The question: Do kids still get chicken pox? What do I do if my daughter gets it?
The answer: In the span of a decade, chicken pox has gone from being one of the most common pediatric conditions to the point now where new, young pediatricians may have never seen a case!
This is a result of a vaccine that has been available in Canada since 1998 and is now routinely given to infants in all provinces and territories. I believe that this has been a good thing for Canadian children. While it is true that chicken pox, also known as varicella, usually causes a mild illness, the complications from this infection are common and can be severe.
In my clinic, we used to see skin infections and subsequent scarring quite regularly following a chicken-pox infection. On occasion, we would see infants who developed inflammation of the brain and nerves that would occur one or two weeks after the varicella rash. Most frightening were the infections that occurred in children receiving chemotherapy for leukemia.
These children required transfer to a children’s hospital intensive care unit for management of their overwhelming infection. I am pleased to report that none of my patients ever died from chicken pox, but deaths do occur.
Interestingly, varicella is one of the few conditions that seem to affect adults more severely than children. Adults who contract chicken pox often need antiviral medication and hospitalization. Another benefit of the vaccine is that it reduces the chance of getting shingles (a painful skin eruption due to previous chicken-pox infection) later in life. Even though the majority of infections in the pre-vaccine era were mild, the cost to society in days of missed work was substantial.
Parents need to know that since 2010, the official recommendation from pediatricians has been for children to receive two doses of the varicella vaccine. Typically the doses are given at 12 and 18 months, but they can be given at any age. It appears that two doses provide significantly better protection than a single dose.
The good news for kids is that the varicella vaccine has now been combined with the MMR (measles, mumps, and rubella) vaccine so that a single dose of MMR-V now replaces the two injections of each vaccine that were previously required. Not all provincial public-health programs are offering the second dose of varicella vaccine, so you may have to discuss this with your family physician or pediatrician.
So what if you child gets the chicken pox? The odds are in your favour that the illness will be mild. I recommend that your child take plenty of fluids by mouth; acetaminophen or ibuprofen (but never aspirin) for pain; and calamine lotion, cool baths and Benadryl if needed for itching.
Although we used to tell parents to wait until the rash dried up before sending their child back to school or daycare, we now know that chicken pox is most contagious before children get the rash. As such, kids can now return to school as soon as they feel up to it, regardless of the state of their rash.
Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He’s a staunch advocate for children’s health in Atlantic Canada through his involvement with the Canadian Paediatric Society.
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