Chickenpox

Chickenpox is a very common childhood illness, caused by a virus called varicella. It starts with red bumps that become small, yellowish blisters affecting the whole body – including the mouth and genitals (which can be very painful). They then open before scabbing over. These are very itchy and can make your child miserable. They may have a temperature, a cough and a runny nose. Children are able to pass the virus to others from the day before the rash appears until the last spot has scabbed over.

Chickenpox rarely needs treatment, unless in a new-born baby, or in a child with a known weak immune system ( i.e. weakened immune system due to anti-cancer treatment, immunosuppressive treatment or genetic immunodeficiency). If you are not sure it is chickenpox look at other childhood rashes here.

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When should you worry?

If your child has any of the following

Breathing very fast, too breathless to talk, eat or drink
Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
Breathing that stops or pauses
Is pale, blue, mottled or feels unusually cold to touch
Difficult to wake up, very sleepy or confused
Weak, high-pitched cry or can’t be settled
Has a fit (seizure)
Has a rash that does not go away with pressure (the ‘Glass Test’)
Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following

Increasing pain and redness between the spots:
New blisters/spots appearing after 7 days
Rash spreading to the eyes
Baby less than 4 weeks old
Breathing a bit faster than normal or working a bit harder to breathe
Dry skin, lips or tongue
Not had a wee or wet nappy in last 8 hours
Poor feeding in babies (less than half of their usual amount)
Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
Temperature of 38°C or above for more than 3 days, shivering with fever (rigors) or if the temperature comes back after a few days
Temperature less than 36°C in those over 3 months
Getting worse or you are worried about them
A parent is pregnant and has not previously had chickenpox
Contact with pregnant women who has not previously had chickenpox, person with a weakened immune system who has not previous had chickenpox or a new-born baby (the contact should seek advice from a healthcare professional)

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

If none of the above features present

Watch them closely for any change and look out for any red or amber symptoms
If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways.
Additional advice is also available to young families for coping with crying of well babies.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111

Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.

What can you do to help your child?

Seeing your child unwell with chickenpox can be very distressing for a parent and while there is usually no treatment for the virus itself, there are simple things you can do to make your child more comfortable:

Regular paracetamol for temperature/pain
Antihistamines (eg piriton) can help with itching and aid sleep
Drink plenty of fluid and try ice lollies if your child is not drinking much
Calamine lotion/oat milk bath/Sodium bicarbonate bath for itch
Pat dry after bath rather than rubbing for comfort
Dress in loose clothes
Don’t give ibuprofen or aspirin unless advised to by a doctor
Cut nails/apply hand mittens at night to reduce damage to skin and try to
Avoid too much scratching if possible

How long does it last?

Usually the last spot has crusted over by 5-7 days after the rash first appears
It is highly contagious until spots have dried and scabbed over
Avoid nursery or school for 5 days from rash onset or until all spots are fully scabbed over
Avoid contact with new-born babies, people with a weakened immune system and pregnant women until all of their spots have scabbed over – if concerned regarding this contact your GP

The chickenpox vaccine

The chickenpox vaccine is a vaccine used to prevent catching and spreading the disease. It is not part of the standard vaccine programme but is offered to childrenwho are at increased risk of severe chickenpox infection and to those with a family member at risk of complications. It is also available privately through travel clinics and pharmacies and costs between £120-£200. More information is available here.

This guidance is written by healthcare professionals from across Hampshire, Dorset and the Isle of Wight.

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