One of the most common childhood diseases that we get to see every winter and spring is varicella .... better known as chicken pox.

This is a highly contagious illness that has infected nearly everyone by the time they are adults. No age group is spared from the newborn period to the elderly. The incubation period is anywhere from 14 to 21 days although some cases will show one or two vesicles (water blisters) somewhere on the body a day or two before the 14th day. The disease is spread through the air by respiratory droplets (coughing, sneezing or saliva) and through the skin by touching an active lesion. The rash is a combination of small water blisters and red pimples. It usually begins on the chest and back and proceeds over the next three to four days to cover the entire body with no parts spared (including the genitals, anal area, eyes and mouth). Some cases will be milder than others but the average case will have between one to two hundred sores. More severe cases will have hundreds of lesions some with large water blisters and giant pustules. At the start of the fourth day the earliest sores begin to scab over and by the seventh day almost all of the sores are dried up. Generally speaking a child may return to school at this time since they are no longer contagious once the lesions are dry and scabbed over. It is not unusual to have a mild to moderate fever along with the chicken pox for the first few days but once the fever is gone it should not return (please call your doctor if it does). Tylenol (acetaminophen) should be used for any fevers but aspirin should never be used. Complications are unusual but may occur, these may be ear infections, strep throat, impetigo, pneumonia, and encephalitis. Scarring may occur if the water blisters are broken or the scabs are picked off.

Treatment for the chicken pox is for the most part, symptomatic. We treat the fever with Tylenol. We treat the itching with an anti-itch medication such as Benadryl ( 1 teaspoon per 25 pounds ) and phenolated Calamine lotion (dabbed on the individual lesions)>>>>>Caladryl should not be used if you are also using an antihistamine. We do not recommend bathing or prolonged soaking in Aveeno Oatmeal but giving a quick shower is okay as long as you do not break open the water blisters.

In newborns or in people who cannot afford to get the chicken pox the is a Zoster Immune Globulin that can be given intramuscularly within the first 96 hours of actual contact. Zovirax, an anti-viral medication for Herpes, can be given within the first 24 hours of having the illness, to children one year or older. This medication is given four times a day for five days and will give you a milder case by decreasing the number of lesions, lowering the fever, making the itching less intense and in most cases shortening the length of the illness to five or six days. Zovirax has been used for many years here in the United States and longer in Japan. It has been shown to be safe and as far as we know does not prevent you from acquiring immunity to chicken pox.

Since the beginning of May 1995 the chicken pox vaccine has been available to those children over one year of age. This vaccine has been studied extensively here (for the last 10 years) and in Japan for a much longer period of time. It has been shown to be highly effective in eliminating chicken pox in about 90 percent or more of those people who are vaccinated. The remainder of people who break through and get the chicken pox have gotten a very mild case. Adolescents and adults who have never had the chicken pox are advised to receive 2 vaccinations a month apart. As of this date immunity does not appear to disappear and tends to rise when you come into contact with someone who has the chicken pox. Since this is an optional vaccine it can only be recommended and parents will have the final say in whether it is given to their child or not. If you would like your child to receive this vaccine, please tell your doctor.