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Chickenpox — DCH MCQ

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ModerateCommon childhood illnessesChickenpoxDCH

A previously well 7-year-old boy develops an itchy vesicular rash 12 days after a classmate had chickenpox. The rash began 18 hours ago and includes lesions at different stages on the trunk and scalp. He is afebrile, drinking normally and has no features of secondary bacterial infection. What is the single most appropriate advice?

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Correct answer: A — Keep him away from school until 5 days after rash onset

The correct answer is A. This is uncomplicated chickenpox in an otherwise healthy child. Current UKHSA education-setting guidance advises exclusion until 5 days after the rash first appears. Management is otherwise supportive: encourage fluids, use paracetamol if required, and consider cooling preparations or pharmacist-advised antihistamine treatment for itching. Cool bathing is acceptable, so bathing need not be avoided. The characteristic clinical presentation does not require routine varicella serology. Fusidic acid should not be applied prophylactically to every lesion; antibacterial treatment is reserved for suspected secondary bacterial infection. Although aciclovir is licensed for chickenpox and must be started early when indicated, it is not routinely prescribed to every otherwise healthy young child.

Reference: UK Health Security Agency. Public health exclusion periods in children and young people's settings. Updated 9 July 2026. https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/public-health-exclusion-periods-in-children-and-young-peoples-settings