Chickenpox

Thanks to a vaccine introduced in 1995, cases of chickenpox have declined more than 80 percent nationwide. But be aware that the vaccine does not completely safeguard against this nasty virus.

The chickenpox virus is in the herpes group of viruses.

Chickenpox is caused by the varicella-zoster virus, one among the family of common infections known as herpesviruses. A common characteristic of all herpesviruses is that once they’ve infected a host, they store away in peripheral nerves and live in the person for life. Typically, an acquired varicella virus will remain dormant and not resurface after the chickenpox outbreak. However, the virus will sometimes reactivate—more often in adults than children—manifested now as shingles. It is not well understood why the virus reappears, but risk for shingles appears to be associated with a suppressed immune system, malnutrition, presence of other infection or physical stresses, and generally poor health.

A second vaccination against chickenpox has been recommended.

At the end of June 2006, the Centers for Disease Control and Prevention (CDC) recommended that children receive a second dose of vaccine sometime between the ages of 4 and 6. According to the CDC, “Fifteen to 20 percent of children who have received one dose of the vaccine are not fully protected and may develop chickenpox after coming in contact with varicella-zoster virus. Additionally, one dose of the vaccine may not continue to provide protection into adulthood when chickenpox is more severe.”

Note that the vaccination is not a guarantee against chickenpox, but anyone who does acquire the disease after vaccination should experience only a very mild case.

Clean skin will help prevent secondary infections.

Contrary to the idea that a child with chickenpox should not get wet, Dr. Jay Hoecker, pediatrician at Mayo Clinic in Rochester, Minn., explains that washing is important. “You have to get wet if you’re going to wash bacteria off the skin, and washing is important for avoiding a secondary bacterial infection. However, you do not want to rub the skin. Soak or pour the soapy water over the skin, and then pour some clean water over it to rinse. Then pat the skin dry as opposed to taking a towel and 'buffing.' "

A few age-old remedies for itch relief have stood the test of time. Oatmeal baths are soothing, since oatmeal helps relieve most any skin irritation. Don’t just dunk your kid in a tub full of Quaker Oats: Use a colloidal oatmeal bath product, such as those available by Aveeno. Calamine lotion, best applied gingerly with a cotton ball, may also bring temporary itch relief, provided your child will tolerate being covered in pink polka dots.

Dr. Hoecker explains that recommendations to use antihistamines are usually misdirected. Antihistamines can provide relief when an excess of histamine is the cause of itchiness, but this is not the issue with chickenpox. Antiviral medications can lessen the severity of a chickenpox episode, but only if the treatment is started in the first few days of infection—and chickenpox is difficult to diagnosis at that early stage, when symptoms closely resemble a common cold.

While a week or two with an incredibly itchy, irritated rash can be miserable, the disease is usually mild in healthy children. The disease may be worse in children with eczema or in any person who is on immune-suppression drugs (such as corticosteroids) or has an otherwise deficient immune system.

In very rare instances, chickenpox can lead to encephalitis (inflammation of the brain) or have other effects on the central nervous system. It is also capable of causing pneumonia, as are many other viruses.

Grandparents should steer clear of grandchildren with chickenpox.

Unless an elderly person has been vaccinated against chickenpox, it is best if they avoid exposure. “Most of the vaccine has been given to children, although it can be given to older people,” says Dr. Hoecker. “Older individuals, especially those with health problems, should avoid being around the disease. They may not even know whether they had it as a child, especially if they had an attenuated [mild] case, so the natural immunities may not be in place.”

“Chickenpox” has been reviewed for accuracy by Dr. Jay Hoecker, pediatrician at Mayo Clinic in Rochester, Minn.

Confused by health myths and misinformation? Each week, Rich Maloof talks to leading health experts to bring you the straight facts on a broad range of health topics.

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