All you need to know about Chickenpox

Did you know? 8 facts about chickenpox

1. Chickenpox commonly causes an illness that lasts about 5-10 days¹.
2. A person with chickenpox can have 250 to 500 blisters¹.
3. An infected person can be contagious as early as 1 to 2 days before the rash appears².
4. Possible complications include skin infection, pneumonia and brain damage².
5. In Singapore, nearly 2/3 of pre-school children, 39.5% of primary school and 29% of adolescents (13-17 years old) are susceptible to varicella (chickenpox) infection³.
6. Chickenpox scars can be found most often on the abdomen, face and back⁴.
7. Anti-viral prescription medications for chickenpox are usually most effective when taken within the first 24 hours of illness².
8. Chickenpox can be prevented through vaccination².

What is chickenpox?

Chickenpox is a highly contagious disease caused by a herpes virus called Varicella Zoster Virus (VZV)¹. Anyone can get chickenpox². However, it is more common in children². Chickenpox can be serious, especially in babies, adults, and people with weakened immune systems¹.

Chickenpox can also give rise to more severe problems in pregnant women². If a pregnant woman gets chickenpox it may result in stillbirths or birth defects, and the disease can spread to their babies during childbirth².

Symptoms of chickenpox

Typical symptoms that may appear 1 to 2 days before the rash include high fever, tiredness, headache and loss of appetite¹.
The classic chickenpox symptom is a rash that turns into itchy blisters¹. This rash / spots may leave scars when scratched².
The rash may start on the face, chest, and back¹. It can then spread to the rest of the body, including inside the mouth, eyelids or genital area¹. It usually takes about 1 week for all the blisters to become scabs¹.

How contagious is chickenpox?

Chickenpox is highly contagious². It can spread in the air through coughing and sneezing, or even by touching chickenpox blisters¹. An infected person can spread the disease from 1 to 2 days before the rash appears until about 1 week later when all the spots are dried².

Chickenpox commonly causes an illness that lasts about 5-10 days¹. Your child may miss 5 to 6 days of school or childcare due to chickenpox¹.

In Singapore, nearly 2/3 of pre-school children, 39.5% of primary school children and 29% of adolescents (13-17 years old) are susceptible to varicella (chickenpox) infection³.

Chickenpox is harmless to most people². However, those with impaired immune systems may experience serious complications, or even death².

Possible complications of chickenpox include²:

• Skin infection
• Dehydration
• Brain damage
• Pneumonia
• Arthritis

Chickenpox spots are itchy and may leave scars when scratched². Up to 18.7% children may get chickenpox scars⁴. These scars can be found most often on the abdomen, face and back⁴.

Chickenpox burden from a parent’s perspective

When a child falls sick due to varicella (chickenpox), the following may impact the parent⁵:

Medical burden

• Doctor consultations
• Hospitalisation in complicated cases
• Use of prescription and/or over-the-counter (OTC) drugs

Societal impact

• Absence from a paid job
• Absence from an unpaid job, e.g. not being able to carry out activities around the house
• Productivity loss at work: e.g. due to lack of sleep because of caring for the child
• Leisure time loss: e.g. due to a doctor visit

Prevention of chickenpox²

Anyone can get chickenpox. Chickenpox can be prevented through vaccination.

Treatment and self-care of chickenpox²

Treatment is directed at reducing the itch and discomfort of the rash. There are also anti-virals prescribed by the doctor to reduce the severity and duration of chickenpox. Anti-virals are usually most effective when taken within the first 24 hours of illness. However, most children do not need them.

Here are some tips for chickenpox self-care:

• Avoid scratching as it can cause scarring. Scratching also can affect the healing process and increase the risk of bacterial infection. To minimize damage due to scratching, put gloves on your child at night and trim the fingernails.
• Take cool baths to help relieve itching especially for children. Also, dabbing the spots with calamine lotion may help relieve the itching.

Seek immediate medical attention if²:

• The rash spreads to one or both eyes.
• The rash gets very red, warm or tender, indicating a possible secondary bacterial skin infection.
• The rash is accompanied by dizziness, disorientation, rapid heartbeat, shortness of breath, tremors, loss of muscle coordination, worsening cough, vomiting, stiff neck or high fever.

References:

1. Centers for Disease Control and Prevention – About Chickenpox; Available from www.cdc.gov/chickenpox/about/index.html; Last viewed on 16 Jan 2014.
2. Health Promotion Board – Chickenpox; Available from www.hpb.gov.sg/diseases/article.aspx?id=6432; Last viewed on 16 Jan 2014.
3. Fatha N et al; Changing seroprevalence of varicella zoster virus infection in a tropical state, Singapore; International Journal of Infectious Diseases; 2014; 22: 73–77.
4. Leung A et al; Scarring resulting from chickenpox; Pediatric Dermatology; 2001; 18(5): 378-380.
5. Wolleswinkel-van den Bosch JH et al; The burden of varicella from a parent’s perspective and its societal impact in The Netherlands: an Internet survey; BMC Infectious Diseases; 2011; 11: 320.

SG/VAC/0002/14n certified 11/09/14