Definition

Chickenpox is a virus that spreads easily to others. It creates a widespread, itchy rash. The infection can also cause serious complications in some people.

Chickenpox

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Causes

Chickenpox is caused by the varicella-zoster virus (VZV). It spreads from person to person via:

    
  • Airborne droplets of moisture containing the VZV virus
  • Direct contact with fluid from a chickenpox or zoster rash

    • It is contagious 1-2 days before the rash erupts. It remains contagious until all of the blisters have crusted. This takes five days. It is most contagious just after the rash has broken out.

    A pregnant mother can transmit the virus to a fetus.

    Risk Factors

    Factors that increase your chance of getting chickenpox include:

        
  • Close contact with an infected person, unless you have been vaccinated or have already had chickenpox
  • Age: less than three years old, with peak incidence between 5-9 years old
  • Immune-deficient state, such as having leukemia, an organ transplant, high-dose steroid use, or HIV
  • Cancer
  • Pregnancy
  • Time of year—late winter, early spring

    • Symptoms

    Symptoms break out about 10-21 days after contact. They are more severe in adults than they are in children.

    Initial symptoms include:

        
  • Mild headache
  • Moderate fever
  • Cough
  • Sore throat
  • Severe itch
  • Lack of appetite
  • General feeling of discomfort
  • Some children complain of abdominal pain

    • The rash appears within 1-2 days after the first symptoms. The rash:

        
  • Begins with small, flat, red spots:     
  • Spots become raised and form a round, intensely itchy, fluid-filled blister
  • Blisters develop in clusters, with new clusters forming over 5-6 days
  • Usually develops into patches on the skin above the waist, including the scalp
  • May also appear on the eyelids, in the mouth, upper airway, voice box, or on the genitals
  • Typically crusts over by day six or seven and disappears within three weeks

    • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis is usually based on the rash and your age. Blood and lab tests to identify the virus are rarely needed.

    Treatment

    Chickenpox is mild in most people. It will naturally run its course. In these cases, treatment focuses on relieving the symptoms.

    To Reduce Itching

        
  • Apply wet compresses to the skin
  • Apply over-the-counter anti-itch creams or lotions
  • Take oatmeal baths
  • Take an oral antihistamine

    • Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome. Ask your doctor which other medicines are safe for your child.

    Antibiotics

    Antibiotics cannot cure infections caused by a virus. They may be given if the rash becomes infected with bacteria.

    Antiviral Medication

    The course, severity, and duration of the infection may be reduced by antiviral medications, such as:

        
  • Acyclovir
  • Valacyclovir
  • Famciclovir

    • They are often used in:

        
  • Adolescents, adults, and individuals with weak immune systems
  • Individuals with chronic skin or lung diseases and those taking aspirin or steroids

    • Special Needs

    Varicella-zoster immune globulin is often given immediately after exposure. It is reserved for newborns and people with weak immune systems.

    Prevention

    Avoid contact with anyone who has chickenpox. This is very important if you have not been vaccinated against the infection.

    Vaccination in Children

    The varicella vaccine, or a combination vaccine called MMRV, is recommended for most children. MMRV protects against measles, mumps, rubella, and varicella.

    There is a catch-up schedule if your child has missed the routine injections.

    Vaccination in Adults

    Adults who have never had chickenpox or received the varicella vaccine should be vaccinated.

    Vaccination After Exposure

    If you or your child has not been vaccinated, but are exposed to chickenpox, a vaccine given right away may help lessen the severity of the infection, or prevent the infection.