Stories from the Pharmacy: Breakthrough Chicken Pox
Sharon came into the pharmacy to ask for some advice. She is feeling stressed as her 4-year-old daughter Amy is up to date with her immunisations, but she was notified that Amy’s kinder classmate has come down with chicken pox. Sharon remembered her daughter was playing with her 2 days ago and wants to know whether it is likely that Amy will also come down with the chicken pox?
To answer Sharon’s question, yes, there is a risk that Amy can still catch chicken pox even though she is currently up to date with her immunisations. In Australia, every Australian-born baby gets access to the free national immunisation program and currently every baby gets vaccinated for chickenpox (varicella) at the age of 18 months together with measles mumps and rubella. Immunisation is achieved in one dose of this vaccine and is 80-85% effective against any Chicken pox. That 1 dose is also 95-98% effective against severe chicken pox. Severe Chickenpox can lead to pneumonitis and brain inflammation called encephalitis.
However, 1 dose of the vaccine which is what the free national program provides, still leaves a small chance of what is known as, or what is generally seen these days as ‘breakthrough varicella (chicken pox)’ which is a mild form of chickenpox. Thus, receiving 2 doses of the varicella vaccine will provide you with increased protection and minimise the chance of ‘breakthrough varicella’. Routine administration of a second dose of the vaccine is not included in the national immunisation program but parents can take their child to their GP to get a second dose of the vaccine at least one month after their first chickenpox vaccination.
What does the research say?
Research also shows us that giving a dose of the Varicella vaccine within 5 days of exposure to someone who has been in close contact will prevent contracting the disease. So if Sharon is worried that her daughter may come down with chickenpox, she can go to her local GP and get a second dose of the vaccine as long as Amy receives it within 5 days of being exposed to the virus. Giving Amy the second dose of the vaccine will prevent her from catching chicken pox from her friend.
And her sister??
Sharon also mentioned that her youngest baby who has just turned 1 comes to kinder pick up with her and has not even had one varicella vaccine to date. I explained that even though it is routine to get the first varicella vaccine at 18 months, it is safe to get it from 1 year of age, so her youngest daughter could get the vaccine now too. Then, when she gets her 18-month injection through the national immunisation program, she will be receiving her second dose of varicella which will give her optimum coverage.
A couple of extra tips:
- If a woman gets vaccinated to Varicella, it is not recommended to try and fall pregnant until 1 month after having the vaccination.
- If currently breastfeeding, there is no risk to the baby if mum gets vaccinated.
- You cannot catch shingles from exposure to chicken pox, but you can catch chicken pox from exposure to shingles. It’s a timely reminder to grandparents, that if they haven’t had a shingles vaccine they should arrange to receive it as soon as convenient, as it can be an extremely painful and can surface more readily when their immune systems are not firing on all cylinders. From November 1st, 2016, the shingles vaccine will be made available for free to people over 70 years of age.
What to do when your child has come down with Chickenpox?
The treatment for chickenpox is usually symptomatic relief:
- Paracetamol is recommended to relieve a fever if the child is very uncomfortable and irritable.
- Children can feel very tired, so plenty of bed rest is recommended. It’s also important to keep offering fluids to prevent dehydration and help bring the fever down.
- The rash can be intensely itchy so Calamine lotion and antihistamines (eg. Polaramine ) can help. Lukewarm baths can help relieve the itch and adding a cup of oatmeal to the end of an old stocking and tying a knot so that the cup of oatmeal is all contained at the end of the stocking and soaking it in the bath can calm the skin and relieve the itch too.
- Soaking gauze pads in bicarbonate of soda with water and placing the pads over the sores can give relief as well as some cooling gels.
- Antiviral therapy may be required when the rash is severe, or complications occur which is rare these days.
- It is important to encourage your child to avoid scratching to prevent scarring. It is easier said than done but keeping the fingernails very short and mittens or socks over the hands at night may help prevent your child from scratching in their sleep.
- Once the scabs have formed, your child is no longer contagious and each dried blister can be treated as a wound. You can apply a wound gel dressing often to the scabs called Solosite gel which will help heal the blisters and prevent scarring.
- Be aware that your child is still contagious and should not return to daycare/school until all the blisters have scabbed over and dried.
Please feel free to leave comments on this blog and if there are any questions I am more than happy to answer them. Also, if you tried a remedy that worked well for your children that was, or wasn’t mentioned above, let me know. I hope this information does help.
Disclaimer – The material on this blog is only to be used for informational purposes only. As each individual situation is unique, you should use proper discretion, in consultation with a health care practitioner, before applying the methods, medicines, techniques or otherwise described herein. The author and publisher expressly disclaim responsibility for any adverse effects that may result from the use or application of the information contained herein. The names of people mentioned in this blog have been changed to protect the real patient’s confidentiality.
