Chickenpox

Chickenpox is an infection caused by the varicella-zoster virus.

Most cases are in children under age 15, but older children and adults can get it. It spreads very easily from one person to another. Chickenpox can sometimes cause serious problems. Adults, babies, teenagers, pregnant women, and those with weak immune systems tend to get sicker from it. Once you catch chickenpox, the virus usually stays in your body. You probably will not get chickenpox again, but the virus can cause shingles in adults. A chickenpox vaccine can help prevent most cases of chickenpox, or make it less severe if you do get it.

Because chickenpox is airborne and spreads very easily even before the rash appears, it is hard to avoid.

A vaccine to prevent chickenpox is part of a child's routine vaccine schedule.

The vaccine often prevents the chickenpox disease completely or makes the illness very mild.

Chickenpox is caused by the varicella-zoster virus. It is a member of the herpesvirus family. The same virus also causes shingles in adults.

Chickenpox can be spread very easily to others from 1 to 2 days before blisters appear until all the blisters have crusted over.

You may get chickenpox:
  • From touching the fluids from a chickenpox blister
  • If someone with the disease coughs or sneezes near you

Most cases of chickenpox occur in children younger than age 10. The disease is most often mild, although serious complications may occur. Adults and older children get sicker than younger children in most cases.

Children whose mothers have had chickenpox or have received the chickenpox vaccine are not very likely to catch it before they are 1 year old. If they do catch chickenpox, they often have mild cases. This is because antibodies from their mothers' blood help protect them. Children under 1 year old whose mothers have not had chickenpox or the vaccine can get severe chickenpox.

Severe chickenpox symptoms are more common in children whose immune system does not work well. 

Most children with chickenpox have the following symptoms before the rash appears:
  • Fever
  • Headache
  • Stomach ache
The chickenpox rash occurs about 10 to 21 days after coming into contact with someone who had the disease. In most cases, a child will develop 250 to 500 small, itchy, fluid-filled blisters over red spots on the skin.
  • The blisters are most often first seen on the face, middle of the body, or scalp.
  • After a day or two, the blisters become cloudy and then scab. Meanwhile, new blisters form in groups. They often appear in the mouth, in the vagina, and on the eyelids.
  • Children with skin problems, such as eczema, may get thousands of blisters.

Most pox will not leave scars unless they become infected with bacteria from scratching.

Some children who have had the vaccine will still develop a mild case of chickenpox. In most cases, they recover much more quickly and have only a few poxes (fewer than 30). These cases are often harder to diagnose. However, these children can still spread chickenpox to others.

In most cases, a person recovers without complications.

Once you have had chickenpox, the virus often remains dormant or asleep in your body for your lifetime. About 1 in 10 adults will have shingles when the virus re-emerges during a period of stress.

Treatment involves keeping the person as comfortable as possible. Here are things to try:
  • Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching.
  • Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area.
  • Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath.
  • Apply a soothing moisturizer after bathing to soften and cool the skin.
  • Avoid prolonged exposure to excessive heat and humidity.
  • Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects, such as drowsiness.
  • Try over-the-counter hydrocortisone cream on itchy areas.
Do NOT give aspirin or ibuprofen to someone who may have chickenpox.

Use of aspirin has been associated with a serious condition called Reyes syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used.

A child with chickenpox should not return to school or play with other children until all chickenpox sores have crusted over or dried out. Adults should follow this same rule while considering when to return to work or be around others.