Health Tips

Chickenpox (varicella) is an infectious disease that causes an itchy, blister-like rash (pox) all over the body. It is a common infection among children.

 Generally, chickenpox is not a serious issue among healthy children. However, it may pose health risks for pregnant women, newborns, teens and adults, and people who have abnormal immune systems that makes it harder for the body to fight off infections. 

How does chickenpox spread from one another?

Chickenpox is caused by the varicella-zoster virus. It can be spread via air when someone with chickenpox coughs or sneezes, or by touching the watery discharge on the chickenpox blisters. 

What can you observe in chickenpox infected individuals?

People with no prior exposure to the virus may develop chickenpox 14 days after contacting infected individuals. The signs and symptoms of chickenpox infection include:

• Fever, generalised tiredness, loss of appetite and headache about five days before the appearance of rash.

• The rash first appears on the chest, back, and face, and then spreads over the entire body. At this stage, the rash may look like raised pink or red bumps, known as the papules. The break out of papules may take over several days.

• In about one day, the rashes may develop into small fluid-filled blisters known as the vesicles, which then break and leak. Take note that watery discharge contains viruses and therefore is infectious. 

• After that, these pox crusted up and scabs may be formed, which cover the broken blisters and require several days to heal.

New rashes continue to appear for several days, so the individual may have all three stages of the rash — bumps, blisters and scabbed lesions — at the same time. Infected individuals can spread the virus to other people for up to 48 hours before the rash appears, and the virus remains contagious until all broken blisters have crusted over.

Although chickenpox is usually mild among children, in severe cases the rash can cover the entire body, and lesions may form in the throat, eyes, and mucous membranes of the urethra, anus and vagina.

Managing chickenpox

• Keeping the infected child away from school or nursery until the rash has crusted, which takes about seven days since the first appearance of rash. This is important to prevent spreading of viruses to other children.

• Do not travel when your child is infected. 

• Consult a pharmacist to purchase paracetamol or ibuprofen for managing the child’s fever.

• Ensure the child takes plenty of fluids and takes balanced meals.

• Ensure the child keeps his or her hands clean.

• Apply calamine lotion on the rashes to reduce itchiness. If the itching is unbearable and affects the child’s sleep, you may consult a doctor or pharmacist for sedating antihistamine that helps to reduce itchiness and promote sleep.

• Keep the child’s fingernails short to prevent skin damage from scratching.

Why is chickenpox infection more severe for adults?

This is rather counterintuitive, but adults are 25 times more likely to die from chickenpox infection than children. As such, adolescents and adults who have never been infected with chickenpox and are not vaccinated against it, are at a higher risk for chickenpox infection. 

Who should be vaccinated against chickenpox infection?

Gaining natural immunity against chickenpox is a common household practice, which may involve parents deliberately taking their children to ‘pox party’ so that they can get chickenpox from an infected child. This practice, however, may cause a child to go through a lot of miserable discomforts and inconvenience in responding to the infection, not to mention the potential life-threatening complications. Vaccinate instead.

In Malaysia, the varicella vaccine is recommended to individuals who are at higher risk for chickenpox infection. This vaccine is available at private hospitals and clinics. Individuals who are encouraged to be vaccinated are:

1. Children under 13 years old.

2. Individuals above 13 years who have never had chickenpox or received their chickenpox vaccine:

• Those who had chickenpox before their 1st birthday may not have developed a lasting immunity and are susceptible to being re-infected with the same virus at a later age

• Childcare workers

• Teachers

• Women planning on pregnancy

• Adolescents and adults living with young children

3. Individuals with the following conditions are recommended to speak with their doctor about whether they should receive the varicella vaccination, including individuals who:

• Has HIV/AIDS or another disease that affects the immune system

• Is being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer

• Has any kind of cancer

• Is getting cancer treatment with radiation or drugs

Shingles and chickenpox

Interestingly, after being infected with chickenpox, some viruses may stay in the nerve cells of the infected individuals. When these viruses are reactivated later in life (usually around 50 years old), the infection is known as shingles. Shingles is not a new infection, it is a new outbreak of the old infection. In other words, shingles only happen in people who already had chickenpox.

Shingles starts with pain in the affected nerve area where the virus had been ‘hiding’. The pain can range from a tingling sensation to very severe burning pain, indicating nerve damage. Infected individuals can also develop rash, which can be quite severe and lead to scarring.

To prevent shingles, individuals aged 50 years and above and at higher risk for shingles can take a vaccination. 

Source:

1. https://www.cdc.gov/chickenpox/about/index.html

2. https://www.mayoclinic.org/diseases-conditions/chickenpox/symptoms-causes/syc-20351282

3. http://www.myhealth.gov.my/en/chickenpox/

4. http://www.myhealth.gov.my/en/varicella-zoster-viral-infection

Written by

Ms Joyce Toh