Upon receiving news that her kids’ childcare centre had reported an outbreak of chickenpox among several cases, Shandy Lim was understandably nervous.
Indeed, the mum of two had never contracted the disease before, and neither had her son, Elliot, 2, or her daughter, Elise, 5. However, Elise had previously taken the chickenpox vaccination, while Elliot had yet to get the jab.
Sure enough, nearly a week after the centre’s outbreak, Elliot came down with a fever and spots stated appearing on his body. While Lim tried to separate her kids as much as possible, it was difficult, because “Elliot clung to me like a koala and Elise is very attached to me as well”.
Two days later, Elise came down with a fever and spots. However, her spots weren’t as red, angry and plentiful as Elliot’s.
“I think Elliot’s case was more severe because he didn’t get the vaccination. On hindsight, I should have done it for him, too.”
“It wasn’t so bad at first, but by day four or five, their spots were blistery and itching very badly. Elliot especially was very fussy and didn’t have much of an appetite,” says Lim.
To ease their symptoms, Lim put them in cool and light clothes, gave them cool baths and applied calamine lotion on their spots. The difficult part, she notes, was stopping them for scratching, as she was “afraid it would cause scarring, especially on their faces”.
When the spots crusted finally after about two weeks, her GP gave the kids the go-ahead to return to school.
Says Lim, who was mentally prepared to contract the disease herself during that period but didn’t. “I think Elliot’s case was more severe because he didn’t get the vaccination. In hindsight, I should have done it for him, too.”
Click through to read more about the signs and symptoms of chickenpox.
What it is
Chickenpox is a common childhood condition caused by the varicella-zoster virus.
“It is highly contagious and can be caught from an infected person through respiratory droplets during coughing for instance, and through direct contact with the chickenpox rash before it crusts over,” says Dr Anita Menon, a paediatrician at Dr Anita's Kids Clinic.
· Runny or blocked nose
· A cough or sore throat
· Loss of appetite
· A typical itchy rash that may appear as small, pink raised vesicles or water-blisters.
Children under age 6 who aren’t inoculated and newborn babies whose mothers contract chickenpox around the time of delivery are very susceptible to the infection. “These babies can get a very serious illness associated with a high mortality rate,” Dr Menon notes.
The severity can vary ― some kids get just a few spots, while others are covered in them. Dr Menon notes that it may not be necessary to see a doctor in mild cases as you can just treat the symptoms yourself. This includes paracetamol for fever and antihistamines to ease itching.
If you contracted a mild infection in childhood that went undiagnosed, you may already have protective antibodies and appear not to get infected when subsequently exposed to the infection again.
As chickenpox is highly contagious, the majority of people who have been exposed to this disease will get the infection. However, if you contracted a mild infection as a child that went undiagnosed, you may already have protective antibodies and won’t get infected when subsequently exposed to the virus again, Dr Menon explains.
While the majority of chickenpox infections tend to be mild, complications can occur, Dr Menon points out:
· Secondary bacterial infections
· Bloodstream infections
· Bone infections
· Pneumonia (coughing, wheezing and chest pains)
· Brain infections such as meningitis and encephalitis
Parents should also watch out for signs of dehydration, especially if junior is vomiting or refuses to drink. Watch out for less urine, drowsiness, as well as dry lips and mouths.
Read on to learn how this disease is treated…
Vaccinations and treatment
Vaccinations are available for chickenpox. You may still get the disease if you have been vaccinated, but it is usually milder with fewer spots and blisters.
It’s not compulsory in Singapore to get the vaccination, but if you decide that you want your child to be vaccinated, it can be administered when junior is 1 year of age, says Dr Menon.
The Ministry of Health’s Expert Committee on Immunisation recommends that children below 13 years of age receive two doses of the vaccine, with an interval of at least three months. The first dose should be given at 12 months of age and the second dose at least three months later, and by 18 months of age. Kids who are 13 years and above are advised to receive two doses six weeks apart.
You may still get the disease if you have been vaccinated, but it is usually milder with fewer spots and blisters.
“It can be given individually, or as a part of the Measles/Mumps/Rubella/Chickenpox or MMRV vaccine,” adds Dr Menon.
To ease the chickenpox symptoms, administer the following symptomatic medications:
· Paracetamol for the fever and pain
· Antihistamines for the itch
For children over age 12 and adults, Dr Menon says that Acyclovir, an anti-viral medication, can be given in the first 24 hours following the onset of the rash. This is particularly recommended for those with chronic skin conditions like eczema, lung ailments like asthma, children with low immunity (because of an illness, for example), and newborns if the mother had contracted chickenpox around the time of delivery.
Other ways to soothe the symptoms include:
· Wearing light and cool clothing
· Applying calamine lotion on the rash
· Bathing in warm water mixed with cornflour
As scratching can affect healing and cause scarring in children, you may want to trim their fingernails, or make them wear gloves at night.
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