Chickenpox is an infectious disease caused due to contagion with varicella zoster virus (VZV) and hence this disease is also known as Varicella. VZV is a group of herpes viruses.
This viral illness of childhood is characterised by a skin rash which are small, itchy blisters and red in colour. This disease is more serious in adults than toddlers.
It causes mild flu like illness and hence the name “chicken” to characterize this mildness. Routine immunization of children with varicella vaccine has decreased the number of cases with this airborne disease.
Although this endemic causes deaths in about 1 per 60,000 infected cases, but in 2013 there were 7,000 deaths globally due to this viral infection.
How does Your Baby Catch Chickenpox?
Chickenpox is an airborne viral infection caused by the herpes group varicella virus. Being an aerial disease, it easily passes from an infected person to your baby through sneezing into your baby’s hand, coughing or being in close contact with your baby.
It also spreads by direct contact with oozing pustule, air droplets from sneezing and contact with clothing and linen of infected person. Your baby can also contact the virus by living in the same room with the infected person.
It is really tough to track down how and where your baby got exposed to this virus. It takes about 10 to 14 days from the day of contracting the virus for the first visible symptoms.
The baby will become infectious from about two days before the onset of skin rashes and parents remain ignorant to this. Generally chickenpox lasts for about five to seven days when the blisters will pop and the rash scab over.
How to Tell if Your Baby has Chickenpox?
Skin rash is the most typical symptom of chicken pox used to identify the disease. Smallpox was the only other disease characterized with skin rashes, which has been eradicated thankfully.
The Few Weeks after Contacting the Virus
First symptoms of chickenpox become visible after two weeks of contracting the virus. Your baby will have nausea, decreased appetite, headache, sore throat and aching muscles.
Mouth and Tonsil areas can develop small ulcers which can be itchy or painful or both. The prodromal symptoms are followed by the development of characteristic skin rashes and mild fever.
Some babies develop rashes without prodromal symptoms. Usually babies who are six months old and younger might not develop prodromal symptoms due to presence of antibodies passed on by their mothers.
In such cases, the first signs are the spots in the oral cavity. Babies with weak immune system will develop prodromal symptoms earlier than usual.
The external skin rash (exanthem) begins as a small red dot on the upper parts of the body about 1-2 days after the first symptoms appear.
These skin rashes first appear on the scalp and face and then spreads to torso, arms and legs which are least affected. In about 10-20 hours it turns to blisters followed by a cutaneous condition called umbilication and then formation of crusts on the healing part.
Though a rarity, but this skin rash can spread to the eyelid, cornea, inside the throat and into the genital area. The blisters are filled with clear fluid and resemble pimples.
Intense itching occurs in the blister stage and when they break open, leads to discharge of pus and develops brown crust as they heal.
New waves of blisters occur as the illness progresses. Children get about 400 to 500 blisters, which seem to run over each other, although they can have just a few too.
The nasal discharge that precedes the external rash contains live viruses and hence the infected person becomes virulent before the onset of vesicular lesions.
The person remains infected till the formation of scabs which takes about 5 days after the formation of blisters and by which time the nausea ceases. The skin rash persists up to a month although the infectious stage does not last more than two weeks.
Diagnosis of Chickenpox in Babies
Chicken pox is diagnosed with prodromal symptoms followed by the characteristic rash. Confirmation will be done by the doctor by gently scraping the blisters for fluid sample which will be sent for testing the presence of varicella virus.
The vesicular fluid is tested for direct fluorescent antibody. Blood tests are done for identifying immunity to previous infection.
When should You call Your Pediatrician?
Talk to your paediatrician if you think your baby has contracted chicken pox or has been in contact with any person with chickenpox or if any adult contacts chickenpox in the family.
Widespread rash and fever in the first three month of life should be taken very seriously as it can cause further complications. There are other rashes which parents might presume to be chickenpox and hence it is best to be diagnosed by a doctor.
Chickenpox is accompanied by severe skin infection. When the blisters are scratched, the bacteria from the skin and under the nail can get into the blisters to from secondary bacterial skin infection identified by a greenish discharge.
The skin around the blisters becomes swollen and painful. On rare occasions, chickenpox can cause encephalitis, a swelling of the cerebellum which causes ataxia (unsteadiness).
If your child begins vomiting or running a fever while recuperating, contact a paediatrician immediately as these are also signs of meningitis.
Pregnant women who have never had chickenpox should seek immediate help if she comes in contact with any infected person as it may spread to the foetus via the placenta.
Child having weakened immune system due to serious illness should be taken to a doctor on first signs of the disease.
Although your baby will become immune to chickenpox, but the virus will stay dormant in the body and later cause shingles when he becomes older adult.
What are Shingles?
Shingles, also known as herpes zoster is an illness resulting in painful rash and following the spinal nerve where the chicken pox virus remained dormant and happens in adults over sixty years of age.
It happens in adults who have a weak immunity due to serious illness such as cancer or HIV. It can be prevented by getting vaccinated with the herpes zoster vaccine.
How should You Treat Your Baby’s Chickenpox?
Chickenpox being a contagious disease requires your child to stay at home until the blisters have ruptured and crusted over to prevent the spread of infection to others. Treatment depends on age, health and symptoms.
A healthy child needs only home treatment to relieve the symptoms of itching and fever. Since it is caused by varicella zoster virus, hence it won’t respond to antibiotics and will go away on its own due to body’s immune system.
Doctors prescribe an antiviral drug called acyclovir for shortening the duration of symptoms by one day. It is currently not recommended for healthy babies as it has no effect on reducing complications.
It is crucial for children with weak immunity. Antibiotics are given if your baby develops secondary bacterial skin infection or bacterial pneumonia.
Follow the package instruction carefully in case of over the counter medicine. Follow your doctor’s advice for prescribed medicines.
Home Treatment for Chickenpox in Babies
- Consult your pediatrician before giving any over the counter medicine to your baby. Children are more sensitive than adults to some medicines. Don’t guess the amount of liquid medicine; use a measuring spoon for it. Maintain good hygiene to prevent secondary bacterial infection.
- The most comforting thing for your baby while recovering will be to relive him of itching. Give him a cool bath after a gap of three to four hours. Sprinkle a handful of baking soda or oatmeal in bath water. Tie the uncooked oats in cheesecloth and put them in bath water. Alternately you can wrap your baby with a wet towel for added relief.
- After bath, put calamine lotion on the itchy lesions to soothe them. Calamine lotion is made of zinc oxide and safe for topical application.
- As a protective measure, trim your child’s fingernail and cover their hand with gloves to prevent them from scratching and possible scarring. Scratching increases the risk of developing secondary bacterial infection. Keep your baby away from scratching.
If your baby is more than one year old, you can ask your doctor to prescribe antihistamines for controlling scratching. Antihistamine Chlorphenamine has a pacifying effect and hence you will find your child to sleep longer than usual. Your paediatrician can also prescribe diphenhydramine which are anti-itch medicines.
- Keep off your baby’s nappy as long as possible to allow the lesions to dry. Dress him in loose fitting cotton clothes to allow the skin to remain cool. Give him plenty of fluids to prevent dehydration. You can also give him water if he is on solids.
- To ease mouth ulcers, dissolve ½ teaspoon of salt in one glass of lukewarm water and use it as a gargle. You can use mild anaesthetic lozenges for older toddlers.
- Fever is body’s response to any infection. Higher than normal body temperature is a natural process to kill disease causing viruses. Fever medicines stop this innate process and hence should be used in case of discomfort. Give infant paracetamol for lowering temperature and reducing pains.
Infant paracetamol can be given to babies older than two months and having weight of 4 kg (9lb) and above. Never give aspirin to children younger than sixteen years old as it causes a deadly condition called Reye’s syndrome.
Ibuprofen and other non steroidal anti inflammatory drugs increases the risk of developing skin infections or aggravating the condition of existing infection and leads to serious complications.
- Contact your doctor immediately if the fever lasts for more than 24 hours.
How will you Prevent Chickenpox in Babies?
Keep your baby away from infected persons during the first year of life. The infected person should be kept in isolation as it is a highly contagious airborne disease. The chickenpox vaccine called varicella vaccine is available since 1995.
The first dose of this vaccine is given when the child is 12-15 month old. A second dose is given 5 years after the initial vaccination. This vaccine can be given to all healthy people who have not been immunized and also to women who are not yet pregnant.
A vaccinated person will develop a milder chickenpox if they come in contact with the virus.
What is the Ground Scenario of Chickenpox in Babies?
Since the advent of varicella vaccine in 1995, chicken pox in babies less than 1 year old have reduced drastically by more than 90 %.
Also chickenpox in babies less than one year old is very rare, as the baby has antibodies passed on by his mother through the placenta. If it occurs, it is very mild.
However, you should consult your pediatrician immediately in case of any symptoms.