Chickenpox & Children with Asthma
Your Questions Answered
Most people think of chickenpox as a common, harmless childhood disease. However, children with chickenpox usually have a high fever, feel ill for several days, and develop a rash. The rash includes tiny, clear blisters that start on the chest, back, or belly. Normally, these blisters form scabs and begin to heal in three to four days. In rare cases, chickenpox may result in serious complications, even death.
Q. Are asthmatic children treated with
an oral steroid at extra risk for complications
A. Some asthmatic children are treated for months or years with an oral steroid. Other asthmatic children may never receive oral steroid treatment, while others may be treated with a short “burst” of an oral steroid for five to seven days. A burst is prescribed in an emergency situation when asthma is suddenly worse. Children receiving oral steroid treatment rarely have complications from chickenpox.
Q. Are asthmatic children treated
with an inhaled steroid at extra risk
for complications from chickenpox?
A. No. There is no evidence that an inhaled steroid poses an increased risk for asthmatic children exposed to chickenpox. Inhaled steroids reduce asthma symptoms and the need for extra medicine, such as oral steroids.
Q. May I stop my child’s steroid
therapy to prevent the risk of side
effects from chickenpox?
A. No. Stopping prescribed asthma treatment is much more dangerous to the child than the potential risk from chickenpox.
Q. How do I prevent my child from
A. Current medical guidelines recommend that almost all children should receive the chickenpox vaccine. Vaccination helps prevent most cases of chickenpox. Even if a vaccinated child develops chickenpox, the disease should be milder and less likely to have severe complications.
Q. How do I know if my child has
been exposed to chickenpox?
A. When cases of chickenpox are reported at school, find out if the infected children are in your child’s class. If so, your child has been exposed to chickenpox. If your child’s playmate becomes infected with chickenpox, your child has been exposed.
Q. What should I do after my child
has been exposed to chickenpox?
A. Check every day for fever and for the tiny chickenpox blisters. Incubation for chickenpox is two to three weeks, so continue to check your child every day for three weeks. If your child is being treated with an oral or injected steroid, call your doctor immediately. Tell the doctor that your child has been exposed to chickenpox. If exposure occurred within the last two days, the doctor may prescribe a shot called Varicella Immune Globulin (VZIG). If your child is being treated with an inhaled steroid but not with an oral steroid, VZIG is not necessary. A special antibiotic, acyclovir, also is available for treatment of asthmatic children with chickenpox.
Q. What do I do if my child is
receiving or has recently received
oral or injected steroids and becomes
infected with chickenpox?
A. Inform your physician immediately. Do not wait for a problem to develop.
Steroid use in asthmatic children under a doctor’s care is safe and effective. Complications due to chickenpox exposure are rare. The key to preventing chickenpox complications for children is to vaccinate them with the chickenpox vaccine before they become infected.
Why Get Vaccinated?
Chickenpox (also called varicella) is a common childhood disease. It is usually mild, but it can be serious, especially in young infants and adults.
- It causes a rash, itching, fever, and tiredness.
- It can lead to severe skin infection, scars, pneumonia, brain damage, or death.
- The chickenpox virus can be spread from person to person through the air or by contact with fluid from chickenpox blisters.
- A person who has had chickenpox can get a painful rash called shingles years later.
- Before the vaccine, about 11,000 people were hospitalized for chickenpox each year in the United States.
- Before the vaccine, about 100 people died each year as a result of chickenpox in the United States. Chickenpox vaccine can prevent chickenpox. Most people who get chickenpox vaccine will not get chickenpox. But if someone who has been vaccinated does get chickenpox, it is usually very mild. They will have fewer blisters, are less likely to have a fever, and will recover faster.
Source: U.S. Department of Health and Human Services Centers for Disease Control and Prevention
Source: American College of Allergy, Asthma & Immunology, www.acaai.org
This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2009.