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Varicella-Zoster: Chickenpox

Most everyone my age and older endured the chickenpox as a child. Certainly none of us feared it; really, it was more an inconvenience or aggravation because sometimes it was super itchy. Chickenpox is super contagious, caused by a virus, spread through the air and by contact. It was hard to avoid. Generally one of the kids would go to school, or an outing, and come home a few weeks later with the classic itchy, red spots all over their body.


Chickenpox used to be a common childhood disease. Then a vaccine was invented to prevent it. Fear causes us to lean into the narrative that this is for the betterment of our society's health and wellness, but the reality is that this was to improve our workforce. The majority of families during this generation were dual income families, so when the first child came home from school covered in pox, mom typically stayed home. However, this also meant two-to-three weeks later when the siblings broke out that Dad would also have to miss a week of work. This hurt families who survived paycheck-to-paycheck and enough motivation to get the kids in for a vaccine.



The confusion I had, early in this development even prior to my medical training, was that the new vaccine was proposed to offer protection for about ten years. Immediately I recognized the concern, that #chickenpox is mostly just an annoyance for our little ones, but ca be quite risky into adulthood. Why then offer a vaccine that would essentially push this illness into those more dangerous decades, and what happens to our "life long protection" if we aren't repeatedly being exposed and maintaining our antibody response? Again, health and wellness wasn't really the priority here.


My older two were vaccinated, but still experienced chickenpox after exposure. My oldest son was a young teenager and hardly recognized he was infected, covered with only a few spots, but my oldest daughter primarily suffered the blisters within her mouth. She could eat or drink and required intravenous hydration. While scary at the time, I am grateful she did have them prior to becoming pregnant so that any exposure during this time would not have impacted her unborn child. Had they not been vaccinated, they would have endured this in their younger, less risky years as my younger two sons experienced.


Although quite rare today, if you are exposed to chickenpox inadvertently, you may not even know your little one has the pox initially. At first this may look more like the flu with a fever, some drowsiness, a poor appetite, headache and sore throat, maybe a stomachache. Several days later the #rash appears, starting on the child's stomach and back, then the face before spreading over the entire body. In more severe cases, the spots can move inside the throat as they did with my vaccinated daughter, even the eyes, bottom, and vagina.


These spots are raised bumps which turn into fluid-filled blisters and ultimately turn into scabs that heal, sometimes leaving scars. Scratching causes them to break open which can lead to infection and of course, increase incident of scarring. Most cases are quite mild and resolve in five to seven days.


What Causes Chickenpox?


This childhood illness is a virus, spread through the air and through contact, typically 10-to-21 days prior to infection. It is also called the varicella-zoster virus so it is the varicella vaccine that helps prevent its spread. This vaccine is often combined with the #MMR immunization as the #MMRV. A day or two prior to the rash outbreak, the exposed individual is contagious and can pass on the illness until all the blisters have formed scabs, typically for about seven days.


The varicella-zoster virus also causes a disease called #shingles. This is a painful skin condition that lays dormant until you get older. It also appears as an itchy, sore rash with blisters. If you have never had the chickenpox, or the vaccine, then you can catch chickenpox from someone with blisters. Varicella is part of the herpes family of viruses. Peek here about my experience with having a shingles outbreak on my insides.


Connect with Your Clinician if You Suspect Chickenpox


Clinicians my age very often remember chickenpox well and can diagnose it on site. A history of symptoms can help support this diagnosis. A smear can be taken from one of the blisters or blood tests can confirm a few weeks after the illness, but generally these aren't performed unless additional support for diagnosis is needed. Noting this in the healthcare record can be helpful, particularly if your child presents with a situation many years later where they are told a vaccine is required, or an update, and their own account of having had chickenpox isn't accepted. Documentation in your medical record can eliminate need for unnecessary vaccines later.


It's important to also connect with your practitioner if they have difficulty breathing, if they have a fever that lasts more than four days or spikes beyond 102, or blisters fill with a yellow, infectious fluid that secrets from the sores. Red, warm, and swollen lesions for example should be evaluated by your provider. Severe headaches, unusual sleepiness or difficulty waking up, avoiding the light, trouble walking, confusion, vomiting or extreme nausea, or a stiff neck are additional reasons to contact your clinician more urgently.


Varicella-Zoster Vaccine


This is one of the recommended vaccines by the CDC, typically administered when the little ones are 12-to-15 months of age, and then another booster is given around 4-to-6 years. The vaccine is reported 99 percent effective in protecting against the virus, gaining more effectiveness since that first decade of administration. On rare occasions, children do get the chickenpox though even when vaccinated, but they typically have a more mild presentation.


Treatment for Chickenpox


This really does run its own course. Antibiotics and steroids are not helpful or recommended, unless infection is evident. Very occasionally an antiviral may be offered, particularly for those over the age of 12 years, those with a chronic skin or lung disease, if they are already on steroidal therapy, or sometimes, in the case of pregnancy. Most of the time, treatment is focused on managing symptoms.


A cool, wet cloth to the blisters can help the itching, as can nettles tea or a homemade herbal salve. Cool or lukewarm baths can also be helpful, covering the lesions afterward with a #calendula ointment. Oatmeal in the bath may also help relieve itching, or as many of us tried as a kid, the infamous calamine lotion. If blisters are in the mouth though, try not to break open those lesions. Offer them cool, soft, and bland foods. Your healthcare provider might offer a topical pain relief cream if requested. Little ones might wear mittens or socks on their hands to keep them from scratching the sores and inviting infection. Not often is pain medication necessary, but if you choose to give an over-the-counter pain reliever, assure you avoid aspirin as this can cause Reye syndrome which may lead to liver failure and death.

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