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to the face, arms, and legs. The rash may also appear on the scalp and genitals and inside the nose, ears, and mouth. After a few days, the blisters break open, dry out, crust over, and form scabs. Once the scabs have formed, the infection is no longer contagious. The rash is very itchy. Scratching is difficult to resist, but scratching the rash can produce scars. A child with chickenpox may also have a slight fever and abdominal pain, and may feel generally ill. Possible complications include pneumonia (see page 660), encephalitis (see page 694), and severe infections of the blisters.

Diagnosis and Treatment

A diagnosis of chickenpox is based on a child’s symptoms and the results of a physical examination. Applying calamine lotion to the rash will help relieve itching. Oatmeal soaps or bath preparations and warm compresses can be helpful. Bathwater should be cool or lukewarm. If the rash occurs in the genital area, an anesthetic cream can be applied to relieve pain; ask the doctor to recommend one. If the rash becomes infected from excessive scratching, your doctor may prescribe a topical antibiotic ointment or an oral antibiotic. In some cases, doctors prescribe an antihistamine such as diphenhydramine to relieve itching. Trimming your child’s nails if necessary can help prevent scratches.

Doctors sometimes recommend an injection of chickenpox antibodies called zoster immunoglobulin to prevent or reduce the severity of the disease in children who have an increased risk of complications, such as those with immune system disorders or who are undergoing chemotherapy for cancer. An antiviral drug called acyclovir, taken by mouth, is sometimes prescribed to reduce the severity of the infection or shorten it.

Give your child cold fluids and soft, bland foods. Avoid salty or acidic foods and drinks. The doctor may recommend giving your child acetaminophen or ibuprofen to reduce fever and relieve pain. (Do not give aspirin to a child or adolescent who has a fever because aspirin has been linked to a potentially fatal disorder called Reye’s syndrome; see page 411.) Most children with chickenpox recover within about 7 to 10 days.

Mumps

Mumps is a viral infection that causes inflammation and swelling of the saliva-producing (salivary) glands between the ear and the jaw. In some cases a child’s joints, pancreas, testicles, or ovaries also may be affected. Mumps occurs most often in the spring and usually is spread through contact with infected saliva. The disease usually occurs in children ages 10 or older; having the infection provides lifelong immunity. Possible complications of mumps include encephalitis (see page 694), meningitis (see page 692), acute pancreatitis (see page 798), and orchitis (swelling of the testicle) in older boys. Doctors recommend that all children be vaccinated (see page 376) against mumps between 12 months and 15 months of age, and again between ages 4 and 6.

Symptoms

The main symptoms of mumps are swelling and tenderness on the sides of the face under the ears, which may be accompanied by an earache. In most cases, both sides of the face become swollen, one side of the face a few days before the other. A child can have difficulty talking, chewing, and swallowing. In most cases, he or she also has a headache, a fever (up to 103°F), loss of appetite, and diarrhea. If a child’s testicle becomes swollen, symptoms include pain in the affected testicle, chills, a high fever (up to 106°F), nausea, and vomiting. Swelling of the ovaries or pancreas can cause discomfort or pain in the lower abdomen.

Diagnosis and Treatment

A diagnosis of mumps is based on a child’s symptoms and the results of a physical examination. Have your child rest, and give him or her plenty of fluids, including water, fruit juice, sports drinks, tea, or decaffeinated soft drinks. Your doctor will recommend giving your child acetaminophen or ibuprofen (not aspirin) to relieve the pain and fever. You can also help relieve pain in the affected area by applying an ice pack wrapped in a towel. If the testicles are swollen, the