duration of infection, symptoms and treatment

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The virus is spread through the respiratory system (coughing, sneezing or inhaling saliva droplets) as well as through direct contact with skin lesions. Also, it is enough that your child is in contact with another little friend with chickenpox for him to have it in turn. It will then be contagious about two days before the appearance of the first pimples, up to one to two weeks on average after the rash. There is no reason to panic however, this childhood illness is rather mild, but the itching is sometimes unbearable for toddlers. And they can cause scars, or even infections if it scratches too much. It is therefore essential to prevent complications, and this especially involves good hygiene or treatments that can soothe it, and therefore prevent it from itching.

The incubation lasts about 14 days: the child remains contagious until the rash turns into a crust.

Chickenpox first manifests as a moderate fever, even abdominal pain and headache, then a rash that occurs a day or two later. It is moreover in the 12 to 24 hours before the eruption of these lesions (pink spots which progress towards the formation of vesicles filled with a transparent substance), that the child is most contagious. The lesions then gradually dry up before being covered with a crust which will fall around ten days during the healing process. Generally, children have the most pimples on their chest and face and where itching is most important.

• Symptoms of severity

High temperature, abdominal pain, vomiting, and superinfection of the lesions can complicate chickenpox. Pneumonia, encephalitis can appear in rare cases. The risks are greater for a newborn baby, a pregnant woman or an immunocompromised person.

Chickenpox is an immunizing disease: if you have had it once, you are protected for life. It is therefore theoretically not possible to contract chickenpox twice. As 90% of people have chickenpox during childhood, they are just as immunized during adolescence and adulthood.

Treatments exist to appease his desire to scratch. Your pediatrician may indeed recommend the application of an antiseptic product (such as chlorhexidine. Eosin does not seem to have proven its effectiveness) on skin lesions as well as antihistamine treatment adapted to reduce itching which can trigger superinfection and leave scars. Treatment of the infection involves the management of symptoms since the viral origin of chickenpox does not require the prescription of antibiotic drugs. Remember that only cases of bacterial superinfection require antibiotic treatment.

Chickenpox naturally disappears within ten to twelve days. But in case of fever or secondary infection, consult your doctor, who will advise you towards the most suitable treatment for your child, depending on his condition.

Just because your child has chickenpox doesn’t mean you can’t wash it. Quite the contrary: lukewarm baths and showers have a soothing effect against itching.

• Bathe your child, possibly adding a little disinfectant soap in the bath.
• Avoid hot water which would promote infections.
• To dry it, go gently so as not to tear off its crusts, which would then increase the risk of scarring.
• Finally, make sure that your child has short nails and that they wash their hands regularly, because it is by scratching with dirty nails that they risk superinfection of the vesicles and the appearance of scars.

To avoid : tight clothes that stick to your child’s skin and increase the urge to scratch. It is indeed preferable to make him wear cotton shirts and wide pants. In case of fever, only paracetamol is recommended.

If the disease remains mild in children, it can nevertheless have more serious consequences in adults, due to the risk of pulmonary or neurological complications (meningitis or encephalitis). It is therefore recommended to vaccinate adolescents between 12 and 18 years of age, as well as women who wish to conceive and who have not been immunized younger.

• Chickenpox and pregnancy

A chickenpox during pregnancy may have risks for the baby, especially since the vaccine is contraindicated in pregnant women and immunocompromised people. Pregnant women who have had chickenpox before pregnancy or who have been vaccinated, are normally immune because they have specific antibodies against the virus that are transferred to the baby. In this case there is a priori no risk for the future mother and the baby. When a pregnant woman is exposed to chickenpox and she does not know if she is protected, a chickenpox serology should be done by taking a blood test.
But according to the National Institute of Health and Medical Research, vaccination of adults against chickenpox would reduce the number of hospitalizations by 31%.

There is a vaccine that protects against chickenpox. It is not compulsory but remains recommended from 12 years for all people who have not had chickenpox yet and who are therefore not naturally immune:

• Adolescents 12-18
• Women of childbearing age or who are planning to become pregnant
• Women following a first pregnancy on effective contraception
• Adults in the immediate environment of a person suffering from chickenpox (within three days of exposure);
• children awaiting organ transplants;
• any unimmunized person in close contact with immunocompromised people.

Vaccination schedule: 2 doses spaced 4 to 8 weeks or 6 to 10 weeks apart, depending on the vaccine used. No reminder is required. In France, two vaccines are available: Varilrix® and Varivax®, which are covered 65% by Health Insurance in certain situations. More information here.

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