Chickenpox

Chickenpox is very common. It is caused by a virus called varicella. If your child has been in contact with someone who has chickenpox it can take 2 to 3 weeks for them to develop the rash. Children can pass the virus to others from the day before the rash appears until the last spot has scabbed over. Your child may also have a temperature, a cough and a runny nose.

Chickenpox_thumbnail.png

Chickenpox starts with red bumps that become small, yellowish blisters. The spots can affect the whole body including the mouth and genitals (which can be very painful). They then open before scabbing over.

Visit the NHS website for more pictures of how the rash develops.

Most children with chickenpox can be looked after at home and do not need to see a doctor. If your newborn baby or child with a weak immune system (for example due to cancer treatment, immunosuppressive treatment or genetic immunodeficiency) catches chickenpox then you should contact a doctor.

It can be upsetting to see your child unwell with chickenpox. While treatment of the virus itself is not usually needed, there are simple things you can do to make your child more comfortable:

  • Paracetamol for a high temperature or pain
  • Antihistamines (for example piriton) can help with itching and sleep
  • Plenty to drink
  • Try ice lollies or jelly if your child is not drinking much
  • Try an oat bath. Put a handful of porridge oats in a small cloth bag or a sock. Tie it at the top and place this in their bath
  • Pat dry after bath rather than rubbing
  • Dress in loose clothes
  • Avoid scratching. Keep nails short or apply hand mittens at night to reduce damage to the skin
  • Don’t give ibuprofen unless advised to by a doctor
  • Speak to your local community pharmacist for advice on what can help with itching

  • Usually the last spot has crusted over by 5-7 days after the rash first appears
  • It is easily passed to other people until spots have dried and scabbed over
  • Avoid nursery or school for 5 days from the start of the rash or until all spots are fully scabbed over
  • Avoid contact with newborn babies
  • Avoid contact with pregnant women (unless they have already had chickenpox) and people with a weakened immune system
  • Now that your child has had chickenpox, they will usually be immune for life. The virus lives in the body forever (in the nerve roots) and may come back at some point in life as shingles. You cannot catch shingles from chickenpox.

The chickenpox vaccine is a vaccine used to prevent catching and spreading the disease. It has recently been recommended but is not yet part of the standard vaccine programme but is offered to children who 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.

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 and you are worried
  • 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:

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?

It can be upsetting to see your child unwell with chickenpox. While treatment of the virus itself is not usually needed, there are simple things you can do to make your child more comfortable:

  • Paracetamol for a high temperature or pain
  • Antihistamines (for example piriton) can help with itching and sleep
  • Plenty to drink
  • Try ice lollies or jelly if your child is not drinking much
  • Try an oat bath. Put a handful of porridge oats in a small cloth bag or a sock. Tie it at the top and place this in their bath
  • Pat dry after bath rather than rubbing
  • Dress in loose clothes
  • Avoid scratching. Keep nails short or apply hand mittens at night to reduce damage to the skin
  • Don’t give ibuprofen unless advised to by a doctor
  • Speak to your local community pharmacist for advice on what can help with itching

Where should you seek help?

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance