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Dear Parents,
I am writing to let you know that we currently have case of chickenpox (su cicegi) in school.
Please read the article and look at the web sites below.
If your child develops symptoms they should not attend school until the spots are all crusted over about 5-6 days after spots appear. It also very important that if your child develops chickenpox and they have been in contact with anyone who is pregnant or with a weakened immune system, that you inform them.
Please fell free to contact me.
Juan Ramirez
School Nurse
Chickenpox is a very common illness that causes a rash and can make you feel generally unwell. It is an infection caused by the varicella-zoster virus, one of the herpes viruses. 'Varicella' refers to the initial infection commonly known as chickenpox and 'zoster' refers to its reactivation in later life, causing the condition shingles.
Who gets chickenpox?
Anyone can get chickenpox but it mainly affects children. 1 More than 90 percent of people have had chickenpox by the age of 15
Most children catch chickenpox in the pre-school or early school years and it is almost always a relatively minor illness. There are widespread outbreaks most years, especially in winter and early spring
Once the symptoms caused by the chickenpox virus have cleared up, it remains in the body and is kept at bay by the immune system. At any time later in life, but usually in adulthood, the virus can be reactivated, causing shingles.1 You cannot get shingles from somebody that has chickenpox.
Symptoms of chickenpox
The chickenpox rash passes through a number of stages.
- Pre-rash symptoms can include headache, fever, sore throat, backache and a general feeling of being unwell.
- Small, itchy, reddish spots on the skin surface then form. This rash often appears on the face and scalp first and then spreads to the chest, arms and legs. The time between catching the virus and the appearance of the rash - known as the incubation period - is usually about 11-20 days
- The spots go on to form raised papules (a pimple-like skin rash). These can develop into small blisters called vesicles. The vesicles are filled with clear fluid.
- Finally, the vesicles form into pustules (spots with pus in) which crust over and heal, usually in less than 16 days.
The spots are usually very itchy. New spots appear over about five to seven days, so that at the peak of the illness there are spots at all stages of development, from new vesicles through to crusts.
Generally, chickenpox is a milder illness for children than it is for adults. Adults often feel quite unwell, with a temperature, a dry cough, a sore throat and may feel sick for several days.
How do you get chickenpox?
Chickenpox is easily passed from one person to another. Someone who has not yet had chickenpox, and who comes into contact with an infected person, will almost certainly catch it.
The virus is spread by:
- direct contact with a person who has broken chickenpox blisters
- indirect contact with clothes or other articles infected with the fluid that leaks from the vesicles, or with saliva and nasal discharge
- small airborne droplets of infected mucus or vesicle fluid
People incubating chickenpox are not infectious immediately and only become so from about two days before the rash breaks out until about five days after.
To prevent further spread, children who have chickenpox should be kept off school for five days after the rash appears. There have been no reports of people passing on chickenpox past this point.
Anyone who is infectious should try to avoid contact with other people who have not had chickenpox, especially those who will be at particular risk if they catch it, such as pregnant women and people with a weakened immune system (see below).
Can you catch it more than once?
Except in rare cases, chickenpox does not strike twice - once you've had it, you are immune for life.
Treatment
The strategy for treating chickenpox is to relieve the symptoms while your immune system fights the virus.
- Itchiness and skin irritation can be reduced by keeping the skin cool with light clothing and tepid baths or sponging.
- Crotamiton or calamine cream or lotions have soothing qualities and may help to relieve itching.
- Taking antihistamine tablets may also help reduce itching - ask your pharmacist for advice.
- Taking a painkiller that you would normally take for a headache may ease discomfort if the skin is painful, and will help lower a fever.
- Although it can be difficult to resist, it's best to avoid scratching spots as this can lead to scarring.
- In severe cases an antiviral drug called acyclovir may be prescribed early on in the infection. This is not recommended for healthy adults and children who can fight the virus. It is usually only an option for people who have a weakened immune system, newborn babies and pregnant women (see below).
Are there any complications?
Chickenpox is almost always harmless but the potential complications are listed below. Most people are not affected.
- The spots can become infected with bacteria. This is the most common complication and happens in about 1 in 10 cases of children with chickenpox. If this occurs, the surrounding skin becomes red and sore. The doctor is then likely to prescribe a course of antibiotics.
- An ear infection develops in about 1 in 20 children with chickenpox.
- When children are recovering from chickenpox, they sometimes become clumsy and unable to walk properly. This is due to inflammation in the cerebellum (a part of the brain) and is called ataxia. This can be alarming, but the symptoms will settle as the rash disappears. Your child does not usually need any special treatment for this, and should recover normally.
- Occasionally, there is a rare complication which causes more swelling of the brain and this may cause confusion and fitting. This complication is called encephalitis and tends to mainly affect adults.
- The chickenpox virus can, in rare cases, cause severe pneumonia. Usually, this only affects adults.
Chickenpox and pregnancy
If you get chickenpox while you are pregnant it may be more severe. There is also a slightly higher risk that you'll develop pneumonia.
Chickenpox in the first half of pregnancy
Catching chickenpox in the first half of pregnancy may be dangerous to the unborn baby. There's about a 1 in 50 chance of the baby having an abnormality. This could be brain damage, birth defects involving the arms and legs, digestive or genito-urinary problems, eye infections, scarring of the skin or poor growth.
There is also a small chance of the mother miscarrying. The risk is highest if chickenpox is caught between the 13th and 20th week of pregnancy.
Chickenpox in the second half of pregnancy
If you have chickenpox after the 20th week of pregnancy, there doesn't seem to be any risk of causing a long-term abnormality to your baby.
However, your newborn baby may develop a serious type of chickenpox called symptomatic varicella infection. This becomes increasingly likely as your pregnancy progresses.
If the mother gets chickenpox one to four weeks before delivery, a third of newborn infants get infected.2 The infection is particularly severe if you get chickenpox four days before delivery and up to two days after. This is because when you contract chickenpox, your body only releases antibodies after around five days. Your baby would normally receive these antibodies through the placenta while in the womb or through breast milk after delivery. However, if you get chickenpox four days before delivery and up to two days after, your body will not have produced the antibodies in time for your baby to receive them.
See your GP urgently if you think you have chickenpox when you are pregnant, or within seven days of giving birth.
Pregnant women with chickenpox can be treated with antiviral medication. This needs to be started within 24 hours of the rash appearing however. It is usually prescribed to mothers who are more than 20 weeks pregnant. It doesn't cure the illness, but makes it less severe.
Chickenpox and a weakened immune system
Other people at risk of severe complications from chickenpox are those with a weakened immune system.
This includes people receiving treatment for cancer, people with HIV/AIDS as well as the elderly. If they have not had chickenpox before, these people must see their doctor immediately after any contact with the infection for appropriate antiviral treatment.
Vaccination
A chickenpox vaccine against the varicella-zoster virus is available and is widely used in the USA. In the UK it is only given to vulnerable individuals, such as:
- non-immune healthcare workers who have direct patient contact (to protect patients from acquiring chickenpox from an infected member of staff)
- non-immune close contacts of immunocompromised patients, where continuing close contact is unavoidable (eg siblings of a child with leukaemia)
The chickenpox vaccine is not currently recommended for routine use in children in the UK.
Further information
NHS Direct
0845 4647
www.nhsdirect.nhs.uk
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