Q: My seven-year-old granddaughter is staying with me because she has chickenpox. The teachers do not want her infecting other children at her school and both her parents have to work. I have heard different opinions on how to tell if the child is no longer infectious and can be allowed back to school. I think it is when the spots start to form scabs. Is this correct? Also, she has an 18-month-old sister. How can I tell if she is getting it?
A: Chickenpox is caused by the varicella-zoster virus. It is one of the most infectious childhood diseases and may be transferred from one person to another through sneezing, coughing or touching. The most infectious period is from three days before the rash appears until all the blisters have formed scabs. You may not be able to tell for up to three weeks but the odds are that the younger sister is going to get it too.
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I assume that you have had chickenpox yourself or you would not have volunteered to look after the sick child. It can be a serious disease for adults, causing high fever for a longer period. Complications are possible such as conjunctivitis, pneumonia, scarring at the site of the blisters, infected blisters and rarely meningitis, encephalitis or myocarditis, an inflammation of the heart muscle. Pregnant women, patients with weakened immune systems or those who are on immunosuppressant drugs such as corticosteroids, are the most likely to develop complications.
People are often confused as to whether a person who has had chickenpox as a child can get shingles as an adult. Shingles is another expression of the varicella virus, where the blisters follow the path of one of the nerves. The virus can sometimes make a reappearance later in life, especially if the immune system is weakened. A person with shingles can infect someone with chickenpox who has not previously been infected. However shingles itself cannot be transmitted. You cannot catch chickenpox more than once but some children who have received the immunization, Varivax, can still get a mild form.
There is no specific treatment for chickenpox because it is a virus, although antiviral drugs may be given to people with weakened immune systems. Try to prevent the child from scratching. Cut her fingernails short and make her wear gloves if necessary. Make sure the bedroom is as cool as possible as heat and perspiration make itching worse. Calamine lotion can be helpful. Antihistamine creams or oral preparations may be necessary in severe cases. In children, chickenpox lasts seven to 10 days.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
