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Varicella Vaccination A vaccine against chicken pox (the varicella vaccine) has been available in India for some years now.  It has good safety and effectiveness, and has been in use for almost twenty years in other countries. It cannot be given to babies under one year of age. Two doses of the vaccine will probably give lifelong protection. It is a safe vaccine.  There may be some redness and pain at the injection site.  Some children develop fever with chicken pox blisters, but this is usually very mild. The varicella vaccine is effective as a protective measure when given to children who have come into contact with the disease.  It must be given within 48-72 hours of the exposure.

Chicken Pox (Varicella)

Chicken pox is a viral disease, caused by infection from a person already having the disease.   It affects almost everyone at some time in a lifetime, but usually occurs only once.  It is believed to be a mild disease, but is associated with dangerous complications, especially in teenagers, persons with reduced immunity, and pregnant women.  Children with reduced immunity, for example children with leukemia, or those taking anti cancer or steroid treatment, are also at high risk for severe varicella.

Spread of Chicken Pox

Chicken pox is spread by air borne droplets and by direct contact.  It is infectious a day or two before the typical skin rash appears, and for five days after.  Thus, a child with chicken pox can spread the disease to others before he is diagnosed.

Signs of Chicken Pox

The disease starts with fever, and the typical rash appears after a day or two.  The rash starts with red spots which become fluid filled blisters before bursting or subsiding.  Children often lose their appetites, and may complain of headache and sore throat.

Itching is a common feature, and is often severe.   After a few days, the blisters will show crust formation, which dry and fall off.

Treatment of Chicken Pox

Paracetamol for fever, and a drug to reduce itching are all that is usually required.  A drug that must not be used is aspirin, because it has been linked to a dangerous condition called Reye's syndrome.  

There is no need to restrict the child's activity in simple chicken pox.  Appetite is often reduced, but no dietary restrictions are necessary.  The child should be encouraged to take a lot of fluids, especially if the drug acyclovir has been prescribed.

Acyclovir is a specific antiviral drug available for chicken pox.  It can reduce the severity if given within 24 hours of onset, but the effect is only of slight benefit in normal children.  It is recommended for adolescents, children with reduced immunity, and in other special situations.

Complications of Chicken Pox

The most common is infection of the skin blisters.  This can lead to a spreading infection under the skin called cellulitis.  Other infections are also more common with chicken pox.  The disease is also associated with potentially fatal complications like encephalitis and pneumonia.  These are more likely in adolescents and adults.

A late complication is zoster, a painful rash along a segment of the body.  This may occur several years after the original infection.

Also read: The Varicella Vaccine

For a more detailed description of chicken pox, please see the Varicella chapter in the Emedicine Pediatric Textbook, also authored by Dr. Parang Mehta.

Last revision: July 15, 2007

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