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Chickenpox (Varicella) Condition, Treatments and Pictures for Infants

The blisters of varicella (chickenpox) are usually small and filled with a clear fluid.

This image displays early varicella (chickenpox), with small, subtle blisters and surrounding redness.

This image displays a close-up of a small varicella (chickenpox) blister.

This image displays blisters typical of varicella (chickenpox), with scratched blisters at the chin.

Graphic content

Please click to view.

This image displays widespread blisters on an infant with varicella.

The blisters of varicella (chickenpox) quickly develop crusts and scabs as they heal.

This image displays blisters in different stages, typical of varicella (chickenpox).

The blisters of varicella (chickenpox) often have a pink or red base.

Images of Chickenpox (Varicella) (8)

Graphic content

Chickenpox (varicella) is a rare infection, which is extremely serious in infants, caused by a virus of the herpes family. Infants who are infected are either infected because their mothers were infected during pregnancy (fetal or congenital varicella) or acquired the virus after they were born (postnatal varicella). Fetal varicella and congenital varicella are much more serious forms of this disease, and there is a high risk of malformations and death to the newborn. Postnatal varicella is less severe, and infants typically only have the classic chickenpox rash. This rash appears as tiny itchy, flat, red spots on the skin that raise into clear fluid-filled blisters that eventually crust over. A fever, headache, and occasional stomach pain may also be present with the rash. The rash usually first appears on the scalp, face, or chest and tends to be more prominent in the center of the body.

People with chickenpox are contagious from 24–48 hours prior to the appearance of the rash and continue to be contagious up until a week after the onset of the rash. This disease is spread by respiratory secretions, such as from mucus or saliva, so it is especially important to keep unimmunized children and infants away from infected persons.

Who's At Risk?

Chickenpox is not as common as it once was due to the varicella vaccine. However, some children that are immunized may still get a milder form of chickenpox. It is most common in children under the age of 10. This disease is rare in infants, as they are usually protected by their mother’s immune system (unless their mother was never infected or vaccinated).

Signs & Symptoms

Most children with chickenpox act sick with fever and vague symptoms (loss of appetite, headache, belly ache) for 1–2 days before they start to break out with a rash. These symptoms last for 2–4 days after the rash appears.

An early pink-to-red, flat, small spot rapidly becomes bumpy and then blisters with a surrounding halo of redness. The spots usually appear first on the trunk or scalp. Linings of body cavities, such as the mouth or nose (mucous membranes), palms, and soles, can also have a few lesions. The average child develops a few hundred blisters, most of which heal without leaving scars. A child who has had the chickenpox vaccine will have far fewer lesions.

The blister typical of chickenpox is usually described as looking like a dewdrop on a rose petal. The blister area (vesicle) is thin-walled and easily broken. Vesicles become cloudy and then crust over, with healing completed within 1–3 weeks. Chickenpox lesions often occur in three or more successive series (crops). Lesions in different stages of development may occur at the same time.

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Self-Care Guidelines

Since the illness resolves on its own after 1–3 weeks, it is most important to keep the child comfortable and to discourage scratching, which can cause infection and scars.

For itching:

• Oatmeal baths in lukewarm water
• Oral antihistamines (diphenhydramine, chlorpheniramine)
• Clip the child’s fingernails
• Apply calamine lotion
• DO NOT USE lotions containing antihistamines or lidocaine, as they are no more effective than the previous measures and might cause allergic reactions later on.

For pain and fever:

• DO NOT USE aspirin in children aged 18 years or younger. Use acetaminophen (Tylenol) or ibuprofen instead.

Because chickenpox is highly contagious, keep the child at home and resting until symptoms are gone and all blisters have dried up. Avoid any contact between your child and pregnant women who have never had chickenpox, newborns, or people who have a weak immune system or eczema. Once all the blisters have dried into scabs, the child is not considered contagious to others.

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Treatments

Antiviral medication may be given if the child with chickenpox is seen early (during the first day of the rash) or for children at higher risk for more severe disease (those with asthma, eczema, recent sunburn, children taking corticosteroids on a regular basis, and those with weak immune systems).

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Most chickenpox infections do not require treatment.

If there are adults or teens in the household who have never had chickenpox or people with eczema, asthma, or a weakened immune system, have them contact their doctor, as they may require antiviral medication. This usually needs to be done early (during the first day of the rash).

Call your child’s doctor if you suspect the child has chickenpox and:

• The child has eczema, asthma, or a weakened immune system.
• The fever lasts more than 4 days or exceeds 102 degrees Fahrenheit.
• Any rash areas look red, swollen, and leak pus.
• The child has a severe cough, vomiting, headache, drowsiness, confusion, stiff
  neck, trouble looking at bright lights, or difficulty walking or breathing.

Trusted Links

• Clinical Information and Differential Diagnosis of Varicella (Chickenpox)

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References

Bolognia, Jean L., ed. Dermatology, pp.1241-1243. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed. pp.2070, 2080-2081, 2434-2437. New York: McGraw-Hill, 2003.

Disease Groups: Childhood Contagious Diseases, New Itchy Skin Rashes in Children

Varicella ("chickenpox")

This infection was named "chickenpox" due to its contagiousness. Its distribution occurs as if with the speed of the wind. A child can get chickenpox by getting into an elevator after a sick person. After the appearance of a sick child in school or kindergarten, most children fall ill after a while.

Chickenpox is one of the most common childhood diseases. In recent years, the incidence of chickenpox in Russia has almost doubled. Predominantly sick children aged 1 to 10 years, the maximum incidence is observed among children aged 3-4 years. Children under 6 months old practically do not get chickenpox, because. the mother passes on her own immunity to them through the placenta and during breastfeeding. The peak incidence is observed in the autumn-winter period.

What is chickenpox?

Chickenpox is an acute viral infection with airborne transmission, characterized by the appearance of a rash in the form of small vesicles on the skin and mucous membranes.

The causative agent of chickenpox is the Varicella zoster virus, which belongs to the family of herpes viruses. In the external environment, the virus is unstable and quickly dies.

Humans are the only source of infection. Susceptibility to chickenpox is very high.

Patients become contagious at the end of the incubation period (48 hours before the onset of the rash) and up to the 5th day after the last element of the rash appears.

The route of transmission of infection is airborne.

Viruses are shed in large quantities when sneezing, coughing, talking. Transmission of the virus from mother to fetus during pregnancy is also possible. It is not possible to transmit the infection through third parties. There is also no chance to bring the virus home on shoes and clothes.

Due to the high volatility of the virus, its spread is possible from floor to floor, at a distance of up to 20 meters.

Chickenpox in adults is much more severe than in children, and can cause serious complications.

Clinical picture.

The incubation period lasts from 10 to 21 days (usually 14-17 days).

In children, the disease begins with a rise in temperature to 38.5 - 39 ^about C, there is weakness, loss of appetite, headache. The child becomes capricious, refuses to eat. Along with the rise in temperature, a rash appears. The severity of the fever corresponds to the abundance of the rash. The duration of the fever is 3-5 days. Each new rash is accompanied by a rise in body temperature. The rash first looks like red spots, which turn into papules within a few hours, then into vesicles, and after 1-2 days a crust remains at the site of the rash. The size of the bubbles is comparable to the size of a pinhead. After the crust falls off, a red spot remains, sometimes a scar. The first elements of the rash usually appear on the skin of the face, scalp, back, abdomen, chest, shoulders, and hips. There is usually no rash on the palms and soles. Children are very worried about the itching of chickenpox vesicles, and therefore children often comb them, rip them off, after which a scar remains, and suppuration is also possible due to the addition of a secondary bacterial infection. There are cases when only single elements appear throughout the disease, or even a rash is absent. Such cases occur mainly in children.

Recovery occurs no earlier than 10 days after the rash.

Complications of the disease.

Chickenpox is considered a benign disease, however, in some cases, severe complications can develop. Among the complications of chickenpox, the most common are purulent skin lesions - boils, abscesses, etc. specific pneumonia is severe, and the most formidable complication of this infection is damage to the central nervous system in the form of encephalitis or meningitis.

Among the adult population, the most common complication is pneumonia, and in newborns, " congenital varicella syndrome ", when a pregnant woman suffered the disease in early pregnancy.
Difficulties in the course of the disease are observed in people with immunodeficiency, including HIV infection.

To prevent the attachment of a secondary infection, it is necessary to monitor the frequency of the patient's hands, clothes, bed linen. During the period of rashes and fever, the patient must comply with bed rest.

It is recommended to lubricate the elements of the rash with a solution of brilliant green. During the period of rashes, washing with a gentle soap is allowed, a washcloth cannot be used, as there is a risk of damage to the crusts.

Parents should promptly respond to changes in the rash and call a doctor to prevent the development of complications:

If the rash increases in size, looks like the onset of a "cold on the lips", becomes covered with numerous vesicles, turns blue, becomes bloodshot, new rashes appear 10 days after the first signs of the "chickenpox" disease appeared.

If the temperature stays above 37 for more than a week or the temperature rises every day,

If the rash spreads to the mucous membranes: eyes, mouth, or genitals, because similar changes can be on the internal organs.

· If you have a cough or runny nose, because herpetic eruptions may be in the nasopharynx

with diarrhea and frequent vomiting,

those. in all cases where chickenpox is atypical.

In any case, as soon as you notice the first signs of the child's malaise and a rash, immediately call a doctor. Only he will accurately determine whether a child has chickenpox or another disease (it is quite difficult to distinguish the symptoms of chickenpox from allergies or other diseases with a rash to an inexperienced eye), and will control the course of the disease.

Adult varicella

Chickenpox in adulthood is much more severe. A distinctive feature of chickenpox in adults are pronounced symptoms of intoxication and the frequent development of complications, up to death. Chickenpox in adults is often complicated by pustular skin lesions, conjunctivitis, and stomatitis. The most dangerous complications of chickenpox are lesions of the internal organs and the brain. Among the most common are pneumonia, meningitis, encephalitis, myocarditis.

Varicella in pregnancy.

A pregnant woman with chickenpox needs careful medical supervision. The infection is dangerous both for the woman herself and for the fetus. Chickenpox can cause visual impairment, as well as a delay in the mental and physical development of the fetus.

Prevention.

General prevention of varicella consists in the timely diagnosis of the disease, isolation of the patient, followed by ventilation and wet cleaning of the premises in order to prevent the spread of infection. A patient with chickenpox is isolated until the 5th day from the moment the last elements of the rash appear. In children's groups, quarantine is imposed from 11 to 21 days from the moment of contact.

To date, specific prevention of chickenpox has been developed. Vaccination is carried out for children who have not had this infection before. The vaccine is administered subcutaneously: children, aged 1 to 13 years - once; children over 13 years of age and adults need two doses of the vaccine with intervals between injections of 6-10 weeks.

Vaccination is indicated for people at high risk: people suffering from severe chronic diseases, patients with acute leukemia, people receiving immunosuppressants, radiation therapy, patients who are scheduled for organ transplantation.

Among vaccinated persons, cases of chickenpox infection are extremely rare. If infection has occurred, then the disease proceeds in a mild or latent form. After the vaccination, the child begins to form immunity on the same day, which completes its formation after 6 weeks. From that moment on, when in contact with a sick child, one should not be afraid of the disease.

Chickenpox in children and adults. How many days do you have chickenpox?

Author

Petrova Marina Nikolaevna

Leading physician

Pediatrician

Creation date: 2016.03.11

Chickenpox (chickenpox) is an acute infectious viral disease transmitted by airborne droplets and is predominantly characteristic of children. A typical manifestation of chickenpox is a profuse blistering rash all over the body.

Most often, chickenpox is ill at the age of from 6 months to 7 years . A child up to 6 months old has immunity received from the mother's body. After 10 years, the disease is rare. However, if a person did not have chickenpox as a child, they can become ill as an adult, in which case the disease is usually severe.

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Causes of chickenpox

Chickenpox in children and adults

The causative agent of the disease is one of the types of herpes virus. It is carried with tiny particles of mucus that enter the air when coughing, sneezing, and even when talking. In the external environment, the virus quickly dies (within 10 minutes). At the same time, the disease is highly contagious, and upon contact with a sick person who does not have immunity to chickenpox, it is almost certain that he will get sick.

The incubation period of chickenpox is from 10 to 21 days (usually 14-17 days). Already a day before the appearance of the rash, the patient can be contagious, so that there was contact with the infection, you can often find out only after the fact. The threat of infection persists throughout the entire period of the rash, and only after five days have passed since the last elements of the rash appeared, contact with the patient ceases to be dangerous.

It is believed that chickenpox gets sick only once in a lifetime . Therefore, chickenpox is considered a "childhood" disease: most of us encounter the pathogen for the first time, while still being children. However, if a person has a severely weakened immune system, he can be re-infected.

After the illness, the virus remains in the body in an inactive form for a long time. This can lead to the development of another disease - herpes zoster (shingles), caused by the same type of virus as chicken pox. Contact of a child with a patient with herpes zoster can lead to chickenpox.

Chickenpox symptoms

Chickenpox usually has an acute onset.

A complex of symptoms appears immediately:

Weakness

Weakness is a symptom of intoxication.

More about the symptom

Temperature

The temperature rises and may stay around 38°C for the entire period until new rashes appear. In some children, at the onset of the disease, the temperature can reach 39-40°C

More about symptom

Rash

Rashes are found throughout the body, including on the scalp, mucous membranes, and even (in exceptional cases) on the palms and feet. At first they look like pink or red spots of round shape . Then bubbles appear. After 2-3 bubbles dry up and crusts form in their place. The rash usually lasts for 5-10 days; therefore, elements at different stages can be present on the body at the same time.

More about the symptom

Chickenpox treatments

As a rule, chickenpox in children passes without complications. The disease is dangerous during pregnancy: if the expectant mother did not have chickenpox in childhood (that is, she does not have the appropriate immunity), the infection can lead to the development of serious pathologies and even death of the fetus.

Treatment of chickenpox is aimed at preventing complications; in children, first of all, one should try to exclude secondary infection from getting into the skin lesions.

If you find symptoms of chickenpox in your child, call our pediatrician at home.

Symptomatic treatment

A sick child is prescribed bed rest. If the child does not tolerate the temperature, he may be prescribed antipyretics. The focus is on relieving itching and treating rashes. Plentiful drinking is recommended. Prescribing antiviral drugs is practiced.

Vaccination

Vaccination is a method of specific prevention of the disease.

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