It’s the season to go spotty. Early summer, chickenpox begins its rounds. While it’s hard to control the spread of this highly contagious disease within a household/classroom, there’s a bunch of things that you can do that will help ease the suffering.
But first, how do you know it’s the pox?
“The appearance of the chickenpox is typical,” says Dr. Mythili Shivaram Rajagopalan, Consultant Paediatrician and Neonatologist, St. Isabel’s Hospital. “The rash appears in crops over a few days, all over the skin, and comes with a spurt of fever.” The rash then develops into fluid-filled blisters (vesicles), which later break and form scabs.
Incubation and spread
“Chickenpox has a long incubation period of two-three weeks after contact,” says Dr. Benny Benjamin, Consultant Paediatricians, Fortis Malar Hospitals. “The person is infectious even before the rash appears, and the early stage of illness is the most infectious. New spots develop over several days, the scabs become dry, turn black and fall off. Once all the lesions dry, it is no longer contagious.” Doctors advise the avoidance of close contact with anyone with chickenpox, although, given the infectious nature of the illness, it is difficult to prevent the spread among family members.
Treatment and care
Chickenpox is treated symptomatically, says Dr. Benjamin. “Anti-allergic medication (anti-histamines), local applications like liquid paraffin or calamine and paracetamol for fever can help keep the patient comfortable.”
There is an effective anti-viral medication — acyclovir — to treat severe chickenpox, says Dr.Benjamin. “If started within 24 hours of the first spots, the illness is shorter and milder,” he says, adding that antibiotics have no role, unless there is secondary bacterial infection.
And to prevent a secondary skin infection, it is important to keep the skin clean, both the doctors advise. “There is no scientific basis for not having a bath,” says Dr. Benjamin. “It is essential to keep clean and bathe the child everyday, if he/she can walk to the bathroom,” says Dr. Mythili. “There is no taboo against washing one’s hair either; it depends if the child is able stand under the shower for that long. But if there are blisters or scabs on the head, it can irritate the scalp when it is dried with a towel,” she explains.
Besides showers to reduce the bacteria on the skin, remember to keep nails short, to prevent scratching. “I encourage using neem leaves for itchy lesions,” says Dr. Benjamin. “It’s a safe way of soothing itchy skin, as the leaves are gentle, and do not damage the skin.”
Chickenpox does not call for any special diet, both doctors agree. “Children might have lesser appetite, so give them frequent, small meals. Give them a lot of fluids, especially if they have diarrhoea. Coconut water is a good option, so are juices and soups,” says Dr. Mythili.
Prevention
Chickenpox is relatively milder in children (it tends to be more severe in adolescents and adults), and once you’ve had it, you develop life-long immunity against the disease. “Since the chickenpox vaccine has become available, we see fewer cases of the illness,” says Dr. Mythili. The vaccine (live attenuated virus) causes no discomfort, although sometimes it produces mild fever/a few spots. “The vaccine is 90 to 95 per cent effective in preventing chickenpox with one dose, in children,” says Dr. Benjamin. “With a second dose, it is close to 100 per cent. Adults need two doses. The vaccine must not be given to children below one year of age, and there is better response if it is administered at 15 months. However, the vaccine cannot be given to people with immuno-deficiencies (HIV, AIDS, or those on steroid and cancer treatments),” he says.
Complication
Although complications are rare, chickenpox can affect the brain, and in older people, cause pneumonia, says Dr. Benjamin. “If skin lesions are numerous, if bacterial infection develops, if there’s severe headache/altered level of consciousness, consult a doctor,” he advises. But in most cases, chickenpox is more of a nuisance, says Dr. Mythili. “There is post-viral fatigue/ tiredness for up to a month although it can be a dangerous to those who are immuno-compromised,” she cautions.
