Copyright 1995, Myriam Godfrey. Use and copying of this information are permitted as long as (1) no fees or compensation are charged for use, copies or access to this information, and (2) this copyright notice is included intact.
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The patient is contagious from 24 hours before the first pock appears until one week after the last new spot has scabbed over. The incubation period is 7 to 21 days after exposure. There is approximately a 70% chance that a non-immune child will catch the disease if fully exposed.
One thing I did do (don't tell the kids!) is fill up the outside kiddie pool with slightly warm (from the hot water tap) water and then mixed in Aveeno oatmeal bath packets. Great trick! Played for 20-30 minutes whereas tub baths were fought after the first two each day. ;-)
The really BAD times (days 2-6) were virtually sleepless for me and them, but on the 6th night they were both over it. They slept 15 hours that first night. I, of course, expected to have to wake up, so was up every hour. :-(
This was certainly borne out by our experience - My son got chicken pox from his daycare buddy. She had a mild case and didn't need a lot of etra parental attention, so her Mom (my daycare provider) didn't mind having my son come anyway. I figured he had already been exposed, so why not send him (rather than use my leave both while she was sick and when he inevitably got them.)My son had a HORRIBLE case.
She posted about the "oatmeal snakes" she made for her son. Figuring I'll be going through this twice, I cut the legs off an old pair of pantihose, filled each with a couple of cups of oatmeal, and tied the open end shut. Mickey used his in a warm bath every evening for 5 days. After his bath, I painted each spot with a little calamine lotion. He broke out on Saturday & was back to school on Friday, looking terrible, but feeling fine.
He didn't scratch while he was contagious, but he has a tendency now to pick at the scabs. The ones on his body - that were painted with calamine - aren't bad, but the ones in his hair are pretty nasty. I'm taking a fairly stiff brush through his hair once or twice a day & that's helping to get the scabs out after they fall off.
I have to confess that we did a very materialistic thing, too. On Sunday,
when we were sure it was chicken pox, I went to the toy store & picked
out a week's worth of small toys. I felt a bit guilty & indulgent,
but the "new toy/day" did help keep him from scratching. I think distraction
may be a big part of it. He didn't just lay around watching TV; when he
felt like playing, he had some new goodies to play with & when he got
sleepy he could rest.
1. It sounds like the scalp is the worst place to have the scabs.
anyone consider a crew cut before they come (I'd wait till he was
definitely sick to be sure). Our last babysitter was SHOCKED that
Nathan had never had a haircut/crewcut because, "you have to cut it to
make it come in thicker." (She's from Slovakia) So, maybe he should
get his first haircut now. He has such beautiful hair though :(
I think is a typical YMMV issue. My son has medium length hair, very fine in texture, but lots of it. (Definitely not a crew cut, but also definitely not "long"). He had LOTS of scabs in his hair and I didn't even realize it until they started hardening and peeling off when I combed his hair. They didn't seem to bother him at all -- I never once saw him scratch his head.
So, anyway, I would not get him a haircut now if you weren't planning on it anyway. I would also put off anything new and possibly "hard to deal with" until he's over the chicken pox. He may be pretty irritable for a few days!
3. Nathan got eczema last week and the Ped told us to use over-the-counter
hydrocortisone on the rash. This is for itching and burning. Why
haven't I seen it's use mentioned for chicken pox?
The explanation I got for this is that it's too easy to overdose a small child with the amount it would take to cover all the open sores with chicken pox. We had adequate relief with a combination of oatmeal baths (the expensive Aveeno kind, I'm afraid) and letting him paint (warm) calamine lotion all over himself with Qtips. (I warmed it in the microwave because when it was cold and wet it really sent him off the deep end! I think his skin was hypersensitive by then).
4. Given that he has these eczema bumps all over him to confuse things,
what specifically should I be looking for as a first sign of C-pox?
If Nathan really does have chicken pox, you'll be surprised in a few days that you asked this! The pox are truly "watery", as my books described them. You will look at them and wonder how come they don't just pop (then, of course, they will, and then the itchy part starts). Also, they seem to hit the torso first.
The only other thing "I wish I knew" is that the pox on the face are the most likely to scar because there are so many bacterias present around your mouth and nose. My son John only has one scar out of lots and lots of pox -- right next to his nose. I thought it was because he kept running into it with his hand being around his face eating, rubbing his nose, etc., and picking at it. His pediatrician says it's because it was really a little infected because of the facial bacteria, and that's why it took longer to heal.
The surprise is some sunburn gel that helped calm down some of the spots INSTANTANEOUSLY. The stuff we have is made by Banana Boat, but I'm sure other manufacturers make the same kind of formula. It has Aloe Vera gel and Lidocaine, and also alcohol. It's blue, and similar in consistancy to hair styling gel.
When I put just a tiny bit of this stuff on one of Ben's "panic" spots (as in "Ooh, Mom! It hurts! It's bad! THIS spot! Ooh! Ouch!"), it took less than a second for him to say "Oh, that's better. It's cool." I don't think it was power-of-suggestion, because the calamine had no such effect. I actually was afraid the gel might sting because of the alcohol, but he just thought it felt fine.
Hope someone finds this info helpful!
Okay, this seroconversion without symptoms thing is really not well known. We have one instance here where somebody, a scientist in the field, tried it and it worked. He had been proven to be chicken-pox-susceptible by a blood test beforehand. The bit about reducing the severity if taken within twelve hours of the first symptom is well-known and has been reported on in several journals, besides happening to a close friend of mine, and Kathleen Riggle's husband, Dave (both on my suggestion after doing a MedLine search).
It is possible to test an individual's blood for immunity to chicken pox. The cost used to be quite high, perhaps $40 or $70, but recently I've read on misc.kids that the test is no longer expensive at all. It might be worth it, especially for a pregnant woman who thinks she's never had the disease. Chicken pox contracted during pregnancy can harm the fetus, in perhaps 1 or 2% of all such cases, and is probably more likely to be fatal to the mother than if she is not pregnant.
Acyclovir was until recently felt to be not as useful in children, as in adults, and was used only for children with immune problems. Now many pediatricians use it routinely, if they get a chance to prescribe it early enough in the course of the infection, because it lightens the course of the disease so much, apparently without harming the development of immunity. If your doctor is too old-fashioned to prescribe it, you might want to do some quick doctor-shopping to avoid unnecessary misery--or you might not.
It's much easier for children. I really envied my half-siblings, who got it from me, who got through it so much easier than I did.
Personal complains aside, I was astonished to find how many people didn't know whether they had had it or not as children! (I phoned people to warn them, etc.) It turned out that all of them had, or at least they didn't catch it from me for some reason. The only people who caught it from me were my two brothers and my two half-siblings. Obviously, there was a correlation between my brothers and I all not having had it as children, and my half-siblings were of ages 5 and 3.
The incubation period is something like two weeks, so don't jump to any false early conclusions that someone didn't get it.
In Canada, the drug 'acyclovir' is used to soften the impact of chicken pox. I was prescribed acyclovir. I don't know if this is used elsewhere.
All this began on Friday evening. On Monday morning we got a followup call from our very level-headed pediatrician, a woman we have a great deal of respect for. When she learned we had used Acyclovir, she hit the roof. She strongly opposes its use, for two reasons: it's a strong anti-viral drug (specifically, an anti-herpes drug--Chicken Pox being a herpes virus), and she felt without an extensive track record, it should not be used with children otherwise in good health. Secondly, it's not certain whether complete immunity will be conferred if the drug is used--it's likely that it will, but not yet proven. And you certainly don't want to get a second outbreak of Chicken Pox as an adult.
With those objections in mind, we had to decide whether we would use the drug on our second daughter, who was guaranteed to get a (much worse) case ten days or so after her prolonged exposure to her twin sister. I looked up the research in the New England Journal of Medicine, where the first results were reported--both the report itself, and the rebuttal several months later. Having read it and thought about it, with some misgiving, we decided to use it on our second daughter too. Our reasoning went this way: even with treatment, our first daughter's case was bad enough--we didn't want to make our second daughter suffer through a triply worse case if not necessary. Secondly, we had given about half the dose that the study used, and it still clipped the course of the disease by at least several days, kept the period of fever much shorter, and stopped new eruptions by the end of the second day. More importantly, we figured that the long-awaited vaccine would answer any danger of second outbreak in adulthood if indeed there proves to be such a danger. Finally, we felt pretty confident the drug itself, especially in the doses we had used, is likely to be safe.
Our second daughter indeed broke out with a very severe case (we stopped counting her chicken pox at 200, and there were areas that were so densely covered you couldn't tell where one ended and the next began). We used exactly the same treatment with her as with our first, and had the same results: the itchiness was not nearly so bad, the eruptions stopped very quickly, she felt bad for only about a day, very few of the spots, though many in number, even got bad enough to crust over, and she was completely well by day four. (The last of her spots were completely gone in about two or three weeks.)
With a vaccine, none of this will matter for other parents before long; in the meantime, if you want to consider the use of Acyclovir, I'd just suggest you read the reports in New England Journal of Medicine yourself (I'm a complete lay person, and it's quite readable) and discuss it with your pediatrician in advance. Once your child's outbreak has begun, you won't have enough time to make a careful decision.
My husband got chicken pox from work couple years ago (pre-kids). He had a mild case and was miserable with flu-like symptoms for a week. However, a friend of mine's two kids got it from day-care first. Then her husband got it and he was in so much pain she had to rush him to the emergency room. Apparently when an adult gets it, it can be internal as well as external. In her husband case, he got it inside his throat and stomach and he felt like "his chest is on fire". He had to live on Gatorade (sp?) only for a few days.
Being that my wife was exposed about a month before delivery, I can give you some info.
The worst times for getting the chickenpox and being pregnant is in the first trimester or 5days before or 3days after delivery. So I would definitely see your Dr ASAP. Don't wait. Better safe then sorry.
If you're immune to the chickenpox, then there isn't any risk to the baby. But just because you had the chickenpox once, does NOT mean you can't get them again(Ie, if you had a light case of the chickenpox, then it is possible to get it numerous times). There is a test they can give you to tell if you're immune or not (vircella zoster[sp?], aka Tiger[sp?] test).
Then if you prove to be suspectible to the chickenpox, there is an immunity shot(I think it only protects you for about a month) they can give you (vizeg globulin?). This is gotten from the Red Cross(one in St.Louis and one in Wichita,KS were the only Red Crosses that had it in our area).
FYI, the price for these shots were shocking. If you or your Dr needs/wants
to, you can call me. It is a rare occurance.
Note: there is likely a second NEJM article and it MAY be in this same issue
On March 17, 1995, the Food and Drug Administration licensed Varicella Virus Vaccine, Live (VARIVAX [registered symbol]), manufactured and distributed by Merck and Co., Inc., (Rahway, New Jersey). This vaccine has been licensed for use in persons aged greater than or equal to 12 months. The recommended dose for susceptible children aged 12 months-12 years is one 0.5 mL dose administered subcutaneously. The recommended dosage for susceptible adolescents aged greater than or equal to 13 years and adults is two 0.5 mL doses of vaccine 4-8 weeks apart. The recommendations of the Advisory Committee on Immunization Practices on the use of varicella vaccine will be published.
Chickenpox (varicella) is a d disease affecting most children in the United States before their 10th birtday. Until recently it could not easily be prevented with a vaccine, only treated. Now, however, parents can have their children immunized against chickenpox with a new vaccine. Regular medical care includes vaccinations which are an important part of your child's total health care.
This brochure discusses chickenpox and why it's beneficial to have your child vaccinated against the disease. The new vaccine can protect your child against chickenpox and prevent the discomfort and possible serious complications the disease can cause.
What is this disease? Chickenpox is one of the most common childhood viral diseases. It is usually mild and not life-threatening to children who are otherwise healthy. The most noticeable signs of chickenpox is a skin rash that develops on your child's scalp and body and then spreads to the face, arms and legs over a period of 3-4 days. The rash forms between 250-500 itchy blisters that dry up into scabs 2-4 days later. School-age children often get a mild fever for 1 or 2 days before the rash appears. Other symptoms of chickenpox are chills, fussiness, loss of appetite, and headaches. Chickenpox is highly contagious and is spread in one of the following ways
Who gets chickenpox?
There are about 3.9 million cases of chickenpox in the United States each year, with more than 95% of all people developing the disease. Cases occur most frequently in children from 6 to 10.
Chickenpox can occur at any time throughout the year, but it's peak times are in the winter and the early spring especially in moderate climates.
What is the treatment for chickenpox?
You may remember from when you were a child just how itchy chickenpox can be. If your child scratches the blister before they are able to heal, they get infected, turn into small sores and possibly leave scars. Discourage your child from scratching but keep his or her fingernails trimmed short just in case.
Oatmeal bath and calamine lotion, which you can buy without a prescription, can help relieve your child's itching. Acetaminophen (Tylenol) may help reduce your child's discomfort, If your child's fever lasts longer than 4 days or rises above 102 degrees, call or see your pediatrician. Also let your pediatrician know if areas of the rash get very red, warm or tender. This may mean that your child has a bacterial infection and needs other treatment.
Acyclovir, an oral drug is used for certain patients who are at risk of developing severe chickenpox. These patients include adolescents and children with skin or lung diseases. To be effective, Acyclovir must be given within the first 24 hours of onset of the chickenpox rash. You may want to discuss the use of Acyclovir with your pediatrician.
Can chickenpox cause complications?
Most children who are otherwise healthy and get chickenpox won't have any complications from the disease. However, each year in the United States about 9,000 people are hospitalized for chickenpox and 90 people die from the disease. The most common complication from chickenpox is bacterial infection of the skin. The next most common problems are viral or bacterial pneumonia and encephalitis. The following groups of people are at higher risk of developing these problems:
What is shingles?
Once someone has had chickenpox, the virus that caused it stays forever in the nerve roots of the infected person. Later in life, the virus in these nerve roots can reappear and cause shingles. Shingles can occur at any age but usually occur after a person is 50 years old. About 10% to 20% of all people who have had chickenpox develop shingles. People with shingles typically feel numbness and itching or severe pain in the skin areas where the affected nerve roots are. Within 3 to 4 days clusters of blister like lesions develop and last for 2 to 3 weeks.
When should my child get the chickenpox vaccine?
The American Academy of Pediatrics recommends the chickenpox vaccine for all children between the ages of 12 and 18 months who do not have a history of chickenpox. Older children should be immunized at the earliest opportunity, also with a single dose. Healthy children who are older than 13, have no history of chickenpox and who have never been immunized against the disease should get two doses of the vaccine 4 to 8 weeks apart.
What are the benefits of vaccinating my child against chickenpox?
Although chickenpox is usually mild, routinely vaccinating all children at age 1 can prevent medical problems and reduce the costs related to the disease. Parents may have to miss work while their children are home from school or childcare. In the average household, a child with chickenpox misses 8 or 9 days of school, and adult caretakers lose up to days of work.
The chickenpox vaccine is 70%-90% effective in preventing chickenpox. If vaccinated children do get chickenpox, they generally get a milder form of the disease. They have fewer skin lesions (15 to 32) a lower fever, and recover more quickly. In fact, the disease may be so mild that the skin lesions look like insect bites. Even so, vaccinated children with a mild case of chickenpox can still infect other at risk of getting chickenpox. Currently a booster for the chickenpox vaccine is not recommended. Studies are underway, though, to determine how long protection from the vaccine lasts and whether a person will need a booster in the future.
Is the new vaccine safe?
In the early 1970s, a vaccine for chickenpox was developed in Japan. More than 2 million doses of that vaccine have been given in Japan and Korea. Since the early 1980s a similar chickenpox vaccine has been tested in the United States in over 9,400 healthy children and over 1,600 adults. These tests have shown this vaccine to be safe and effective. Adverse reactions from the chickenpox vaccine generally are mild and include redness, stiffness soreness and swelling where the shot was give.: tiredness; fussiness; fever; and nausea. Also, a small rash of several bumps or pimples may develop at the spot where the shot was given or on other parts of the body. This can occur up to 1 month after immunization and can last for several days.
Your child can get the chickenpox vaccine at the same time he or she gets the measles-mumps-rubella (MMR) vaccine. If your pediatrician doesn't give your child the chickenpox and MMR vaccines at the same time, your child should wait at least a month between getting each vaccine. Otherwise, your child can get the vaccine for chickenpox at the same time or at any time before or after vaccines for diphtheria, tetanus, pertussis (DTP), polio, hepatitis B and Haemophilus influenza type b. Although the chickenpox vaccine is approved for use in otherwise healthy children, there are certain groups of people, such as children with a weakened immune system or pregnant women who should not receive it. Talk to your pediatrician about whether your child's falls into any of the high risk categories and should not be vaccinated against chickenpox.