Spotting chicken pox

Dr Bariah Dardari talks to Time Out about the symptoms and treatments for chicken pox and gives tips on avoiding it completely Discuss this article

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What are the symptoms of chicken pox?
If the patient hasn’t been vaccinated, there is sometimes fever for a day or two, then the rash appears in the form of fluid-filled pimples. Usually this will persist for four to five days, then the old rash becomes crusty and new pimples appear over the course of three to five days. The sufferer might also develop a cough.

How common is it for complications to arise?
We see complications in five-10 per cent of kids. This can mean pneumonia or a secondary bacterial skin infection (this is indicated by the rash turning red). The chances of complications are higher with teenagers and adults, or babies less than one year old.

Are most people already vaccinated?
Actually, a lot of my patients are not vaccinated because they come from parts of the world where it’s not offered as standard – for example, in the UK and also in government hospitals here, it’s not a routine vaccination. Many parents are surprised that there is even a vaccine available for chicken pox, but I think schools are helping to increase awareness.

Are there any side effects of the vaccination?
It’s a very benign vaccination – one in 100,000 might see a mild chicken pox after the vaccine, but the majority of kids tolerate it well. It generally gives 90-95 per cent immunity and then you can have a booster at the age of five, which gives almost 100 per cent immunity. It’s a live vaccine, though, so we don’t do it if the kid has a problem with their immunity.

So when the child is vaccinated, you’re putting a little bit of the chicken pox virus into them?
That’s true, yes. We basically weaken and preserve the virus, and then we put it into the body and the body produces antibodies against the vaccine in case it gets exposed to the real thing. The vaccine actually takes about two weeks to kick in, so with children particularly prone to complications, like newborns, you can also give immunoglobulin. This contains antibodies taken from other people who are immune, and it can protect the patient until the vaccine takes effect.

How should chicken pox be treated?
If a child is healthy and they just get mild fever and mild rashes, we don’t do much; just keep the child comfortable and hydrated. For the itching we usually give an antihistamine. If parents seek medical attention in the first 48 hours, we can give acyclovir which is an antiviral medication and can shorten the duration of the disease by around 48 hours, but it doesn’t prevent complications and we don’t often use it.

How can we make children who’ve got chicken pox more comfortable?
You can administer pain medication and fever medication, but parents should stay away from aspirin because the combination of aspirin with any viral infection can cause a severe syndrome called Reye’s syndrome, where kids can have bad rashes and mucous membrane in the mouth, throat and skin. Instead, use paracetamol and antihistamines. In the past we used calamine lotion, but it doesn’t really help much, that’s more to soothe the parents!

Should kids be kept home while they’ve got chicken pox?
We do recommend for kids to stay home until all legions are crusted; that’s usually five to seven days after the start of the symptoms. But the problem is that they can be contagious three to five days before the symptoms start, and that’s what’s risky about not vaccinating kids. Chicken pox spreads so easily in schools.

Can we prevent its spread in the home?
It’s hard, but try to separate siblings as much as possible, because it doesn’t only spread through skin-to-skin contact; particle droplets from the nose and mouth are contagious too. It’s a good idea for the adults to get vaccinated if they’re not already.

Is there a particular season when chicken pox is more common?
Usually in the cold, northern hemisphere, it’s in the spring and the late winter, but here, actually, I see that the season is more prolonged because of the climate. We see it throughout the summer and the fall – there’s been another outbreak of cases recently, too.

Has the frequency of chicken pox cases here gone up or down in the last few years?
Unfortunately, we don’t have this kind of data in the UAE. All we know is that it is very common because large numbers are not vaccinated.

Can you get the vaccine on insurance?
The majority of insurers do not pay for any vaccinations. The cost of the vaccine in the American Hospital is Dhs182, plus a consultation fee.

Is there anything else you think we should know?
I know there’s a big phobia of immunisation at the moment and a lot of parents are obtaining incorrect information on the internet. I would recommend that people talk to their physicians, who are reliable sources.

Dr Dardari practises at the American Hospital Dubai (04 336 7777)

By Karen Iley
Time Out Dubai,

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