What is Chickenpox?
Chickenpox is a viral illness that generally starts with a fever. There are multiple small, red bumps on the skin that become thin-walled blisters filled with water. These become cloudy blisters or open sores and finally dry up with brown crusts (all within 24 hours). There are repeated crops of these sores for 4 to 5 days. The rash is on all body surfaces, but usually starts on the head and back. Some sores may be in the mouth, eyelids or genital area. There may be an exposure to a case of chickenpox 2-3 weeks earlier.
What is the cause?
Chickenpox is caused by a highly contagious virus known as varicella-zoster virus. The varicella virus belongs to the Herpes group of viruses.
What is the course of the disease?
The fever is usually the highest on the third or fourth day. Children start feeling better and stop having fever once they stop getting new crops. On an average, a child gets a total of 300 chickenpox sores.

The normal chickenpox scars can take 6 to 12 months to fade. Chickenpox rarely leaves any permanent scars unless the sores become infected or the scabs are picked off repeatedly. A single attack usually gives lifelong immunity. Very rarely, a child may have a second mild attack.

Children with chickenpox are contagious until all the sores have crusted over, usually about a week after the rash begins. To avoid exposure to other children, avoid taking the child to the doctor’s clinic. Once all the sores have crusted over (after 6 to 7 days), the child does not have to stay at home anymore even though scabs may still be there. It may take up to 2 weeks for all the scabs to fall off.

Most adults who think they did not have chickenpox as a child probably had a mild attack. Siblings will come down with chickenpox in 7 to 21 days. The second case in a family generally has many more chickenpox sores than the first case.
How is it treated?
The treatment for skin discomfort and itching is a cool bath every 3 to 4 hours for the first few days. Add 4 tablespoons of baking soda per tub of water. Bath water does not spread chickenpox. Calamine lotion can be applied on the itchy areas. The itchy areas can be massaged with an ice cube.

Paracetamol may be given in the dose appropriate for the child's age for fever over 102°F (39°C). Do NOT give aspirin to children and adolescents with chickenpox because of the risk of Reye's syndrome, a neurological illness.

Since chickenpox sores also occur in the mouth and throat, the child may be picky about eating. Encourage the child to drink cold fluids. For infants, use a cup rather than a bottle because the nipple can cause pain. A soft, bland diet, avoiding salty foods and citrus fruits is good.

If urination becomes very painful due to sores in the genital area, apply 5% Xylocaine ointment to the genital ulcers every 4 hours for pain relief.

Acyclovir is an expensive, oral anti-viral drug that can be used to treat chickenpox. It helps only if it is started within 24 hours of the appearance of the first sores. It may reduce the number of sores and the duration of illness. The complications are not reduced. Some doctors prescribe acyclovir for adults and older students. It may also be prescribed for younger children having social obligations (such as travel). Most doctors do not treat normal, healthy children with acyclovir.
When should the doctor be called?
Consult the doctor immediately if some chickenpox sores look infected (yellow pus, spreading redness, red streaks), the child looks very sick, or fever lasts more than 4 days, or the itching is severe and doesn't respond to treatment.
Can chickenpox be prevented?
A chickenpox vaccine is available that is recommended for all children who haven't had chickenpox. It is given at any time after 12 months of age.

Vaccinations required for children

  Vaccination

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