Help – there’s a chickenpox outbreak at pre-school!

Is chickenpox contagious? How do you soothe a chickenpox rash? We answer your questions…

It’s the sign you dread going up on the pre-school door: “we’ve had cases of chickenpox”. But when the virus strikes, what can you do to manage chickenpox symptoms and help make your child as comfortable as possible, keep scratching to a minimum and ensure they – and you! – get some sleep? Here’s your need-to-know.

Uh-oh, chickenpox is doing the rounds. What symptoms should I look out for?

Spots are often the first sign, says Dr Babak Ashrafi, clinical lead at Zava, the online GP service. “The chickenpox rash starts off as small red spots which become fluid-filled crusty bubbles. There may also be fever (temperature above 38 degrees), cold-type symptoms, decreased appetite and lethargy.”

If another child has it, is it too late for the chickenpox vaccine?

Yes, sorry. “The infectious period is from two days before spots come out,” says Dr Ashrafi. “So, children will have been exposed before the outbreak is recognized.” The chickenpox vaccine is effective before an outbreak though. Chickenpox is considered a mild illness, but its available privately.

If there are cases at nursery, how likely is my child to catch it?

Put it this way, you’d be wise to free up your schedule. “It’s transmitted via direct contact and droplet spread,” says Dr Ashrafi. Which includes all those delightful things children do – sneezing without covering their noses, sharing water cups and yep, occasionally even licking each other.

Chickenpox happened. How long should my child be kept home?

“It’s contagious from two days before spots erupt until they scab over, which is usually five days after appearing,” says Dr Ashrafi. Check your nursery or pre-school’s policy, but as a minimum they need to stay off until the chickenpox rash subsides and the spots scab over.

Is it enough to hunker down at home with CBeebies or should we go to the doctor?

It’s fine to stay at home, says Dr Ashrafi, but inform your GP that your child has chickenpox so it can be put on their record. “However, if they start showing symptoms such as persistent high fever, feeling drowsy, having breathing issues or spots on their eyes, then see your doctor ASAP,” he says. It’s also worth speaking to your GP (or calling 111) if you’re not sure it’s chickenpox, if the skin around the blisters is red, hot or painful, your child is dehydrated, or if you’re concerned about your child getting worse.

My kid has a fever and is scratching like crazy. What can I do?

“Try calamine or other cooling gels for the itching,” says Dr Ashrafi. “Paracetamol, staying hydrated and resting will help with the temperature and aches and pains. Do NOT give ibuprofen or Nurofen. They’re non-steroidal anti-inflammatory drugs (NSAIDs) which can speed up or even cause skin infections in chickenpox or shingles in children.” It’s also worth keeping their nails cut short and covering their hands at night to stop them scratching and leaving scars.

Should I throw a chickenpox party so everyone can "get it out of the way"?

“Absolutely not!” says Dr Ashrafi. Never deliberately expose a child to chickenpox as there’s a very small possibility of dangerous complications, such as pneumonia. If your child hasn’t been exposed yet and you want them to build up immunity, get them vaccinated instead. “Those with chickenpox should also stay away from pregnant women and newborn babies, as well as those with low immunity, such as cancer sufferers and the elderly,” he says, “as their immunity might be compromised,” and it could put them at greater risk of more serious complications.

My child seems fine "in himself" but his spots haven’t scabbed. Can we go out?

Yes, with caveats. “They shouldn’t be in confined spaces with anyone who hasn’t had it before, or have any direct contact with them either,” says Dr Ashrafi, “but going for a walk is ok.” 

We made it! The spots are scabbed. Can he catch chickenpox again?

“Theoretically yes,” says Dr Ashrafi, “But it’s unlikely and extremely rare. In some people it can manifest again as shingles since the virus lays dormant in the nerve cells and awakens from time to time.”