What is it?
Chicken pox is a common illness caused by the varicella-zoster virus.  It causes a mild fever, and an itchy skin rash (pox) of small red bumps that blister, ooze, and then crust over.  The rash often starts on the abdomen, chest and back, and then spreads to the face and limbs.  some people may show only a few pox, and others may be covered with lesions.  The illness usually lasts for 5-7 days.

Although chicken pox is usually a mild illness for children, it can be more severe for young infants, adolescents and adults.  In addition, chicken pox can be a life threatening illness for people with immune problems (e.g., HIV/AIDS, cancer chemotherapy, organ transplant, taking steroid medication).  If a pregnant woman catches chicken pox, it can infect the fetus and cause abnormalities of the limbs, eyes and nervous system, or newborn chicken pox which can be fatal.

How is it spread?
Chicken pox is very contagious.  It is a respiratory disease that is spread by contact with nasal mucus and saliva.  it can be spread by coughing and sneezing, kissing on the lips and sharing food, eating utensils and mouthed toys.  It is also spread by touching your hands to your nose and mouth, reusing tissues, and forgetting to wash your hands after blowing noses.  It spreads most easily in crowded and poorly ventilated rooms.  Rarely, it can also be spread from contact with the oozing skin lesions.

When is it contagious?
Chicken pox is contagious from 2 days before the rash appears until 5 days after the start of the rash.  In milder cases, the contagious period may end sooner, around the time that the pox scab over.  After exposure to chicken pox, it usually takes 11-14 days (up to 21 days) to develop the illness.

How is it diagnosed and treated?
Chicken pox is diagnosed by the distinctive rash.  If you call the child's health provider and describe the rash, they usually do not recommend taking the child to the clinic and risking spreading the illness to others.  Usually, no treatment is needed for chicken pox other than good nutrition, plenty of liquids to drink, and rest.  Children who are itchy can be bathed in water with baking soda or an oatmeal preparation, and treated with skin lotions (e.g., calamine) and antihistamine medications to relieve the itching.  Children who are uncomfortable with fever may be given acetaminophen - never give aspirin since it can cause a fatal condition called Reye Syndrome.

People with immune problems and pregnant women exposed to chicken pox should consult their health provider immediately.  They may be given anti viral and/or immune treatment to prevent severe complications.

Should the child stay home?
A child with chicken pox should stay home until 6 days after the start of the skin rash or when all the skin lesions are scabbed over, whichever is earlier.

How can we limit the spread?

• Cough and sneeze into your elbow and away from people.
• Wipe runny noses with a clean tissue, throw the tissue away, then wash your hands.
• Don't share food, pacifiers, bottles, or toothbrushes.  Wash eating utensils and drinking cups well between uses.
• Clean and disinfect mouthed toys and dining tables after each use.  Clean and disinfect water fountains, telephone receivers, and other frequently handled items daily.
• don't kiss children on the mouth.
• Maximize outdoor play and indoor ventilation.
• Avoid touching the chicken pox lesions.  Wash hands well after contact.
• Avoid exposing pregnant women and people with immune problems to chicken pox.
• Discuss with your health provider the new vaccine that has been developed to protect against chicken pox.

Information provided on this page is not intended to provide medical advice or take the place of medical treatment.  The recommendations do not indicate a course of treatment or medical care.

These are guidelines to develop policies and procedures for preventing, recognizing and managing communicable disease in child care.  If the children in your care have been exposed to this disease, you may copy this exposure notice and hand out to your day care parents.

This Exposure Notice has been copied from "Keeping Kids Healthy, Preventing and Managing Communicable Disease in Child Care", a project of the The Center for Health Training funded by the California Department of Education, Child Development Division.