Is the course of chickenpox unusually severe in some children?


The disease is self-limited in most children as their immune system is well developed. If, however, a child whose immunity is low develops chickenpox, he is more likely to suffer from a severe course. Hence, children suffering from leukemia (blood cancer) or HIV infection or those on anti-cancer drugs may develop a severe variety of chickenpox. Adolescents may have an unusually severe course of chickenpox. Fever and constitutional symptoms are severe. Rash is heavier and confluent, complication rate higher and chances of fatality greater in them.

What are the consequences for a pregnant woman who comes in contact with a case of chickenpox?



If a pregnant woman has previously suffered from chickenpox and has immunity against it, she is at no risk of developing chickenpox. If not, she may contract the infection which may have a severe course with higher likelihood of complications like pneumonia and may even succumb to the disease. There could be effects on her unborn fetus too.

What are the effects on fetus, if a pregnant woman develops chickenpox?



The effects depend on timing of the infection. If a mother develops infection during early pregnancy (e.g. first three months of pregnancy), the growth of various fetal organs may get affected and baby may be born with skin scarring, abnormalities of limb development and cataract. These babies may be mentally retarded, and may develop heart defect too. There is a possibility that abortion may occur in the pregnant woman.

If the infection occurs later in pregnancy but not too close to delivery, the baby will be normally born but there is a possibility that she will develop herpes zoster(shingles) during infancy.

If mother develops chickenpox within 5 days prior to the delivery or in 2 days after the delivery, the baby receives the virus but not the ready-made maternal antibodies. Given her immature immune system, such a baby is in a weaker position to combat varicella infection and may develop severe manifestation of the disease. Newborn babies are more likely to develop serious complications like pneumonia and are at an enhanced risk of death from infection.

How is shingles related to chickenpox?


Both these conditions are caused by varicella zoster virus. First exposure to the varicella zoster virus results in chickenpox, which is followed by immunity against the infection, which usually lasts life-long. The virus, however, hides in certain nerve roots and remains dormant. The virus may get reactivated many years later leading to shingles (Herpes Zoster).

How does shingles present?


Shingles usually afflicts adults' especially old people. The rash, in shingles is vesicular and is limited to one or two segments on one side of the body. However, the rash is extremely painful. This pain is notorious for not getting easily controlled by routinely used analgesics or painkillers. If the rash affects the eye, it is a potentially sight-threatening complication.

Shingle may be followed by neuralgia and pain may persist for several months and years. Immunocompromised individuals like those suffering from leukemia / cancer or AIDS or patients on immunosuppressive therapy like steroids, anti-cancer therapy or radiation, may develop shingles which may involve many segments of the body and can have complications which are potentially fatal.

Does childhood chickenpox have a social impact?


Yes. The full impact of childhood chickenpox on patients and their families is often not appreciated. Physically, varicella is very uncomfortable for patients because they have to endure discomfort from symptoms such as the rash and the associated itching, fever anorexia and other constitutional symptoms. Patients often need to be isolated and kept at home. Thus, a school-going child may miss her school for a few days up to month (which is ideally not needed). Child may develop chickenpox during the examination period, which is usually held during March-April, which is also peak period for developing chickenpox (in winter). The rash may leave behind a permanent scar, which, for cosmetic reasons, may cause concern during adolescence or adulthood.

What are economic costs for a family when a child suffers from chickenpox?



The economic costs can be divided into direct costs and indirect costs. The cost of medications to control fever, relieve itching can be considered as direct costs. Occasionally, the child may have to be hospitalized or rarely suffer a severe complication. These add to direct costs. In addition, there are indirect expenses that the family has to incur. E.g. when a child has chickenpox, he cannot attend school and cannot be cared for in a day-care center, for the fear of spreading infection. This compels one of the adult household members, usually a parent to abstain from work and be at home to take care of the sick child. This may mean missing important appointments, rescheduling assignments or even loss of wages.

How does one treat chickenpox?


As stated earlier, chickenpox presents with fever, other constitutional symptoms and rash. In most children, it has a self-limited course. Paracetamol can be given to control fever. Use of aspirin should be avoided, as it is feared to give rise to certain complications. Itching can be controlled by application of calamine lotion or oral antihistaminic drugs after consulting your doctor. The fingernails should bathed daily (contrary to general belief) so as to decrease the possibility of secondary infection.

Anti-viral drugs effective against vericella are known but are usually not required for otherwise healthy children and for uncomplicated cases of chickenpox. They may, however, be required when complications such as varicella pneumonia occur or when an immunocompromised child suffers from chickenpox.

What vaccines are available against chickenpox?


A vaccine containing a live attenuated strain of varicella is available. This strain is capable of stimulating the body's immune system to produce immunity against varicella virus without causing the disease. The vaccine is administered subcutaneously and is effective in providing protection for over 90% of vaccinees. Children below the age of 12 years require only one dose while older children; adolescents and adults require two doses at an interval of 6-10 weeks. The vaccine is usually well tolerated and side effects are generally mild and transient. These include local pain, mild rash and fever. Thus chickenpox is now preventable through vaccination. Please consult your doctor.

See Frequently Asked Questions On"Chicken Pox"

Last created on 23-02-2001
Last updated on 12-05-2007