Chickenpox and Corticosteroids
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.
Are asthmatic children treated with an oral steroid at extra risk?
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 5-7 days. A burst is prescribed in an emergency situation when asthma is suddenly worse. Children receiving oral steroid treatment rarely have complications from chickenpox.
Are asthmatic children treated with an inhaled steroid at extra risk?
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.
May I stop my child's steroid therapy to prevent the risk of side effects from chickenpox?
No. Stopping prescribed asthma treatment is much more dangerous to the child than the potential risk from chickenpox.
How do I prevent my child from getting chickenpox?
Current medical guidelines recommend that almost all children should receive the 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.
How do I know if my child has been exposed to chickenpox?
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.
What should I do after my child has been exposed?
Check every day for fever and for the tiny chickenpox blisters. Incubation for chickenpox is 2 to 3 weeks. Check your child every day for 3 weeks.
If your child is 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 2 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.
What do I if my child is receiving or has recently received oral or injected steroids and becomes infected with chickenpox?
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.