said I didn’t.’
‘It’s possible that you had it so mildly, you only had one or two spots and your mum thought they were gnat bites,’ Rachel reassured her. ‘Studies show that eighty per cent of people who can’t recall having chickenpox are actually immune. And chickenpox in pregnancy is really rare—only about three in every thousand pregnant women get it.’
‘What about the baby?’
‘Yes, there is a risk of the baby developing problems such as skin scarring, eye problems and neurological problems, but that’s only a risk if you get it between thirteen and twenty weeks. So you can stop worrying about birth defects because you’re well past twenty weeks.’ She paused. ‘When did Jasmine go down with it?’
‘She got the first spots yesterday. She was in the bath and I saw them.’ Megan shook her head. ‘I’d heard you can literally see chickenpox spots coming out, but I thought people were exaggerating. But I could see them popping up on her back.’
Rachel nodded, calculating mentally that Jasmine became infectious four days ago. The incubation period was between ten days and three weeks, so if Megan did develop chickenpox it would be somewhere between the end of the following week and the next fortnight. ‘Right. You’re due to have the baby in ten days’ time. If the baby’s late, that could mean you’ll deliver the baby in three weeks’ time. Jasmine’s spots will all have crusted over by the end of next week, so there shouldn’t be any risk to the baby from Jasmine.’
‘What about if I have the baby early? Or if I get it?’
‘Let’s not panic yet. There’s a very high probability that you’re already immune—remember, around ninety-five per cent of adults have already had it—so I’ll do a blood test and ask the lab to rush it through for me. If you’re not immune, I can refer you to the hospital for preventative treatment—they can give you something called VZIG and give the baby the same thing when he’s born.’ She smiled. ‘That stands for “varicella zoster”—chickenpox to me and you—“immunoglobulin”. They’re antibodies which will protect you and the baby against developing chickenpox.’
Megan was shaking slightly. ‘But if I do get it—or the baby?’
‘If you get it before you have the baby, we can give you an antiviral medication called acyclovir. We can also give the baby antibodies and the antiviral medication.’ Rachel thought it prudent not to mention that ten per cent of pregnant women with chickenpox went on to develop pneumonia—Megan didn’t smoke, so that cut her risk anyway—or how serious chickenpox could be for newborns. Until they knew whether Megan was immune or not, Rachel didn’t want to panic her patient. ‘How’s Jasmine?’
‘Miserable.’
‘If she’s got a temperature, you can give her some infant paracetamol or ibuprofen to bring it down.’
‘She hasn’t said she’s hot, just itchy. I keep telling her not to scratch, but she can’t help it. Mum says I should put calamine lotion on her.’
‘That’ll help to stop the itch—though there’s something out now that stops the itch for a bit longer and isn’t quite as messy.’ Rachel scribbled a note on her pad, tore off the top sheet and handed it to Megan. ‘You don’t need a prescription for this. If Ian at the pharmacy doesn’t have it, he can tell you who does stock it or what’s the next best thing. Putting a bit of bicarb soda in a tepid bath can help, too. If it’s affecting her sleep, bring her to see me and I can give her some antihistamines to stop the itch and help her sleep. She might have a sore throat, so give her plenty of cool drinks. Otherwise, I’d recommend keeping Jasmine’s nails really short and doing things with her that keep her hands occupied so she can’t scratch. Make sure you get enough rest, though.’ She smiled at Megan. ‘Do you want a glass of water before I do the scary needle thing?’
Megan shook her head, smiling back. ‘No, I’m OK. At least you don’t leave bruises. Lucy does.’
‘Poor Lucy. She’s paranoid that half my mums ask her to let me do the blood samples instead of her.’
‘So, has Sophie had chickenpox yet?’ Megan asked, looking away as Rachel deftly took the blood sample.
‘No. I saw the notice up at nursery this morning. I’ll be watching her for the next couple of weeks.’ Rachel put her hand flat on the desk. ‘Touch wood, we haven’t had the nits notice up for a while.’
‘Oh, no. Don’t talk that up!’ Megan groaned.
‘Nits scare me a lot more than they scare Soph. She refuses to let me put her hair in a ponytail. And she hates even a detangling comb in her hair—I dread to think what she’d be like with a nit comb,’ Rachel said ruefully. ‘OK, you can press on the cotton wool for a few seconds.’
‘You’re done already?’
‘I’m done. Not so bad, was it?’ Rachel wrote out the lab form. ‘I’ll ring you as soon as I get the results through. It probably won’t be until Monday, but don’t spend the weekend fretting about it. There’s a very, very strong chance that you’re immune—and if you’re not, we can protect you and the baby.’
‘Thanks, Rachel.’ Megan took a deep breath. ‘I feel a bit better now.’
‘Good. If you’re worried, talk to me or Lucy, OK? That’s what we’re here for.’ The calmer Megan stayed, the better her blood pressure would be—and the better it would be for the baby.
When Rachel had finished surgery, she checked with Rita that Oliver didn’t have a patient with him, then knocked on Oliver’s door. At his ‘Come in’ she put her head round the door.
‘Good or bad time?’ she asked.
He pulled a face. ‘Not brilliant.’
‘OK, then, I’ll keep it short. Chickenpox is doing the rounds again. The note’s up on the nursery door. If Soph gets it, we’re going to need locum cover for one of us where our shifts overlap.’ It would probably be her, but she’d give Oliver the option of nursing their daughter if he wanted to.
Oliver rolled his eyes. ‘That’s all I need. Good locums are—’
‘Like gold dust,’ Rachel finished. She’d heard him say it so often. ‘That’s why you’re getting advance warning. So you can be prepared. I’m not saying Soph’s definitely going to get it.’
‘But it’s one of the most infectious viruses, it spreads by droplets in the air, and ninety per cent of susceptible contacts get it.’ Oliver sighed. ‘I hope she doesn’t get it as badly as Rob did.’
‘Me, too.’ Rachel paused. ‘Um, it’s Sophie’s full day at nursery today. Want to meet me for lunch in the Red Lion for one of their bacon and Brie baguettes?’ If that didn’t tempt him, nothing would.
‘Sorry, I can’t. I’ve got a pile of house calls, plus I’m seeing a drug rep, and I’ve already put him off four times.’
‘Right.’ So it was nothing, then. She shrugged. ‘Just thought I’d ask.’
‘Rach—’
‘Doesn’t matter.’ She wanted to get away before the tears pricking
