Children who have never had chicken pox can be vaccinated at 12 months and 4 to 6 years of age. Adolescents and adults who have never had chickenpox can also get the vaccine. The vaccine has proven very effective in preventing severe chickenpox. The CDC Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians recommend that all children be vaccinated for chickenpox.
Many states now require vaccination prior to entry into preschool or public schools.
Chickenpox is a highly contagious disease, usually associated with childhood. By adulthood, more than 90 percent of Americans have had chickenpox.
The disease is caused by the varicella-zoster virus (VZV). Transmission occurs from person-to-person by direct contact or through the air.
Until 1995, chickenpox infection was a common occurrence, and almost everyone had been infected by the time he or she reached adulthood. However, the introduction of the chickenpox vaccine in 1995 has caused a decline in the incidence of chickenpox in all ages, particularly in ages one through four years.
Symptoms are usually mild among children, but may be life threatening to adults and people with impaired immune systems. The following are the most common symptoms of chickenpox. However, each individual may experience symptoms differently. Symptoms may include:
- fatigue and irritability one to two days before the rash begins
- itchy rash on the trunk, face, under the armpits, on the upper arms and legs, and inside the mouth
- feeling ill
- decreased appetite
The symptoms of chickenpox may resemble other skin problems. Always consult your physician for diagnosis.
Once exposed, the incubation period is typically 14 to 16 days, but it may take as few as 10 and as many as 21 for the chickenpox to develop. Chickenpox is contagious for one to two days before the appearance of the rash and until the blisters have dried and become scabs. The blisters usually dry and become scabs within four to five days of the onset of the rash. Children should stay home and away from other children until all of the blisters have scabbed over.
Family members who have never had chickenpox have a 90 percent chance of becoming infected when another family member in the household is infected.
The rash of chickenpox is unique and therefore the diagnosis can usually be made on the appearance of the rash and a history of exposure.
Specific treatment for chickenpox will be determined by your physician based on:
- your overall health and medical history
- extent of the condition
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
Treatment for chickenpox may include:
- acetaminophen (to reduce fever)
- calamine lotion (to relieve itchiness)
- antiviral drug acyclovir (for severe cases)
- increased fluid intake (to prevent dehydration)
- cool baths with baking soda or Aveeno (to relieve itching)
Children should not scratch the blisters because it could lead to secondary bacterial infections. Keep fingernails short to decrease the likelihood of scratching.
Most people who have had chickenpox will be immune to the disease for the rest of their lives. However, the virus remains dormant in nerve tissue and may reactivate, resulting in herpes zoster (shingles) later in life. Sometimes a second case of chickenpox does occur. Blood tests can confirm immunity to chickenpox in people who are unsure if they have had the disease.
Complications can occur from chickenpox. Those most susceptible to severe cases of chickenpox are adults and people with impaired immune systems. Complications may include:
- secondary bacterial infections
- encephalitis (inflammation of the brain)
- cerebellar ataxia (defective muscular coordination)
- transverse myelitis (inflammation along the spinal cord)
- Reye syndrome - a serious condition; a group of symptoms that may affect all major systems or organs. Children with varicella should not be given aspirin because administration of aspirin to children with varicella increases the risk of Reye syndrome.
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