MEDICINE FOR ALL

If your child has chickenpox after transplant, will their symptoms be more severe?

In general, even in a transplant patient, chickenpox usually causes the same  signs and symptoms that we see in other children, mostly the fever and the skin rash.

Rarely, chickenpox can affect other body organs in a transplant patient and a potentially can make the patient very sick and on rare occations even cause them to die.

If your child develops spots  that you think may be chickenpox, please see your family doctor or pediatrician or call the kidney transplant team. Your child may need to receive anti viral medication either by mouth or IV. If there are signs that the chickenpox rash quite severe or if the virus appears  to be affecting other organs, your child may need to be treated in hospital,

What happens if your child is at risk for chickenpox?

If your child is not protected from chickenpox through a previous infection or a vaccine, you will need to make sure that you instruct relatives, friends, teachers and caregivers to tell if your child has been exposed to chickenpox while in their care.

You will also need to avoid contact with people who have shingles. This is a painful rash that is also caused by the varicella virus. Close contact with someone with shingles can cause chickenpox in a child.

Although it is best to avoid, being exposed to it is not an emergency. There are normally a few days before the virus takes hold during  which your child’s doctor can arrange for your child to get medication if they need it. You can contact your kidney transplant team to discuss the exposure.

Chickenpox (varicella)

Chickenpox is a disease caused by the varicella virus. People with chickenpox develop an itchy rash that looks like insect bites at first before it develops into fluid-filled blisters that may break open and crust over. Chickenpox can also cause fevers, headache, abdominal (belly) pain, muscle aches, and a general feeling of “unwellness” or irritability.

Chickenpox used to be very common, with most people getting the disease in childhood. A vaccine has made chickenpox much less common in many countries, but it is still possible for children to catch the disease.

A child who has had a kidney transplant is at risk for getting chickenpox if they have not had it or had the varicella vaccine. A blood test is performed before a child is listed for kidney transplant to see if they are protected against chickenpox. If they are not protected your doctor may want them to have the chickenpox vaccine before transplant.

Serious viral infections

Some kinds of infections may put children with kidney transplants at particularly high risk. These include:

• Chickenpox (varicella)
• Herpes simplex virus
• Cytomegalovirus
• Epstein-Barr virus

If your child gets one of these viruses, they will likely be monitored more closely and they may be treated for them.

What signs of infections should you watch for?

There are many signs or symptoms that your child may have an infection. Contact your pediatrician or family doctor if your child is sick with any of these signs or symptoms:

• Fever
• Runny nose and cough that is not improving after several days or is severe
• Sore throat or sore ears
• Pains in the stomach
• Vomiting
• Diarrhea that has blood or mucous or is not improving after 1-2 days
• Feeling of burning or pain when peeing
• Sores on the lips  and around the mouth
• Rashes

As in all children, your child will likely get many of the colds and flus caused by viruses “going around” every year.

Other important ways for your child to avoid infections:

• Getting enough rest
• Eating healthy foods
• Drinking enough fluids
• Keeping active

How do you help your child avoid getting infections:

• Practice good hand washing for everyone who lives at home. Hand washing is especially important before preparing food and after diaper changes or going to the bathroom
• Ask friends and relatives who are sick to avoid visiting until they are better
• Have all close contacts up to date on their immunizations
• Wash hands well after contact with animal body waste (for example cleaning up after a family pet)
• If you have been told to do so, tell the kidney transplant team if your child is in contact with someone who has chickenpox,