Chickenpox

Chickenpox is a childhood illness caused by infection with the varicella zoster virus (VZV) that causes a distinctive rash, fever, and fatigue.

Chickenpox was very common prior to the development of the varicella vaccine (chickenpox vaccine), affecting nearly all school-aged children.

The varicella virus that causes chickenpox remains dormant in the body after the chickenpox symptoms resolve. The virus may be triggered years later and cause a different set of symptoms called shingles, or zoster.

What Are the Symptoms of Chickenpox?

The rash of chickenpox usually begins as small itchy red bumps (papules) that appear on the trunk, scalp, and face. These bumps spread to other parts of the body, such as the limbs.

The papules evolve into small pink blisters (pustules) that have been described as “dew drops on a rose petal". The blisters eventually crust over with small dark scabs. A person infected with chickenpox may have bumps, blisters and scabs on the skin at the same time.

Chickenpox
 

Most, but not all, infected individuals develop a fever at the onset of the rash. If exposed, people who have been vaccinated against the disease may get a milder illness, with less severe rash (sometimes involving only a few red bumps that look similar to insect bites) and mild or no fever.

The number of skin lesions can vary from just a few to more than 1,000. Children with skin disorders such as atopic dermatitis generally develop more lesions. Unless the blisters become infected, there is no long-term scarring of the skin.

Healed chickenpox lesions may appear lighter (hypopigmentation) or darker (hyperpigmentation) than the surrounding skin for several months.

Are There Complications of Chickenpox?

People infected with chickenpox are at risk of developing other complications, including bacterial infection of the skin (cellulitis), swelling of the brain, and pneumonia. Adolescents and adults are more at risk for severe cases of chickenpox. Chickenpox during pregnancy may be complicated by pneumonia, premature delivery, and infection of the fetus.

How is Chickenpox Spread?

Chickenpox is very contagious and is spread by coughing and sneezing, direct contact with a lesion, and formation of tiny airborne droplet of virus from skin lesions. If exposure occurs in the early phase of disease, a person who is not immune to varicella has nearly an 80% chance of infection.

A person with chickenpox is considered contagious 2 days prior to the onset of rash and until all lesions have formed scabs, which usually takes a week to 10 days. The incubation period for chickenpox is 10-21 days; that is, a person exposed to chickenpox may take up to three weeks to develop symptoms.

What Is the Chickepox Vaccine?

The varicella vaccine can prevent chickenpox. Currently, two doses of vaccine are recommended for children, adolescents, and adults.

In children, varicella vaccine is now routinely administered at 12-15 months and again at 4-6 years. It is thought to be extremely effective against more severe cases, and nearly 90% effective against mild chickenpox cases. Even if the vaccine is given after exposure to varicella, it may help modify the severity of infection.

What Home Treatments are Available for Chickenpox?

Parents can do several things at home to help relieve their child’s chickenpox symptoms. Because scratching the blisters may cause them to become infected, keep your child’s fingernails trimmed short. Calamine lotion and Aveeno (oatmeal) baths may help relieve some of the itching.

Do not use aspirin or aspirin-containing products to relieve your child's fever. The use of aspirin in children with chickenpox has been associated with development of Reye’s syndrome (a severe disease affecting all organs, most seriously affecting the liver and brain, that may cause death). Use non-aspirin medications such as acetaminophen (Tylenol).

What Treatments Might Be Prescribed for Chickenpox?

Your doctor will advise you on treatment options.

Antiviral medications may help reduce the severity of symptoms. These include:

Antiviral medications may be recommended for people who are more likely to develop serious disease, including people with chronic skin or lung disease, otherwise healthy individuals 13 years of age or older, and people receiving steroid therapy.

People whose immune systems have been weakened from disease or medication should contact a doctor immediately if they are exposed to or develop chickenpox. If you are pregnant and are either exposed to or develop chickenpox, immediately discuss prevention and treatment options with your doctor.

Can I Avoid Getting Chickenpox if I Have Been Exposed to the Varicella Virus?

Yes, varicella zoster immune globulin (VZIG) can prevent or modify disease after exposure to chickenpox. However, because it is costly and only provides temporary protection, VZIG is only recommended for people at high risk of developing severe disease who are not eligible to receive the chickenpox vaccine. VZIG should be administered as soon as possible, but no later than 96 hours, after exposure to chickenpox.


 

 

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