What is chickenpox?
Chickenpox is a common childhood illness caused by the varicella zoster virus which occurs when a person is first exposed to the virus.
Most well children make a rapid recovery after a brief illness lasting from four to seven days. Children who have had organ transplants and are on immunosuppressant medication may be sicker and more prone to complications if they get chickenpox.
What are the symptoms of chickenpox?
- Fever
- Cold like symptoms
- Poor appetite
- Lethargy
- Itchy rash which quickly develops into fluid filled blisters which gradually crust over. The rash tends to be most concentrated over the trunk and back. Some children may only develop a few spots, others may have an extensive rash including on soles, palms, eyes or in their mouths. Children on immunosuppressant medication do not always develop a typical rash and may continue to produce new spots for longer than usual.
How is the varicella zoster virus spread?
The virus is very infectious and usually occurs after contact with an infected person, with fluid from the blisters that occur with chickenpox and shingles or saliva or mucous from an infected person during coughing or sneezing.
Contact between a person who has never had varicella zoster and someone with shingles may lead to them developing chickenpox, but they will not develop shingles.
Usually, people with chickenpox are considered infectious from one day before the rash appears and then until all the spots have crusted over. Unfortunately, children who are on immunosuppressant medication cannot be vaccinated against chickenpox or shingles as the vaccine is live and therefore unsuitable for them.
What is the difference between chickenpox and shingles?
Shingles can develop only after a person has had chickenpox in the past. The virus that causes chickenpox lies dormant in the body in nerve tissue but can reactivate in the future as shingles. This can be many years later and is more common in adults.
What are the symptoms of shingles?
- Tingling, numbness, or pain around a nerve, typically just on one half of the body. The trunk is often affected but it can occur anywhere including affecting an eye.
- Feeling generally unwell
- Headache
- Blotchy rash which appears a day or two later and develops into fluid filled blisters which gradually crust over.
- Pain which may continue for some time after the rash has gone away.
What should I do if my child has had a chickenpox or shingles contact?
If you think your child has been in contact with someone who has chickenpox or shingles, you should contact your transplant team for advice.
Depending upon when the contact occurred and how close the contact was, preventative treatment may be necessary. This is usually in the form of antiviral medication by mouth which will start seven days after the contact occurred. This will not completely prevent your child from developing chickenpox but may lead to a milder illness.
Sometimes this may be necessary several times due to the frequent outbreaks of chickenpox that can occur in nursery and primary schools. It is important to check your child for the chickenpox rash developing.
Contact your transplant team for advice if your child may have gone on to develop chickenpox as the antiviral medicine dose will need adjusting. Once your child has had chickenpox and developed immunity, it will not be necessary for them to take preventative treatment if they encounter someone with chickenpox or shingles again.
A blood test can confirm whether they have developed immunity, and your transplant team can advise you about this.
What should I do if my child has developed chickenpox or shingles?
If your child has confirmed chickenpox or shingles, it will be necessary for them to start antiviral medication. This may be taken by mouth if their illness is mild. In some cases, it may be necessary for the medication to be given intravenously in hospital and for your child to be monitored more closely.
What complications may develop with chickenpox or shingles?
Children taking immunosuppressant medication are more likely to be sicker or develop complications after developing chickenpox.
These can include serious illnesses such as pneumonia (lung infection), encephalitis (brain infection), hepatitis (liver infection) or blood disorders.
If you are concerned that your child is dehydrated, difficult to wake, has trouble breathing or you are concerned that they are becoming more unwell, seek medical attention by calling 999 or attending your emergency department.
Please also make your child’s transplant team aware on the numbers below.
If you would like to speak to someone further, please do not hesitate to talk to a member of staff at your next clinic appointment, or, you can call the children’s transplant nurse specialists on the numbers below.
Resources
- NHS – Chickenpox
- NHS – Shingles
- Pediatric Heart Transplant Society
- GOV UK – Guidelines on post exposure prophylaxis for varicella or shingles
Contact
Office hours
Monday to Friday, 9am to 5pm.
Outside of these times please ring ward 23 on 0191 213 7023 if you have an urgent query affecting your child’s transplant health
