Chicken Pox

 

 

 

 

CHICKENPOX

  

 

What is chickenpox?

  • Chickenpox is very common and is probably the most likely encountered infectious childhood rash in community pharmacy.
  • Chickenpox is a viral illness caused by the herpes zoster virus (also known as the Varicella-Zoster virus)
  • It is very contagious
  • Commonly occurs in children and over 90% of the population have had chickenpox by the age of 15 years.

 

How is chickenpox transmitted?

Chickenpox is very contagious (easy to catch).  Over 90% of close contacts (such as family members) will get chickenpox if they have not already had it or not been immunised.

The chickenpox virus spreads by either:

  • Droplet infection (coughing & sneezing), or
  • Contact with vesicular exudates (i.e. contact with blisters, fluid in blisters or touching something that has touched the fluid in blisters)

 

What are the signs and symptoms?

  • Incubation period = 10-20 days (period of illness to develop after contact with an infected person)
  • Prior to the rash developing, the patient will experience a sudden onset of slight fever, runny nose, headache, sore throat and feeling generally unwell.  These symptoms will last 3 days.
  • Small red lumps then appear that rapidly develop into vesicles, which crust over after 3-5 days.  The vesicles are often extremely itchy.
  • A person is contagious from 1-2 days BEFORE the rash appears until all lesions have crusted over.

How can chickenpox be prevented?

 

§         Pregnant women should avoid contact with someone with chickenpox.  If a pregnant woman gets chickenpox during the first half of a pregnancy, there is a small risk that the unborn baby may be affected (< 2%). Some of the effects include scarring, and birth defects.

§         People with chickenpox should avoid others (not to attend school or childcare) until at least 5 days after the appearance of rash and all blisters have crusted

  • Good personal hygiene should be maintained.
  • In Australia, a free vaccine (Varilrix) is available for infants at 18 months of age as part of the Childhood Immunisation Schedule. A catch-up program is also available for some children that have not had chickenpox or the vaccine.

 

Complications from chickenpox

 

  • Bacterial infection of skin sores (from excessive scratching), which are more likely scar.
  • Adults will usually have a more severe illness with a few suffering from pneumonia.
  • After an infection, some of the virus may remain in the system in nerve cells and at a later stage in life the virus might become active again causing shingles.

 

Symptomatic treatment

 

 

Symptom

 

Product(s) to recommend

How to use

 

Fever & headache

 

Pharmacy 777 Paracetamol mixture or tablets

 

Pharmacy 777 Ibuprofen tablets

Or Ibuprofen mixture

 

Children < 12 years: 10-15 mg/Kg/dose every 4-6 hours

 

 

Children >6 months: 5-10 mg/Kg/dose 3-4 times a day.

 

Sore Throat

 

Betadine Sore Throat Gargle

 

Use pre-diluted or concentrated solution up to four times a day.

 

Itchy skin

 

Topical: Hydrogel dressing

 

 

Topical: Calamine Lotion

 

Oral: Antihistamines

 

 

Wash

 

Solosite or Band-aid Healing gel.  Apply to lesions daily to provide a moist & soothing healing environment and minimise scarring.

Apply liberally to skin to minimise itching.

 

Drowsy: Polaramine, Phenergan (Not if < 2 years)

Non-drowsy: Telfast, Claratyne, Zyrtec

 

Ego Pinetarsol Gel, bath oil or spray.

Dermaveen wash or bath oil.

 

Dehydration

 

Pharmacy 777 oral hydration sachets

 

Advise on drinking plenty of water and/or hydration fluids if not eating. If blisters are in the mouth, advise not to give food or drinks that have a lot of acid or salt.

 

Scarring

 

Vitamin E cream, Rose Hip Oil, Bio-Oils

 

Can be used after full recovery and healed lesions to promote further healing of skin and minimise scarring