Chickenpox Management

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  • Chickenpox (varicella) is a virus that causes an itchy rash and red spots or blisters (pox) all over the body. Although usually isn’t a serious problem in healthy children, it is highly contagious. An infected person can spread it onto others when sneezing, coughing, or sharing food or drinks. The fluid from a broken chickenpox blister is also contagious. A person who has chickenpox can spread the virus even before he or she has any symptoms. For most people, getting chickenpox provides immunity for life. At the same time, those who have never had the illness and have not had the chickenpox vaccine are at risk for chickenpox.
  • The varicella-zoster virus is usually more active during late winter and early spring. It starts with fever, chills, poor appetite, sore throat, cough, muscle and joint soreness, and develops a blister-like rash with itching in 1-2 days. The rash starts from the trunk and the face, and can spread over the entire body. It usually takes about 1 or 2 days for the spot to go through all its stages: blistering, bursting, drying, and crusting over. New red spots will appear every day for up to 5 to 7 days. The first symptoms of chickenpox usually develop about 14 to 16 days after contact with a person infected with the virus.
  • A person with chickenpox can spread the disease as soon as they have any symptoms, the 1 to 2 days before the rash have begun. They remain contagious until all their chickenpox blisters have scabbed, usually 5~10 days. After this, then the person with chickenpox can return to day care, school, or work.
  • Chickenpox can be serious, especially in babies, people with weakened immune systems, and pregnant women. The best way to prevent chickenpox is to get the chickenpox vaccine.
  • Fever management：
    1. Fever when armpit temperature is over 37.5ºC or anal, forehead, or temporal temperature is over 38ºC.
    2. When your child has chills, keep him/her warm by adding another blanket or elevating the thermostat temperature. Do not give him/her an ice pillow.
    3. If your child has fever but the limbs are warm, give him/her a warm bath (water temperature 26~36ºC).
    4. Encourage your child to drink plenty of water to prevent dehydration. Dry off the sweat immediately. Do not wear too many layers of clothes or use too many blankets.
    5. Fever medication (antipyretics) may be given when the child’s temperature is above 38.5℃. Repeat if necessary with at least 4 to 6 hours between the antipyretics. If your child has a history of febrile convulsion, use antipyretics at a lower temperature to help prevent convulsion.
    6. Antipyretics usually need around 30 minutes to work. You may check your child’s body temperature every hour until the fever has reduced.
    7. Take antipyretics as instructed. Do not take aspirin.
  • IV (intravenous therapy) and IV pump care：
    1. Keep the dressing and injection cannula (the small plastic tube which is inserted into the vein) clean and dry.
    2. Periodically check that the the distal extremities (far end of the limb with the injection; ie. fingers or toes) that they are warm and pink.
    3. Keep the injected limb lowered to avoid IV fluid or blood refluxing into the tubes.
    4. Do not adjust the IV rate or touch the buttons of the pump by yourself. Inform the staff if you think adjustment is needed.
    5. The IV pump has a rechargeable battery. You may remove the electric the charging cable when walking around. Please keep the cable plugged in when possible.
    6. Gently compress the injection site for 1~3 minutes with a sterile cotton ball after the cannula has been removed. Remove the cotton balls if there is no more bleeding.
    7. If any of the following conditions occur, please inform the nursing staff：
      • Pain, swelling, redness, or wetness at the injection site.
      • Painful or reddening of the skin after the cannula was removed.
      • You heard the sound of pump alarm.
      • Your child needs a shower or change the clothes.
  • Rash care：
    1. Clothing, bedding, towels, wound dressings, toys, utensils, or anything that might have come in contact with the patient’s body fluid should be cleaned separately. Do not share them with others.
    2. Wear loose clothing and keep the body clean and dry. Cool ambient temperature can help reduce the itching sensation.
    3. Do not break blisters as this may lead to infection and scarring.
    4. Keep the hands clean and trim nails regularly. Before going to bed, wear cotton gloves and socks to avoid scratching.
    5. Try skin calming lotion for the itch.
  • Patients should stay at home and avoid public places. Do not come in contact with pregnant women or infants who have never had chickenpox.
  • Infants should get a varicella vaccine once they are 12 months old.
  • Please go to the hospital as soon as possible if there are following symptoms：
    1. Persistent vomiting or severe headache
    2. Difficulty walking or unsteady gait
    3. Severe coughing
    4. Difficulty breathing
    5. Chest pain
    6. Severe abdominal pain
    7. Fever over 39 degree Celsius or fever lasting longer than 24 hours
    8. Confusion, agitation, drowsiness, coma
    9. Stiff neck and back pain
    10. Signs of wound infection (skin redness, pain, swelling, pus)
    11. Evident new blister formation after 7 days or rash that lasts for over 2 weeks
    12. Chickenpox on the eyeball
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