If you are wondering what happened to workingmuminlondon and why the posts have not been so frequent recently the answer is: scarlet fever, tonsillitis and chickenpox. Yes, we had them all, in a row! Not exactly a relaxing summer.
Here below you will find all the things I wish I knew before we started. I will focus on chickenpox because a) number 2 got it really bad so I ended up doing a lot of research b) there might be steps you can take to limit its severity.
What is it
Chickenpox, also known as varicella, is a very contagious disease caused by the varicella-zoster virus. It is spread easily through the air (when infected people sneeze or cough) and through direct contact with the infected blisters. Just being in a room with someone who has the disease can be enough to get infected BUT less than 5 hours exposure is not likely to result in an infection while a very prolonged exposure of several days can result in a more severe case (typical in the case of siblings). Chickenpox is contagious from 1 to 2 days before the appearance of the rash until all blisters have formed scabs (or lesions fade away if no blisters develop). If you or your child are still contagious it is best if you can stay at home or at least avoid busy places (trains, buses, planes, supermarkets, shops). Infecting someone ‘at risk’ (see below) can have terrible consequences.
And one last point: the scabs are not contagious.
Symptoms appear between 7 and 21 days after exposure to the varicella-zoster virus. They are:
1) fever – 38 up to 40 centigrades for up to 4 days
2) loss of appetite and general malaise
3) pink rash that becomes ‘blistered’ with 24/48 hours. The blisters are initially small, then fill up with a clear fluid that gradually becomes cloudy and then scabs over. The rash generally starts on chest and face but rapidly spreads over the body (even into mouth, ears, eye lids) for 2 to 5 days. Note that in some cases, 7 days after the first rash, a ‘second wave’ – a brand new rash and new blisters – can develop. The extent of the rash and size of the blisters varies from individual to individual (and seems to be related to the length of exposure to the virus). Some people may only have a handful of small spots while others will be literally covered from head to toe (250-500 blisters) with quite large vesicles (1-1.5 cm diameter). Once formed, the crusts will completely fall off in 1 to 6 weeks.
4) Redness around the blisters/vesicles may suggest a bacterial infection, probably introduced by scratching. This needs to be monitored carefully and might be treated with antibiotics.
Who is ‘at risk’
The risk of serious complications is higher for:
1) adults (can develop lung problems, pneumonia),
2) pregnant women (during the first 20 weeks of pregnancy there is a serious risk of birth defects) and
3) babies below 4 months.
4) For children it is not usually dangerous but in around 20% of cases a bacterial infection of the vesicles develops. This needs to be treated with antibiotics as soon as possible. If not treated can even lead to death in as little as a few days.
Prevention by vaccination – for boys and adults a must!
1) The chickenpox vaccination does not guarantee life immunity to the virus but reduces the risk of contagion and reduces the severity of the illness. I read that in clinical trials two doses of vaccine (in general one at 12-15 months and one at 4-6 years of age) were 99% effective in preventing the disease in children.
So if you have boys it is definitely worth getting them vaccinated. If you have girls it is less of a no brainer (they can still catch it when pregnant).
2) For adults and children of 13 and above it is also recommended to give two doses of the chickenpox vaccine, administered 4-8 weeks apart.
3) The varicella vaccine is safe. It has been around since 1995. The most common side effects are mild pain and redness at the injection site. In the USA chickenpox vaccination is done routinely.
Best treatment in case of infection
1) drink plenty (milk and water)
2) cut short your baby’s nails (or use mitts on the hands) to reduce the risk of bacterial infection of the vesicles. You can also dress your child in loose cotton clothing to prevent further irritation.
3) in case you notice some redness/swelling around the blisters/vesicles try to treat the area with some Chlorhexidine Gluconate. This is a pink liquid that prevents bacterial infections. It is not easy to find but some Boots stock it.
4) take paracetamol to ease high temperature (fever), headaches, and pains. Aspirin and ibuprofen should be avoided with chickenpox.
5) take anti-histamines (such as Zirtek, Piriton). Although they have limited effect on itchy skin conditions they cause drowsiness and help the child sleep better.
6) if your case looks right away very severe ask your doctor if aciclovir might be advisable. Antiviral pills such as aciclovir (Zovirax) can limit the severity of chickenpox by stopping the virus from multiplying. Adults, teenagers over the age of 14 and sometimes young children that were heavily exposed to the virus (young siblings of an infected child) may be advised to take an antiviral medicine. Note it can only be started within 24 hours of the rash first developing. My doctor advised aciclovir to my number two.
7) Try soothing creams (general emollients) on the spots to ease itching. Unfortunately there is not one product recognised to universally work but searching around I came across a few that you might want to try:
-Chickweed creams/ointments. These can help soothing the itchy and crusty skin. We used under the suggestion of a dear friend ‘Chickweed, Neem, Tamanu, Nettle and Vitamin E Cream’ by the Organic Pharmacy, pictured above but there are plenty more around.
-Calamine lotion, although widely used in the UK my doctor said it can have a drying effect on the skin that may exacerbate the condition and actually cause further itching and scarring.
-ViraSoothe Chickenpox Relief Cooling Gel this should relieve the itchiness without any drying effect on the skin but it did not seem to help my daughter very much.
-Some friends in Italy used happily Talco Mentolato but is difficult to find in the UK and some doctors are against it (again it can have drying effects).
8) Avoid long baths and soaking of the blisters that can fall off and delay the healing process.
What is your favourite chickenpox remedy? If you found something amazing please comment on this post. I will try to amend it over time if I discover anything else of value. I hope it helps!
Sources: among others National Foundation for Infectious Diseases Web site: http://www.nfid.org (USA).