Chicken pox

[Rosie67]

Hi Everyone! Last week a parent called stating her daughter had a rash looking like chicken pox to face and trunk. Student had a fever several days prior. Has had one Varicella. Parent is not very reliable and really couldn't describe lesions to me. Stated doctor diagnosed her over the phone and refused to give her appt to confirm. She is in 8th grade.

Today, I had another parent call. He is in 6th grade. Had both Varicella vacs. In school all last week, I see him often for every little thing not related to illness! Mother reports he had no complaints until he broke out in rash this weekend, "all over, looks like chicken pox". Called them red but not blistering. She is calling doctor, will let me know what they say.

I don't know where to go from here. It is unlikely they had any contact at school. We keep the upper lever grades separate from 5th and 6th. They don't live by each other and I have never seen them together. Unfortunately, they are both from odd families with less than attentive mothers. I don't want to let something get out of hand but really not interested in mass hysteria.

Any thoughts???

[schooldistrictnurse]

This might be totally random. Remember that the varicella vaccine isn't 100% effective, and since the vaccine has to be stored frozen, there are opportunities for vaccine failure due to improper storage. Another monitoring tool you can use is to ask whomever takes attendance calls to alert you if parents call a student in with rash and f/u with those parents. Do you have a local health dept that can be a resource to you? You might alert them and seek their advice also. The criteria for returning to school in my district is when all lesions are scabbed (and, of course, student is fever-free, but that should be done long before the lesions are scabbed). We loosely go by "three or more unrelated cases" as far as parent notification, etc.

We had an "outbreak" of pertussis two years ago. If this does escalate, the other thing we did when we had pertussis is specifically notify parents of unvaccinated students so they would know what to watch for. If it had been worse, the local Health Dept could have directed the district to have unvaccinated students excluded from school until the "outbreak" was over. Didn't get that far. This year I had two cases of MRSA reported in two weeks. You'd better believe I was checking if the kids were in the same classes, lunch, activities, etc.

No matches. No further cases. WHEW! Keep us all posted.

[Jolie, BSN]

I would suggest contacting the local health department for advice and assistance.

Ours is very helpful in contacting doctor's offices to confirm communicable disease diagnoses and then advising us on whether or not school-wide notification is necessary, as well as providing vaccines and information on excluding inadequately vaccinated students.

[MySonIsAdorable]

Just now reading this because my son has the chicken pox. And yes he was vaccinated. His pediatrician told me that (which is what I assumed after researching it before I decided to call it in for an appt.) when a child actually gets the chicken pox after being vaccinated they are likely to only have around 40 lesions...and they aren't really even blistered usually until a day or two after being spotted. Because they do have some immunity its not likely that a child who has be vaccinated to have full blown chicken pox. However they are still just as contagious.

When my son's father called me last night to tell me that out of no where my son had a rash & said "I think its chicken pox" I thought, yeah right...well turns out that the Dr said without a doubt he Dx as varicella!

He said that its more likely in his case that he was in contact with someone who has shingles. Because there haven't been any reported cases of chicken pox in our area recently.

[mustlovepoodles, RN]

Both of my younger kids got chicken pox from 1 to 8 years after their varicella vaccination. Neither of them were particularly sick with it and the bumps they had didn't look all that blistery. DS had them only under his shirt--take off his clothes, he looked like he was wearing a polka dot undershirt. DD had them on her back and chest. She came to me complaining about acne. When she showed me her bumps, there was no doubt it was chicken pox. Unfortunately, this was the day AFTER my husband was released from 10 days in CCU after suffering septic shock! Yowsa! I trotted DD up to the doctor faster than you can blink. Sure enough, chicken pox. Thankfully, DH managed. But about a year later he broke out in shingles (the guy can't get a break!)