Chickenpox - A Serious Disease
by A. Dixon, R.N.

Chickenpox is not just an itchy, contagious rash. Chickenpox can cause serious
problems, even death. Nearly four million people in the United States, mostly children,
get chickenpox each year. About 9,300 people are hospitalized (80% are children
and adolescents) for medical complications and about 100 people die. A frequent
complication is skin infection, which may result in scars. Rarely, blisters can be
infected with certain kinds of germs that can quickly cause shock, organ failure,
and "flesh-eating disease" (necrotizing fascitis).

Other serious problems include swelling of the brain, loss of muscle coordination,
pneumonia, ear infections, and Reye's syndrome (a rare disease that has been
associated with aspirin use during chickenpox infection) . Complications contribute
to lost time from work and school, the possible cost of sick-child visits to the doctor,
medications, and hospitalization.

Chickenpox is an acute, highly contagious, viral disease caused by the varicella
zoster virus. This disease can occur any time throughout the year but its peak times
are the winter and early spring, especially in moderate climates. Chickenpox is
spread by direct contact with fluid from broken blisters, or through the air when
an infected person coughs or sneezes.

Chickenpox can spread even before infected people know they have chickenpox
or before the rash develops. A person with chickenpox is contagious and can infect
others for about two days before the rash appears and until the pox have crusted
over. It has been proven that the secondary (pass-along) cases of chickenpox can
be more severe than the infection that occurs in the first person. It usually takes
about two to three weeks before symptoms start once a person has been infected.

The time period between catching the infection and feeling sick is called the
"incubation period." At the end of the incubation period, which can last anywhere
from one to three weeks, an infected person may feel achy and feverish, experience
a loss of appetite, and feel like he/she is "coming down with something."

Next comes the rash that usually starts as little red spots or as a rash on the
chest, stomach or back, and then on the face, arms, and legs. The rash may
consist of only a few spots or it may develop into hundreds of spots over the
next three to f ive days. The spots will change into clear blisters filled with f luid.
These blisters become cloudy, can break open, and form a crust or scab.
These scabs can be very itchy and may lead to permanent scarring.

The rash can spread to the scalp or even inside mouth or other body openings,
which can be very uncomfortable. The infected person will start to feel better
after about three to five days. However, if the fever returns or if the fever rises
rapidly and/or a cough develops, complications may be starting. It's important
to contact your health-care professional if these symptoms persist.

The course of chickenpox will vary with each infected person. A person is
usually sick for about to seven days. New blisters usually stop appearing by the
fifth day, most are crusted by the sixth day, and most scabs are gone within
twenty days after the rash begins. If complications set in, however, the recovery
period may be longer.

Fortunately, there's a vaccine to protect anyone who has not already had
chikenpox. In the early 1970s, a vaccine developed in Japan. More than two
million doses of this vaccine have been given in Japan and Korea. Since the
early 1970's,a similar vaccine has been tested in the United States in over
9,400 healthy children and 1,600 adults. These tests have shown this vaccine
to be safe and effective.

Any adverse reactions from the vaccine are usually mild , and the vaccine
is 70% to 90% effective in preventing chickenpox. If vaccinated people do
get chickenpox, they usually have a much milder form of the disease. They
have fewer skin lesions, 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 others at
risk of getting chickenpox.

A booster for the chickenpox vaccine is not  currently recommended. Studies
are underway to determine how long protection from the vaccine lasts and
whether or not vaccinated people will need a booster in the future.

The American Academy of Pediatrics recommends the chickenpox vaccine
for all children between twelve and eighteen months who do not have a history
of chickenpox. Older children and adults should be immunized at the earliest
opportunity. Anyone over the age of thirteen will need two doses of the vaccine
four to eight weeks apart. You can still get the vaccine even if you're not sure
that you never had the disease.

NEW FOR YEAR 2000! Children in daycare or entering the Georgia school
system for the first time (school year 2000 - 2001) will have to have had the
chickenpox vaccine, or a reliable history of having had the disease. This must
be documented on the Georgia Certificate of Immunization form #3231.

If you have any questions or would like more information about chickenpox
or the chickenpox vaccine, ask your health-care worker or call the Fayette
County Health Department. The cost of the vaccine is $10.
Please call (770) 461-1178, ext. 5416 for an appointment.

Return to Articles List