 5% of vaccinated people, a slight skin rash may occur and in these cases the child could be contagious.

Like any substance foreign to the body, the vaccine can rarely cause allergic reactions.

Dr Kathryn Barlow

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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