Skin rash chicken pox: Chickenpox – Symptoms and causes
Chickenpox (for Parents) – Nemours Kidshealth
What Is Chickenpox?
Chickenpox is a viral infection that causes fever and an itchy rash with spots all over the body.
It used to be a common childhood illness in the United States, especially in kids under age 12. It’s much rarer now, thanks to the varicella vaccine.
What Are the Signs & Symptoms of Chickenpox?
Chickenpox often starts without the classic rash, with a fever, headache, sore throat, or stomachache. These symptoms may last for a few days, with the fever in the 101°–102°F (38.3°–38.8°C) range.
The red, itchy skin rash usually starts on the belly or back and face. Then it spreads to almost everywhere else on the body, including the scalp, mouth, arms, legs, and genitals.
The rash begins as many small red bumps that look like pimples or insect bites. They appear in waves over 2 to 4 days, then develop into thin-walled blisters filled with fluid. The blister walls break, leaving open sores, which finally crust over to become dry, brown scabs.
All three stages of the chickenpox rash (red bumps, blisters, and scabs) appear on the body at the same time. The rash may spread wider or be more severe in kids who have weak immune systems or skin disorders like eczema.
What Causes Chickenpox?
Chickenpox is caused by the varicella-zoster virus (VZV). This virus also can cause a painful skin rash called shingles (herpes zoster) later in life. After someone has had chickenpox, the virus stays dormant (resting) in the nervous system for the rest of their life. The virus can reactivate (“wake up”) later as shingles.
Kids who are vaccinated against chickenpox are much less likely to develop shingles when they get older.
Is Chickenpox Contagious?
Chickenpox is very contagious. Most kids with a sibling who’s infected also will get it (if they haven’t already had the infection or the vaccine), showing symptoms about 2 weeks after the first child does.
Someone with chickenpox can spread the virus:
- through droplets in the air by coughing or sneezing
- in their mucus, saliva (spit), or fluid from the blisters
Chickenpox is contagious from about 2 days before the rash starts until all the blisters are crusted over.
Someone with shingles can spread chickenpox (but not shingles) to people who haven’t had chickenpox or the vaccine.
Because chickenpox is so contagious, a child who has it should stay home and rest until the rash is gone and all blisters have dried. This usually takes about 1 week. If you’re unsure about whether your child is ready to return to school, ask your doctor.
What Problems Can Happen?
Some people are more at risk for complications from chickenpox, including:
- pregnant women
- newborns born to mothers who had chickenpox
- patients with leukemia
- kids receiving medicines that suppress the immune system
- anyone with immune system problems
If they are exposed to chickenpox, they might be given a medicine (zoster immune globulin) to make the illness less severe.
Can Chickenpox Be Prevented?
Yes. Most people who get the chickenpox vaccine will not get chickenpox. And if they do get chickenpox, their symptoms will be much milder.
Doctors recommend that kids get the chickenpox vaccine as:
- a first shot when they’re 12–15 months old
- a booster shot when they’re 4–6 years old
People 6 years of age and older who have never had chickenpox and aren’t vaccinated can and should get two doses of the vaccine.
Kids who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness.
How Is Chickenpox Diagnosed?
Doctors usually can diagnose chickenpox by looking at the telltale rash.
Call your doctor if you think your child has chickenpox. The doctor can guide you in watching for complications and in choosing medicine to ease itching.
If you take your child to the doctor, let the staff know ahead of time that your child might have chickenpox. It’s important not to expose other kids in the office — for some of them, a chickenpox infection could cause serious complications.
How Is Chickenpox Treated?
viruscauses chickenpox, so antibiotics can’t treat it. But antibiotics are needed if
bacteriainfect the sores. This can happen when kids scratch and pick at the blisters.
An antiviral medicine might be prescribed for people with chickenpox who are at risk for complications. The depends on the:
- child’s age and health
- extent of the infection
- timing of the treatment
Your doctor can tell you if the medicine is right for your child.
How Can I Help My Child Feel Better?
To help relieve the itchiness and discomfort of chickenpox:
- Use cool wet compresses or give baths in lukewarm water every 3–4 hours for the first few days. Oatmeal bath products, available at supermarkets and drugstores, can help to relieve itching. (Baths do not spread the rash. )
- Pat (don’t rub) the body dry.
- Put calamine lotion on itchy areas (but don’t use it on the face, especially near the eyes).
- Ask your doctor or pharmacist about pain-relieving creams to apply to sores in the genital area.
- Ask the doctor about using over-the-counter medicine to take by mouth for itching.
To prevent scratching:
- Put mittens or gloves on your child’s hands to avoid scratching during sleep.
- Trim fingernails and keep them clean.
If your child has blisters in the mouth:
- Give cold, soft, bland foods because chickenpox in the mouth can make it hard to drink or eat. Avoid anything acidic or salty, like orange juice or pretzels.
- Give your child acetaminophen to help relieve pain.
Never give aspirin to kids with chickenpox. It can lead to a serious illness called Reye syndrome.
When Should I Call the Doctor?
Most chickenpox infections don’t need special medical treatment. But sometimes, problems can happen. Call the doctor if your child:
- has a fever that lasts for more than 4 days
- has a severe cough or trouble breathing
- has an area of rash that leaks pus (thick, yellowish fluid) or becomes red, warm, swollen, or sore
- has a severe headache
- is very drowsy or has trouble waking up
- has trouble looking at bright lights
- has trouble walking
- seems confused
- is vomiting
- seems very ill
- has a stiff neck
Chickenpox | Johns Hopkins Medicine
What is chickenpox?
Chickenpox is a common childhood disease. It causes an itchy, blistering rash and is easily spread to others.
Until the varicella vaccine was licensed in 1995, chickenpox infection was very common. Almost everyone had been infected as a child. Now a vaccine is available to prevent chickenpox. Two doses of the vaccine are recommended for children, teens, and nonimmune adults.
What causes chickenpox?
The disease is caused by the varicella-zoster virus. It is easily passed from person-to-person by direct contact or through the air by coughing or sneezing.
Who is at risk for chickenpox?
Any child or adult who has never had chickenpox or been vaccinated against it is at risk for getting the disease.
Chickenpox is passed from person-to-person by direct contact or through the air by coughing and sneezing. It can also be spread by being exposed to the fluid from the blistering rash. Once exposed, symptoms usually appear within a couple of weeks. But it may take as few as 10 and as many as 21 days for the chickenpox to develop.
Chickenpox is contagious for 1 to 2 days before the rash starts and until the blisters have all dried and become scabs. The blisters usually dry and become scabs within 5 to 7 days of the onset of the rash. Children should stay home and away from other children until all of the blisters have scabbed over. It is important that people who are infected avoid those with weak immune systems, such as those with organ transplants, HIV, or those getting cancer treatment.
Family members who have never had chickenpox have a high chance of becoming infected when another family member in the house is infected. The illness is often more severe in adults compared to children.
Most people who have had chickenpox will be immune to the disease for the rest of their lives. However, the virus remains inactive in nerve tissue and may reactivate later in life causing shingles. Very rarely, a second case of chickenpox does happen. Blood tests can confirm immunity to chickenpox in people who are unsure if they have had the disease.
What are the symptoms of chickenpox?
Symptoms are usually mild in children. But symptoms may be life-threatening to adults and people of any age with weak immune systems. However, each person may experience symptoms differently. Symptoms may include:
- Fatigue and irritability one to two days before the rash begins
- Itchy rash on the trunk, face, scalp, under the armpits, on the upper arms and legs, and inside the mouth. The rash appears in several crops. It starts as flat red spots and progresses to raised red bumps that then become blisters.
- Feeling ill
- Decreased appetite
The initial symptoms of chickenpox may resemble other infections. Once the skin rash and blisters happen, it is usually obvious to a healthcare provider that it is chickenpox. If a person who has been vaccinated against the disease is exposed, he or she may get a milder illness with less severe rash and mild or no fever. Always talk with your healthcare provider for a diagnosis.
How is chickenpox diagnosed?
The rash of chickenpox is unique. Diagnosis can usually be made on the appearance of the rash and a history of exposure.
How is chickenpox treated?
Specific treatment for chickenpox will be determined by your healthcare provider based on:
- Your overall health and medical history
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
Treatment for chickenpox may include:
- Acetaminophen (to reduce fever). Children with chickenpox should NEVER be given aspirin.
- Skin lotion (to relieve itchiness)
- Antiviral drugs (for severe cases)
- Bed rest
- Drinking plenty of fluids (to prevent dehydration)
- Cool baths with baking soda (to relieve itching)
Children should not scratch the blisters because it could lead to secondary bacterial infections. Keep fingernails short to decrease the likelihood of scratching.
What are the complications of chickenpox?
Complications can happen from chickenpox. They are more common in adults and people with weak immune systems. Complications may include:
- Secondary bacterial infections
- Pneumonia (lung infections)
- Encephalitis (inflammation of the brain)
- Cerebellar ataxia (defective muscular coordination)
- Transverse myelitis (inflammation along the spinal cord)
- Reye syndrome. This is a serious condition marked by a group of symptoms that may affect all major systems or organs. Do not give aspirin to children with chickenpox. It increases the risk for Reye syndrome.
When should I call my healthcare provider?
If your symptoms get worse or you have new symptoms, call your healthcare provider. You should tell your provider as quickly as possible if you get these symptoms:
- A fever that lasts longer than 4 days or goes above 102°F (38.8°C)
- The rash becomes more red or warm and tender, and has pus
- A change in mental status, such as confusion or extreme sleepiness
- Having problems walking
- Stiff neck
- Having problems with breathing or a frequent cough
- Frequent vomiting
Key points about chickenpox
- Chickenpox is a common childhood illness. It is easily spread to others.
- There is a vaccine available to prevent chickenpox.
- Symptoms are usually mild in children. They may be life-threatening to adults and people of any age with weak immune systems.
- The rash of chickenpox is unique and the diagnosis can usually be made on the appearance of the rash and a history of exposure.
- Treatment helps reduce fever and itchiness of rash. Children with chickenpox should NEVER be given aspirin.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
Varicella Zoster – StatPearls – NCBI Bookshelf
Continuing Education Activity
Chickenpox or varicella is a contagious disease caused by the varicella-zoster virus (VZV). The virus is responsible for chickenpox (usually primary infection in non-immune hosts) and herpes zoster or shingles (following reactivation of latent infection). Chickenpox results in a skin rash that forms small itchy blisters which scab over. This activity describes the cause, presentation, and pathophysiology of chickenpox and highlights the role of the interprofessional team in the treatment and prevention of this infection.
Identify the etiology of chickenpox.
Review the presentation of chickenpox.
Outline the treatment and management options available for chickenpox.
Explain interprofessional team strategies for improving care coordination and outcomes in patients with chickenpox.
Access free multiple choice questions on this topic.
Chickenpox or varicella is a contagious disease caused by the varicella-zoster virus (VZV). The virus is responsible for chickenpox (usually primary infection in non-immune hosts) and herpes zoster or shingles (following reactivation of latent infection). Chickenpox results in a skin rash that forms small, itchy blisters, which scabs over. It typically starts on the chest, back, and face then spreads. It is accompanied by fever, fatigue, pharyngitis, and headaches which usually last five to seven days. Complications include pneumonia, brain inflammation, and bacterial skin infections. The disease is more severe in adults than in children. Symptoms begin ten to 21 days after exposure, but the average incubation period is about two weeks.
Chickenpox is a worldwide, airborne disease that is spread by coughing and sneezing, and also by contact with skin lesions. It may start to spread one to two days before the rash appears until all lesions are crusted over. Patients with shingles may spread chickenpox to those who are not immune through blister contact. The disease is diagnosed based on the presenting symptoms and confirmed by polymerase chain reaction (PCR) testing of the blister fluid or scabs. Tests for antibodies may be performed to determine if immunity is present. Although reinfections by varicella may occur, these reinfections are usually asymptomatic and much milder than the primary infection.
The varicella vaccine was introduced in 1995 and has resulted in a significant decrease in the number of cases and complications. It prevents about 70% to 90% of infections and 95% of severe disease. Routine immunization of children is recommended. Immunization within three days of exposure may still improve outcomes in children. 
Chickenpox or varicella is caused by the varicella-zoster virus (VZV), a herpesvirus with worldwide distribution. It establishes latency after primary infection, a feature unique to most herpes viruses. 
It is acquired by inhalation of infected aerosolized droplets. This virus is highly contagious and can spread rapidly. The initial infection is in the mucosa of the upper airways. After 2-6 days, the virus enters the circulation and another bout of viremia occurs in 10-12 days. At this time the characteristic vesicle appears. IgA, IgM, and IgG antibodies are produced but it is the IgG antibodies that confer life long immunity. After the primary infection, varicella localized to sensory nerves and may reactivate later to produce shingles.
Varicella occurs in all countries and is responsible annually for about 7000 deaths. In temperate countries, it is a common disease of children, with most cases occurring during the winter and spring. In the United States, it accounts for more than 9000 hospitalizations annually. Its highest prevalence is in the 4 to 10-year-old age group. Varicella has an infection rate of 90%. Secondary cases in household contacts tend to have more severe disease than primary cases. In the tropics, varicella tends to occur in older people and may cause more serious disease. Adults will get deep pock marks and more prominent scars.
Exposure causes the production of host immunoglobulin G, M, and A. IgG antibodies persist for life and confer immunity. Cell-mediated immune responses are important in limiting the duration of primary varicella infection. After primary infection, it is theorized varicella spreads to mucosal and epidermal lesions to local sensory nerves. It then remains latent in the dorsal ganglion cells of the sensory nerves. The immune system keeps the virus in check but reactivation can still occur later in life and results in the clinically distinct syndrome of herpes zoster (shingles), postherpetic neuralgia, and sometimes Ramsay Hunt syndrome type II. Varicella zoster can harm the arteries in the neck and head, resulting in a stroke.
The United States Advisory Committee on Immunization Practices (ACIP) suggests that all adult older than the age of 60 years old get vaccinated to avoid herpes zoster. One in five adults who had chickenpox as children, especially those who are immune-suppressed, get singles. Shingles are most commonly found in adults older than the age of 60 who were diagnosed with chickenpox before the age of 1.
History and Physical
The prodromal symptoms in adolescents and adults are aching muscles, nausea, decreased appetite, and headache followed by a rash, oral sores, malaise, and a low-grade fever. Oral manifestations may precede the skin rash. In children, the illness may not be preceded by prodromal symptoms, and the initial sign could be a rash or oral cavity lesions. The rash begins as small red dots on the face, scalp, torso, upper arms and legs. Over the next ten to 12 hours it progresses to small bumps, blisters, and pustules; and eventually umbilication and scabs formation. Of note, the rash of chickenpox occur in crops and are typically at different stages of evolution.
At the blister stage, intense pruritus is present. Blisters may occur on the palms, soles, and genital area. Commonly, visible evidence develops in the oral cavity and tonsil areas in the form of small ulcers which can be painful and itchy; this enanthem may precede the external exanthem by one to three days. These symptoms appear ten to 21 days after exposure. Adults may have a more widespread rash and longer fever, and they are more likely to develop pneumonia, the most important complication in adults.
Because watery nasal discharge containing live virus precedes exanthems by one to two days, the infected person is contagious one to two days before recognition of the disease. In the majority of cases, the infection resolves itself within two to four weeks.
A common complication is a secondary bacterial infection that can present as cellulitis, impetigo or erysipelas.
Disseminated primary varicella is usually seen in immunocompromised individuals and carries a very high mortality. CNS complications are rare but may present as Guillain barre syndrome or encephalitis.
Primary varicella infection during pregnancy can also affect the fetus, who may present later with chickenpox. In addition, the virus also has the potential to cause the varicella congenital syndrome.
The diagnosis of varicella infection is primarily based on the signs and symptoms. Confirmation is by examination of the fluid within the vesicles, scraping of lesions that have not crusted or by blood for evidence of an acute immunologic response. Polymerase chain reaction (PCR) has the highest yield and can be utilized for non-skin samples such as bronchoalveolar lavage sample and cerebrospinal fluid. Direct fluorescent antibody testing has largely replaced the Tzanck test. The vesicular fluid can also be cultured, but the yield is low compared to PCR. Blood tests are used to identify a response to acute infection (IgM), previous infection, and subsequent immunity (IgG). Prenatal diagnosis of fetal varicella can be performed using ultrasound, though a delay of 5 weeks following primary maternal infection is advised. A PCR (DNA) test of the amniotic fluid can be performed, though the risk of spontaneous abortion due to amniocentesis is higher than the risk of the baby developing fetal varicella. 
Treatment / Management
Treatment is symptomatic relief of symptoms. As a protective measure, those infected are usually required to stay at home while they are infectious. Keeping nails short and wearing gloves may prevent scratching and reduce the risk of secondary infections. 
Topical calamine lotion may relieve pruritus. Daily cleansing with warm water will help avoid secondary bacterial infection. Acetaminophen may be used to reduce fever. Avoid aspirin as it may cause Reye syndrome. People at risk of developing complications and who have had significant exposure may be given intramuscular varicella-zoster immune globulin, a preparation containing high titers of antibodies to varicella-zoster virus, to help prevent the disease. 
In children, acyclovir decreases symptoms by one day if taken within 24 hours of the start of the rash, but it has no effect on complication rates, and it is not recommended for individuals with normal immune function.
In adults, infection tends to be more severe, and treatment with antiviral drugs (acyclovir or valacyclovir) is advised if they can be started within 24 to 48 hours of rash onset. Supportive care such as increasing water intake and the use of antipyretics and antihistamines are an important part of the management. Antivirals are typically indicated in adults, including pregnant women because this group is more prone to complications. The preferred treatment is usually oral therapy, but for immunocompromised patients, intravenous antivirals are indicated.
The varicella-zoster immunoglobulin is used to manage patients who are immunocompromised. In addition, a live attenuated vaccine has been available since 1995. There is high seroconversion following the vaccine which is long lasting. Adverse effects of the vaccine are rare.
In healthy children, the prognosis is excellent. However, in immunocompromised individuals, the infection has high morbidity.
Pearls and Other Issues
Chickenpox is rarely fatal. Non-immune pregnant women and those immunocompromised are at highest risk. Arterial ischemic stroke associated with childhood chickenpox is a significant risk. Varicella pneumonia is the most common cause of fatality in adults (10% to 30%), and in those requiring mechanical ventilation, this may reach 50%.
In pregnant women, antibodies produced as a result of immunization or previous infection are transferred via the placenta to the fetus. Varicella infection in pregnant women could spread via the placenta and infect the fetus. If infection occurs during the first 28 weeks of pregnancy, congenital varicella syndrome may develop. Effects on the fetus can include underdeveloped toes and fingers, structural eye damage, neurological disorder, and anal and bladder malformation.
If maternal infection occurs seven days before delivery and up to eight days following birth, the baby may develop neonatal varicella with presentation ranging from mild rash to disseminated infection. Newborns who develop symptoms are at a high risk of pneumonia and other serious complications.
Maternal herpes zoster, on the other hand, constitutes little risk of neonatal complications or congenital varicella syndrome probably because of established circulating maternal antibodies.
Enhancing Healthcare Team Outcomes
Chickenpox is usually acquired after inhalation of aerosolized droplets from an infected individual. The majority of cases occurring in children less than 10. The key to lowering the morbidity of chickenpox is via education. Besides the primary caregiver, the nurse practitioner and pharmacist play a vital role in patient education. The parents of infected children should be told to trim the child’s fingernails to avoid or minimize skin damage and the associated bacterial infections. Further, parents should be told not to give aspirin to young children to control fever, because of the risk of developing Reye syndrome. Finally, the parents should be told to apply cold compresses and keep the skin moisturized to prevent the itching and dryness. All clinicians should urge parents to get their children vaccinated because this can prevent the morbidity associated with the infection. The vaccine is safe and very effective. Children who are immunocompromised should be referred to an infectious disease specialist for further management. (Level V) Clinicians should also educate pregnant women who are seronegative for chickenpox to avoid contacts with patients with an active infection. All pregnant women who develop chickenpox must be managed by a team of specialists who can make a decision regarding treatment.
For most children who develop chickenpox, the outcome is excellent. However, in immunocompromised individuals, there is increased morbidity and mortality. (Level V)
Chickenpox (Varicella). Contributed by the Center for Disease Control and Prevention (CDC)
- Shrim A, Koren G, Yudin MH, Farine D. No. 274-Management of Varicella Infection (Chickenpox) in Pregnancy. J Obstet Gynaecol Can. 2018 Aug;40(8):e652-e657. [PubMed: 30103889]
- Pereira L. Congenital Viral Infection: Traversing the Uterine-Placental Interface. Annu Rev Virol. 2018 Sep 29;5(1):273-299. [PubMed: 30048217]
- Kasabwala K, Wise GJ. Varicella-zoster virus and urologic practice: a case-based review. Can J Urol. 2018 Jun;25(3):9301-9306. [PubMed: 29900816]
- Al-Turab M, Chehadeh W. Varicella infection in the Middle East: Prevalence, complications, and vaccination. J Res Med Sci. 2018;23:19. [PMC free article: PMC5961286] [PubMed: 29887897]
- Rice ME, Bannerman M, Marin M, Lopez AS, Lewis MM, Stamatakis CE, Regan JJ. Maritime varicella illness and death reporting, U.S., 2010-2015. Travel Med Infect Dis. 2018 May – Jun;23:27-33. [PMC free article: PMC6624850] [PubMed: 29621623]
- Schmader K. Herpes Zoster. Clin Geriatr Med. 2016 Aug;32(3):539-53. [PubMed: 27394022]
- Bakker KM, Martinez-Bakker ME, Helm B, Stevenson TJ. Digital epidemiology reveals global childhood disease seasonality and the effects of immunization. Proc Natl Acad Sci U S A. 2016 Jun 14;113(24):6689-94. [PMC free article: PMC4914188] [PubMed: 27247405]
- Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018 Apr;41(2):95-105. [PubMed: 29498740]
- Dayan RR, Peleg R. Herpes zoster – typical and atypical presentations. Postgrad Med. 2017 Aug;129(6):567-571. [PubMed: 28540752]
- Inata K, Miyazaki D, Uotani R, Shimizu D, Miyake A, Shimizu Y, Inoue Y. Effectiveness of real-time PCR for diagnosis and prognosis of varicella-zoster virus keratitis. Jpn J Ophthalmol. 2018 Jul;62(4):425-431. [PubMed: 29948430]
- Onyango CO, Loparev V, Lidechi S, Bhullar V, Schmid DS, Radford K, Lo MK, Rota P, Johnson BW, Munoz J, Oneko M, Burton D, Black CM, Neatherlin J, Montgomery JM, Fields B. Evaluation of a TaqMan Array Card for Detection of Central Nervous System Infections. J Clin Microbiol. 2017 Jul;55(7):2035-2044. [PMC free article: PMC5483905] [PubMed: 28404679]
- Harrington D, Haque T. Varicella Zoster Immunoglobulin G (VZIG)-Do current guidelines advocate overuse? J Clin Virol. 2018 Jun;103:25-26. [PubMed: 29609167]
- Poole CL, James SH. Antiviral Therapies for Herpesviruses: Current Agents and New Directions. Clin Ther. 2018 Aug;40(8):1282-1298. [PMC free article: PMC7728158] [PubMed: 30104016]
- Hayward K, Cline A, Stephens A, Street L. Management of herpes zoster (shingles) during pregnancy. J Obstet Gynaecol. 2018 Oct;38(7):887-894. [PubMed: 29565203]
- Ogunjimi B, Van den Bergh J, Meysman P, Heynderickx S, Bergs K, Jansens H, Leuridan E, Vorsters A, Goossens H, Laukens K, Cools N, Van Tendeloo V, Hens N, Van Damme P, Smits E, Beutels P. Multidisciplinary study of the secondary immune response in grandparents re-exposed to chickenpox. Sci Rep. 2017 Apr 24;7(1):1077. [PMC free article: PMC5430877] [PubMed: 28439065]
- Ogunjimi B, Van Damme P, Beutels P. Herpes Zoster Risk Reduction through Exposure to Chickenpox Patients: A Systematic Multidisciplinary Review. PLoS One. 2013;8(6):e66485. [PMC free article: PMC3689818] [PubMed: 23805224]
- Meylan P, Gerber S, Kempf W, Nadal D., Swiss Herpes Management Forum. [Swiss recommendations for the management of varicella-zoster virus infections]. Rev Med Suisse. 2007 Sep 19;3(125):2116-22, 2124-9. [PubMed: 17939531]
- Wang X, Zhang X, Yu Z, Zhang Q, Huang D, Yu S. Long-term outcomes of varicella zoster virus infection-related myelitis in 10 immunocompetent patients. J Neuroimmunol. 2018 Aug 15;321:36-40. [PubMed: 29957386]
- McRae JE, Quinn HE, Macartney K. Paediatric Active Enhanced Disease Surveillance (PAEDS) annual report 2015: Prospective hospital-based surveillance for serious paediatric conditions. Commun Dis Intell Q Rep. 2017 Sep 01;41(3):E264-E278. [PubMed: 29720076]
- Dommasch ED, Joyce CJ, Mostaghimi A. Trends in Nationwide Herpes Zoster Emergency Department Utilization From 2006 to 2013. JAMA Dermatol. 2017 Sep 01;153(9):874-881. [PMC free article: PMC5710426] [PubMed: 28636704]
Chickenpox: Symptoms, Causes, Treatments
What is chickenpox?
Chickenpox is a common illness caused by a virus (germ) called varicella zoster. People often get the virus as young children if they have not been vaccinated against it. A child with chickenpox can easily give the virus to other children. Almost all children catch chickenpox but few develop any serious problems. Chickenpox today is much less common because most children are vaccinated when they are young.
Once you have had chickenpox, you will not catch it again from another person. Adults who get chickenpox may become very sick, so it’s better to have chickenpox when you are a child, or prevent getting it by being vaccinated.
How is chickenpox spread?
Children can get chickenpox at any age. After being exposed to chickenpox, your child may appear to be fine for one to three weeks before feeling sick. Children can spread the virus from one day before they show signs of illness to about five days after a skin rash appears.
The virus is spread by:
- Coming in contact with someone who has chickenpox
- Breathing air from an infected person who sneezes or coughs
- Coming in contact with fluids from an infected child’s eyes, nose or mouth
Symptoms and Causes
What are the symptoms of chickenpox?
Signs of chickenpox are easy to see. Healthcare providers often can look at a child’s skin and know if he or she has chickenpox. Signs of chickenpox usually happen in the following order:
- Fever, feeling tired, headache
- A stomachache that lasts for one or two days
- A skin rash that is very itchy and looks like many small blisters
- Bumps filled with a liquid that looks like milky water
- Scabs after the blisters break
- Skin that looks blotchy
- Spots that fade away
Diagnosis and Tests
How is chickenpox diagnosed?
Signs of chickenpox are easy to see. Healthcare providers often can look at a child’s skin and know if he or she has chickenpox.
Management and Treatment
How can I help my child get well?
Make sure your child gets plenty of rest and fluids. Chickenpox will go away on its own in a week or two. To help your child feel less itchy, you can:
- Press a cool, moist rag on the rash.
- Keep your child cool.
- Encourage your child not to scratch. Trim the fingernails so he or she can’t scratch.
- Put a lotion with antihistamines on the rash. These lotions can be bought at the drugstore. If you don’t know what to buy, ask the pharmacist for help.
- Give your child an over-the-counter pill form of antihistamine. Benadryl® is one example.
- Give your child a cool bath or shower every day. You can also give your child an oatmeal bath.
Don’t give your child aspirin. Aspirin can harm children who have fevers. If you must give your child a pain killer, use acetaminophen (such as Tylenol®). If you are not sure what pain killer to use, ask your healthcare provider or pharmacist.
To prevent dehydration, give your child fluids. Cold fluids and a soft bland diet will help if he or she has mouth sores.
What if my baby gets chickenpox?
If your newborn baby (up to age 3 months) gets chickenpox, let your healthcare provider know right away.
What complications are possible with chickenpox?
- Bacterial infections of the skin, blood, and soft tissues
- Becoming dehydrated
- Blood clotting or healing issues
- Liver problems
Who is more likely to have complications from chickenpox?
Healthy people who get chickenpox do not usually have complications. However, having a severe case of chickenpox could be more dangerous for very young babies, teenagers, pregnant women and people with immunity issues, such as transplant patients. This group also includes people with cancer or HIV or people being treated with chemotherapy or steroids.
Can my child get a shot to prevent chickenpox?
A vaccine for chickenpox is available and recommended. Ask your healthcare provider about the vaccine.
What should I know about the chickenpox vaccine?
Two doses are recommended. In children under the age of 13, one dose should be given between the ages of 12 and15 months, while the other is given at the age of 4-6 years.
If you are 13 or older and never got the vaccine, you should get two doses at least 28 days apart.
There is a vaccine that is only for chickenpox called Varivax®. There is another called ProQuad® that protects against measles, mumps, rubella and varicella (MMRV).
Who should not get the chickenpox vaccine?
- People who are allergic to the vaccine or to any part of the vaccine
- Pregnant women or women who think they might be pregnant
- People with immune system problems
- People with tuberculosis
- People who do not feel well (Get the vaccine when you feel better.)
- People who have recently had a blood transfusion or any other live vaccines
Outlook / Prognosis
Can adults get chickenpox?
When children get chickenpox, their bodies fight the illness by making a substance called antibodies. The antibodies fight the virus and help the body get well. These antibodies stay in the body throughout an adult’s life. If an adult comes in contact with the virus, the antibodies are there to fight the germ.
Rarely, adults get chickenpox even though they’ve already had it. When the chickenpox virus in an adult becomes active again, the illness that results is called “shingles.” People “catch” shingles from their own chickenpox virus. People with shingles can spread chickenpox to people who have not had chickenpox.
What are shingles?
Shingles also looks like a rash of small bumps. It can be painful and can take longer to heal. Shingles will usually go away on its own in a week or two.
Is there a vaccine for shingles?
A new shingles vaccine is now available. This product is called Shingrix® (recombinant zoster vaccine. Shingrix is given as a shot in the arm. You should have two shots that are given 2-6 months apart. The vaccine is only a preventive therapy and is not a treatment for those who have already developed shingles. However, if you have had shingles, you can still get the vaccine to prevent further outbreaks.
Due to high levels of demand for GSK’s Shingrix vaccine, providers should anticipate ordering limits and intermittent shipping delays for Shingrix. It is anticipated order limits and shipping delays will continue throughout 2019. GSK increased the US supply available for 2018 and plans to make even more doses available in the US in 2019. Additionally, GSK will continue to release doses to all customer types on a consistent and predictable schedule during 2019.
Who should be vaccinated with Shingrix?
This vaccine is recommended for those 50 years of age and older who are in decent health.
You should get the Shingrix vaccine even if:
- You have had shingles already
- You have been vaccinated with an older vaccine called Zostavax® (zoster vaccine live), but you should wait at least 8 weeks after having Zostavax.
- You do not know for sure if you have ever had chickenpox
Who should not be vaccinated with Shingrix?
- People who have ever had a severe allergy to this vaccine or any part of this vaccine
- Women who are breastfeeding or pregnant
- People who are somewhat ill or very ill
When should you call your healthcare provider if your child has chickenpox?
Call your healthcare provider if your child:
- Is acting ill, with a severe headache
- Has sores in the eyes
- Has sores that get bigger or have pus in them
- Has difficulty breathing or is breathing very fast
When can my child go back to school?
Your child can go back to school seven days after the rash appears. It is not necessary to wait for the scabs to heal.
Where can I learn more about chickenpox and vaccines?
Call your local public health department or contact the following:
National Immunization Program
Centers for Disease Control
Chickenpox (varicella zoster infection)
Last Reviewed: January 2014
What is chickenpox?
Chickenpox is a highly contagious illness caused by the varicella-zoster virus (VZV), a type of herpes virus. It is often a mild illness, characterized by an itchy rash on the face, scalp and trunk with pink spots and tiny fluid-filled blisters that dry and become scabs four to five days later. Serious complications, although rare, can occur mainly in infants, adolescents, adults and persons with a weakened immune system. These complications include bacterial infections of skin blisters, pneumonia, and encephalitis (inflammation of the brain). In temperate climates, such as the Northeast, chickenpox occurs most frequently in the late winter and early spring.
Who gets chickenpox?
Chickenpox is a common childhood illness with 90 percent of the cases occurring in children younger than ten years of age. Before the availability of the varicella vaccine in the U.S., almost everyone developed chickenpox. Most people who are vaccinated will not get chickenpox. Those who are vaccinated and develop chickenpox usually have a mild form of the illness. They have fewer spots and recover faster.
How is chickenpox spread?
Chickenpox is transmitted from person to person by directly touching the blisters, saliva or mucus of an infected person. The virus can also be transmitted through the air by coughing and sneezing. Chickenpox can be spread indirectly by touching contaminated items freshly soiled, such as clothing, from an infected person. Direct contact with the blisters of a person with shingles can cause chickenpox in a person who has never had chickenpox and has not been vaccinated. Blisters that are dry and crusted are no longer able to spread chickenpox.
What are the symptoms of chickenpox?
Initial symptoms include sudden onset of slight fever and feeling tired and weak. These are soon followed by an itchy blister-like rash. The blisters eventually dry, crust over and form scabs. The blisters tend to be more common on covered than on exposed parts of the body. They may appear on the scalp, armpits, trunk and even on the eyelids and in the mouth. Mild or asymptomatic infections occasionally occur in children. The disease is usually more serious in young infants and adults than in children.
How soon do symptoms appear?
Symptoms commonly appear 14 to 16 days (range of ten to 21 days) after exposure to someone with chickenpox or herpes zoster (shingles).
What are the complications associated with chickenpox?
Newborn children (less than one month old) whose mothers are not immune may suffer severe, prolonged or fatal chickenpox. Any person with a weakened immune system, including those with cancer, human immunodeficiency virus (HIV) or taking drugs that suppress the immune system, may have an increased risk of developing a severe form of chickenpox or shingles.
Reye Syndrome is an unusual complication of chickenpox that is linked to children who take aspirin or aspirin-containing products during the illness. Reye Syndrome is a severe disease affecting all organ systems, but, most seriously the brain and liver and may be fatal. The exact cause of Reye Syndrome is unknown. Aspirin or aspirin-containing products should never be given to children under 18 years of age with chickenpox.
When and for how long is a person able to spread chickenpox?
A person is most able to transmit chickenpox from one to two days before the rash appears until all the blisters are dry and crusted. People with a weakened immune system may be contagious for a longer period of time.
Is there a treatment for chickenpox?
Acyclovir is approved for treatment of chickenpox. However, because chickenpox tends to be mild in healthy children, most physicians do not feel that it is necessary to prescribe acyclovir. Acyclovir can be considered for otherwise healthy people who are at risk of moderate to severe varicella. It is important to consult with your physician for recommendations on the use of acyclovir.
Does past infection with chickenpox make a person immune?
Most people do not get chickenpox more than once. However, since varicella-zoster virus remains in the body after an initial infection, infection can return years later in the form of shingles in some older adults and sometimes in children.
Is there a vaccine for chickenpox?
A vaccine to protect children against chickenpox was first licensed in 1995. Children who have never had chickenpox should routinely be administered two doses of varicella vaccine with the first dose at 12 to 15 months and the second dose at four to six years of age. Persons 13 years of age and older who have never had chickenpox or have not received the varicella vaccine should get two doses of the varicella vaccine at least 28 days apart.
The varicella vaccine may be given along with the measles-mumps-rubella (MMR) vaccine in a combination called measles-mumps-rubella-varicella (MMRV) that is approved for use in children 12 months through 12 years of age.
In New York State, varicella vaccine is required for children enrolled in pre-kindergarten programs and schools. Vaccination is recommended for healthcare personnel and college students who have never had chickenpox.
What can be done to prevent the spread of chickenpox?
Maintaining high levels of varicella immunization in the community is critical to controlling the spread of chickenpox. To prevent further spread of chickenpox, people infected with the disease should remain home and avoid exposing others who are susceptible. Infected persons should remain home until the blisters become dry and crusted. It is very important to avoid exposing non-immune newborns and persons with a weakened immune system to chickenpox.
Varicella vaccination is recommended for outbreak control. During an outbreak, persons who do not have adequate evidence of immunity should receive their first or second dose as appropriate.
In 2006, a new product called VariZIG™ became available to protect patients without evidence of immunity to varicella who are at high risk for severe disease and complications and have been exposed to chickenpox. The patient groups recommended to receive VariZIG include those with a weakened immune system, pregnant women, newborns whose mothers have symptoms of varicella around the time of delivery (five days before to two days after delivery) and certain premature infants exposed to chickenpox as newborns.
Chickenpox (Varicella) Condition, Treatments, and Pictures for Parents – Overview
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Images of Varicella (Chickenpox)
Chickenpox (varicella) is an infectious disease caused by the varicella-zoster virus that goes away on its own. Infection spreads among humans through fluids from the airways, such as from coughing and sneezing, with non-infected household members at high risk of becoming infected as well. The development (incubation) period is 14–16 days, and the first sign of disease is a rash. People are considered contagious for 2–5 days before the onset of skin lesions and for 6 days after the last series of rashes have appeared.
The most common complication is infection of lesions with bacteria. Rare complications include lung infection (pneumonia) or brain infection (encephalitis). Children who have weak immune systems, eczema, or recent sunburns have more severe symptoms. Because the virus remains resting (latent) in the parts of nerves that are near the spinal cord (nerve roots) for life, about 1 in 10 adults will get shingles (zoster) when the virus reappears, usually under conditions of stress to the body.
After having chickenpox, a person is usually immune for life, although reinfection is possible.
Who’s at risk?
Chickenpox occurs most commonly in children under 10. Those under 1 year of age (whose mothers have had chickenpox before) are not usually infected, as they still have some immunity from their mother’s antibodies, which were transferred to them before birth.
The chickenpox vaccine has been part of routine childhood vaccinations (at age 12–18 months) since 1995, but many children have still not been vaccinated. About 85% of children who have been vaccinated avoid infection, but even if they do show symptoms, they are generally mild. Most infections occur from March to May.
Signs and Symptoms
Most children act sick with fever and vague symptoms (loss of appetite, headache, belly ache) for 1–2 days before they start to break out with a rash. These symptoms last for 2–4 days after the rash appears.
An early pink-to-red, flat, small spot rapidly becomes bumpy and then blisters with a surrounding halo of redness. The spots usually appear first on the trunk or scalp. Linings of body cavities, such as the mouth or nose (mucous membranes), palms, and soles, can have a few lesions. The average child develops a few hundred blisters, most of which heal without leaving scars. A child who has had the chickenpox vaccine will have far fewer lesions.
The blister is usually described as looking like a dewdrop on a rose petal. The blister area (vesicle) is thin-walled and easily broken. Blisters become cloudy and then crust over, with healing completed within 1–3 weeks. Lesions often occur in 3 or more successive series (crops). Lesions in different stages of development may occur at the same time.
Since the illness resolves on its own after 1–3 weeks, it is most important to keep the child comfortable and to discourage scratching, which can cause infection and scars.
- Oatmeal baths in lukewarm water
- Oral antihistamines (diphenhydramine, chlorpheniramine)
- Clip the child’s fingernails
- Apply calamine lotion
- DO NOT USE lotions containing antihistamines or lidocaine, as they are no more effective than the previous measures and might cause allergic reactions later on.
For pain and fever:
- DO NOT USE aspirin in children aged 18 years or younger. Use acetaminophen (Tylenol) or ibuprofen instead.
Because chickenpox is highly contagious, keep the child at home and resting until symptoms are gone and all blisters are dried up. Avoid any contact between your child and pregnant women who have never had chickenpox, newborns, or people who have a weak immune system or eczema. Once all the blisters have dried up into scabs, the child is not considered contagious to others.
When to Seek Medical Care
Most infections do not require treatment.
If there are adults or teens in the household who have never had chickenpox or people with eczema, asthma, or a weakened immune system, have them contact their doctor, as they may require antiviral medication. This usually needs to be done early (during the first day of the rash).
Call your child’s doctor if:
- He or she has eczema, asthma, or a weakened immune system.
- The fever lasts more than 4 days or exceeds 102 degrees Fahrenheit.
- Any rash areas look red, swollen, and leak pus.
- He or she has a severe cough, vomiting, headache, drowsiness, confusion, stiff neck, trouble looking at bright lights, or difficulty walking or breathing.
Treatments Your Physician May Prescribe
Antiviral medication may be given if the child is seen early (during the first day of the rash) for children at higher risk for more severe chickenpox infection (those with asthma, eczema, recent sunburn, children taking corticosteroids on a regular basis, and those with weak immune systems).
MedlinePlus: ChickenpoxClinical Information and Differential Diagnosis of Varicella (Chickenpox)
Bolognia, Jean L., ed. Dermatology, pp.1241-1243. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.2070, 2080-2081, 2434-2437. New York: McGraw-Hill, 2003.
Chickenpox versus shingles—What’s the difference?
Did you know? The same virus that causes chickenpox also causes shingles. Although shingles and chickenpox are caused by the same virus, they are not the same illness. Chickenpox is usually a milder illness that affects children. Shingles results from a reactivation of the virus long after the chickenpox illness has disappeared.
The chickenpox virus stays in the body even after recovery. Later in life, the virus can reactivate and cause shingles. If you have shingles, you can spread the varicella virus to people who have never had chickenpox or never received the chickenpox vaccine. These people will develop chickenpox, not shingles. It takes from 10 to 21 days after exposure to chickenpox or shingles for someone to develop chickenpox.
What are the symptoms?
- Initial symptoms include sudden onset of fever, headache, and feeling tired.
- An itchy blister-like rash, usually starting on the face, chest or back, follows 1-2 days later.
- The rash then spreads to the rest of the body, and new blisters continue to appear for about 3-4 days.
- Generally, within 1 week, the blisters dry out and scabs form and fall off.
Shingles (Herpes Zoster)
- The first sign is often a tingling feeling on the skin, itchiness, or a stabbing pain.
- After several days, a rash appears, beginning as a band or patch of raised dots on the side of the trunk or face or other areas of the body.
- It then develops into small, fluid-filled blisters which begin to dry out and crust over within a few days.
- When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain.
- The rash and pain usually disappear within 3-5 weeks.
How contagious is it?
Chickenpox is very contagious. The virus can spread by breathing in the viral particles that come from the blisters. It can also be spread by direct contact with the fluid of skin lesions. A person with chickenpox can spread the disease from 1 to 2 days before they get the rash, until all their chickenpox blisters have formed scabs.
Shingles (Herpes Zoster)
Shingles cannot be passed from one person to another. Someone with an infectious shingles rash can spread chickenpox if the other person has never had chickenpox. However, someone with shingles will not cause another person to develop shingles.
Is there a vaccine?
There are two vaccine options:
- Two doses of the varicella vaccine.
- A combination vaccine called MMRV (measles, mumps, rubella, and varicella).
Shingles (Herpes Zoster)
The Centers for Disease Control and Prevention (CDC) recommends that healthy adults 50 years and older get the shingles vaccine.
How can these diseases be prevented?
The best way to prevent chickenpox and shingles is to get vaccinated.
- Avoid direct contact with a person infected with chickenpox or shingles.
- Cover the rash.
- Avoid touching or scratching the rash.
- Clean your hands often.
Prevention of chickenpox | City polyclinic №72
Chickenpox today is one of the most common infections in children after acute respiratory viral infections and intestinal infections and can cause severe complications and even death. The widespread opinion in Russia about safety and even the need to “have chickenpox” is a dangerous delusion caused by a lack of information about the disease.
Chickenpox is an acute infectious disease caused by the Varicella-zoster virus (VZV).This is a virus from the group of herpes viruses that causes disease only in humans. The virus causes two forms of the disease – chickenpox and herpes zoster, or, as they sometimes say, “shingles”. When infected for the first time, a person carries chickenpox, but the body is not cleared of the virus, after recovery, the virus continues to “quietly live” in our body in the cells of the spinal cord (in the ganglia), and when there is a decrease in immunity (either age-related, or as a result of a serious illness, or as a result of taking drugs that suppress the immune system), the virus “revives” causing already herpes zoster.Clinically, this is manifested by rashes along the nerve endings, segmental, mainly on one side, less often on two. One of the leading symptoms is pain syndrome, which is usually intensely burning in nature, intensifies at night.
The source of the virus is a person who is sick with one of the variants of infection, the route of transmission is airborne. The susceptibility reaches 100%, i.e. of those who have been in contact with the patient, almost all fall ill. Patients become infectious in the last 2 days of the incubation period and remain so for 4-5 days after the appearance of the last rash.
Annually in Russia about 750 thousand people fall ill with chickenpox. More than 50% of chickenpox cases occur between the ages of 5 to 9 years, by the age of 7, about 80% of children have the infection. Recently, there has been a “maturation” of chickenpox – already about 10% of diseases occur in children over 15 years of age and adults. In this case, the disease is much more severe (headache, lumbosacral pain, fever, massive rashes and severe itching). In addition, the risk of complications increases!
The most common complication is various skin infections.An itchy rash almost always provokes scratching, the resulting wounds are the entrance gate for opportunistic microflora, which can lead to purulent inflammation of the skin. In most cases, it is not dangerous for life, however, after the healing of such pustules, scars remain on the skin. More serious problems arise when elements of a rash on the mucous membranes of the eyes, mouth, ears, genitals are infected.
As a result, keratitis (corneal opacity) may develop, which can affect visual acuity, stomatitis (lesions of the mucous membranes of the mouth with ulcers), otitis media, vulvitis.In very severe cases, usually in people with immunodeficiency, the mucous membranes of the gastrointestinal tract (rashes, ulcers) may also be affected.
One of the most serious complications of chickenpox is damage to brain tissue (encephalitis). Signs of damage to the nervous system occur both in the period of the rash, on days 2-8 after the onset of the rash, and in later periods. Headache, vomiting, drowsiness appear. The occurrence of seizures, disturbances of consciousness is possible. Gait disturbances are characteristic, children can neither stand nor sit, there is a tremor of the head, chanted speech.The duration of chickenpox encephalitis is from several days to 3-4 weeks. Long-term consequences of the transferred encephalitis occur in about 15% – 25% of patients. The formation of epilepsy, paresis and other symptoms is possible.
The defeat of the respiratory system by the chickenpox virus is unlikely with a normal state of immunity. However, with immunodeficiency of any origin, the so-called chickenpox pneumonia is possible. In addition, a similar complication often occurs with chickenpox in adolescents and adults.Chickenpox pneumonia is a serious complication,
with which most of the deaths in adults and patients from risk groups are associated, but the course of the infection may also be complicated in young children. Respiratory symptoms (cough, shortness of breath, cyanosis, hemoptysis, pain that increases with breathing) usually occur 1-6 days after the onset of the rash. Chickenpox is especially dangerous for pregnant women and newborns. Intrauterine damage to the fetus can lead to congenital chickenpox or neonatal chickenpox, which in 30% of cases leads to the death of the child. “
To date, the most effective method for preventing the spread of chickenpox and preventing the severe course of this infection with possible complications is vaccine prophylaxis.
In the Russian Federation, a live attenuated vaccine is registered and is used, the use of which is possible from 1 year. For the formation of long-term immunity, a double administration is recommended at any age. In some cases, 5-10% of the vaccinated have short-term reactions from the 4th to 15th days after vaccination in the form of fever, malaise, rarely rashes that cannot be compared with the disease itself.If a child or an adult is not vaccinated, but has come into contact with a patient with chickenpox or herpes zoster, within 3 days after contact, you can urgently be vaccinated with a high preventive effect.
Head of the Department of Prevention of Infectious Diseases of the Federal State Budgetary Institution “Children’s Scientific and Clinical Center for Infectious Diseases of the FMBA of Russia”, Professor, Doctor of Medical Sciences Kharit S.M.
Senior Researcher of the Department of Prevention of Infectious Diseases of the Federal State Budgetary Institution Children’s Scientific and Clinical Center for Infectious Diseases of the FMBA of Russia, Ph.D. Fridman I.B.
90,000 Chickenpox (chickenpox) – first signs, questions about treatment
Symptoms, treatment and prevention of chickenpox
Chickenpox or chickenpox is an acute infectious disease that is widespread and affects children aged 6 months to 10 years. There are exceptions when the disease affects older people. Knowing the symptoms of the onset of chickenpox in children will help to take quick remedial measures, shorten the recovery time and prevent possible complications.
Ways of transmission of infection
The disease is caused by the herpes virus, is contagious and is transmitted by airborne droplets or through contact with a patient. If a sick child is identified in a preschool or school institution, quarantine may be declared – for chickenpox in kindergarten, for example, it lasts 3 weeks. The problem lies in the fact that the patient poses a risk of infection to others even before the appearance of obvious signs of the disease. It is this factor that provokes outbreaks of epidemics in institutions.
How long is the incubation period for chickenpox? This period can be 7-21 days, but symptoms never appear earlier than a week or later than three weeks from the moment of infection. The danger to others from a sick person disappears after 7-10 days from the onset of the first signs.
Symptoms of chickenpox in children
How quickly do the signs of chickenpox appear in a child after contact with a sick person? This can occur throughout the entire incubation period of the disease – 1-3 weeks.The beginning is always sharp:
- increase in body temperature to critical values;
- Great weakness, constant drowsiness;
- headaches that appear at regular intervals and are not relieved by pain relievers.
The initial stage of chickenpox looks the same in children and adults, but the latter are more acute – aggressive hyperthermia and semi-fainting general condition. The main symptom of the disease is a characteristic rash – small acne with liquid content, localized mainly on the head and trunk.Most often, the face and scalp, chest and décolleté are affected, less often the buttocks, limbs and perineum. The rash is characterized by severe itching, which is very difficult to tolerate – even if the patient somehow restrains his impulses during the day, then at night he begins to scratch the skin uncontrollably.
The rash appears and spreads very quickly – first a red spot with slight swelling forms, then blisters form on this site, which, as the disease progresses, transforms into sores, crust over and disappear.There is a wave-like course of the infection, so the rash can appear and disappear with frequency.
Treatment and prevention of chickenpox
A lot of questions are asked about the methods of treatment of chickenpox:
- How to treat the skin against itching and rash with chickenpox? This is done with a weak solution of “brilliant green”, fucorcin or Castellani liquid. This is done pointwise, lubricating each bubble, but if the rash is too abundant and drained, then you can smear it all over.This tactic prevents the transformation of rashes into crusty ulcers, making itching less severe.
- Should I give my child antihistamines? This is allowed – ½ tablets of Suprastin or Diazolin will reduce the intensity of itching and inflammation of the blisters. For specific appointments, it is better to consult a pediatrician.
- How to smear rashes in the mouth with chickenpox? Sometimes, especially in young children, the main sign of chickenpox is present on the oral mucosa.Rashes of such localization greatly disturb the patient, he cannot eat, drink liquid, and even talk is difficult for him. Doctors recommend lubricating the bubbles with sea buckthorn oil, chlorophyllipt or Kalgel gel. This will relieve pain and ease the general condition of the patient.
- Do I need to bring down the temperature with drugs? This is done only if the hyperthermia is very disturbing and worsens the patient’s condition. Standard antipyretic drugs will come in handy – Paracetamol, Nurofen.
- Can I wash and walk outside with chickenpox? You can take a shower or bath only after all bubbles and crusts have disappeared, or when they dry out. Exposure to water on the bubbles leads to their bursting, and the crusts soften and disappear, leaving behind scars. You can walk on the street after 10 days from the onset of the rash, or choose deserted places.
- Can I get chickenpox a second time? This happens very rarely, because the immune system produces antibodies immediately after the disease.But there are exceptions – secondary chickenpox is difficult, complications are possible.
- If a pregnant woman gets chickenpox, what should I do? This situation requires constant monitoring by doctors – a woman is placed in an infectious diseases department, her condition is monitored, an ultrasound scan of the fetus is done to detect abnormalities in its development. Complications of chickenpox are dangerous during pregnancy, because the causative agent of the disease is the herpes virus, which provokes violations of the intrauterine development of the unborn baby.In some cases, an artificial termination of pregnancy is performed for medical reasons.
- Can the chickenpox vaccine be given as a child? Such a vaccine exists and is given at the age of over a year. Doctors believe that it is better to get sick with this infection in childhood. The disease is easily tolerated, and scars on the face and other consequences of chickenpox go away without additional medical intervention.
Pediatricians and infectious disease specialists are engaged in the treatment and prevention of chickenpox.It is these doctors who have complete information about the disease, therefore, they will competently consult each patient.
How to treat repeated chickenpox in an adult, get rid of itching and prevent the formation of scars at the site of rashes – you can find out about this on our website Dobrobut.com.
What is important to know about chickenpox?
90,090 In 2017, 1542 cases of chickenpox were registered in the Republic of Altai (in 2016 — 2345 cases). This is an extremely common disease that many children and their parents are familiar with firsthand. But do you know how to behave correctly if someone in your family gets sick with chickenpox?
Which wind brings chickenpox?
Chickenpox, which is also often called “chickenpox”, is an acute infectious disease. The causative agent of infection is unstable in the environment, at low temperatures it lasts for a long time, is resistant to repeated freezing.An increase in the incidence of chickenpox is observed in the autumn-winter period.
In adults, chickenpox is rare, in 80% of the disease occurs among children under 7 years of age.
The source of infection is a sick person. After infection, it begins to be contagious to others 2 days before the onset of the rash and up to the 5th day after the appearance of the last element of the rash.
The main route of spread of infection is airborne.Infection is also possible by contact, through various objects, for example, children’s toys.
The incubation period is 9 to 21 days.
The onset of the disease is usually acute. The first symptoms of infection are skin rashes and fever (sometimes the temperature remains normal). The elements of the rash at first are pink spots 2-4 mm in size, which after a few hours turn into vesicles filled with transparent contents.Itching of the skin is common. The rash appears on the skin of the trunk, face, neck, and on the skin of the extremities. The presence of rashes on the scalp is very characteristic. In addition, dripping is possible for several days.
Simultaneously with a rash on the skin, a rash appears on the mucous membranes of the oral cavity, sometimes on the genitals, especially in girls.
In adults, the disease often proceeds with severe symptoms of intoxication and an increase in body temperature, the rash is profuse and the rash lasts longer.
In the vast majority of cases, the disease is not severe. Chickenpox is especially dangerous for pregnant women, since transplacental transmission of the pathogen is possible. Isolated cases of congenital chickenpox are described.
Chickenpox is usually benign. Complications are rare. They develop in connection with the direct action of the virus itself or are associated with the stratification of a bacterial infection. Among the specific complications are pneumonia, chickenpox encephalitis and meningoencephalitis; nephritis and myocarditis are less common.
Bacterial complications (pyoderma, abscesses, phlegmon, erysipelas, stomatitis, purulent conjunctivitis) occur in weakened children in violation of hygienic care of the skin and mucous membranes.
With chickenpox, patients are treated at home. Hospitalization is carried out in the case of a severe course of the disease, with the addition of complications or for epidemiological indications.
In the acute period, bed rest is prescribed. To prevent the accumulation of secondary infection and faster drying of the bubbles, the elements of the rash are lubricated with a solution of aniline dyes. Rashes on mucous membranes are treated with aqueous solutions of aniline dyes or other disinfecting solutions.
With chickenpox, caring for the patient consists in performing hygienic measures aimed at preventing infection of the elements of the rash.It is necessary to monitor the cleanliness of the child’s hands, cut nails short, and often change underwear and bedding.
In case of rashes in the oral cavity, food should be given wiped, it should not contain irritating components.
To prevent the spread of infection, chickenpox patients are isolated from the children’s team for 9 days from the moment the rash appears. For the purpose of active immunization for epidemic indications, the vaccine can be used at the age of 9 months.Children from 9 months to 12 years old are vaccinated once, at the age of 13 years and older – twice, with an interval of at least 6 weeks.
Persons called up for military service who have not previously been vaccinated and have not had chickenpox are subject to vaccination. The effectiveness of emergency vaccination is 90-92%.
Children under the age of 7 who have been in contact with a patient with chickenpox are subject to separation for 21 days. With a precisely established day of contact, separation is carried out from the 11th to the 21st day.It is prohibited to admit children who have not had chickenpox to the group (class) of an organized team for the period of quarantine.
In order to identify patients with chickenpox, daily medical supervision is established for contact persons, including thermometry, examination of the skin and mucous membranes.
After the disease, stable, lifelong immunity is formed. Repeated cases of chickenpox are rare. The prognosis is favorable.
How To Recognize? Symptoms and treatment of chickenpox.
Chickenpox (also called chickenpox) is a viral infection (and highly contagious) that causes a rise in temperature, followed by an itchy rash, starting with red spots that turn into blisters with crusts all over the body.
How to recognize chickenpox
The first manifestations of this infection are usually: fever, signs of a cold, including headache and malaise, abdominal pain or discomfort in the throat. Such manifestations usually last for several days and, as the temperature decreases from 38.3–38.8ºC to a lower one, the first rash appears.It usually looks like itchy red spots in the abdomen, back, and face. Gradually, they spread to the scalp, limbs and perineum.
The rash begins with many small red bumps that look like pimples or insect bites. They appear in waves for 2-4 days, then turn into thin-walled bubbles filled with liquid. The walls of the blisters break open, leaving open sores that eventually crust over into dry, brown sores.
All three stages of chickenpox (red bumps, then blisters and crusts) appear on the body almost simultaneously. The rash can spread wider or be more severe in children with weak immune systems or skin conditions such as eczema.
What causes chickenpox?
Chickenpox is caused by the varicella-zoster virus (variacella zoster). This virus can also cause a painful skin rash called shingles later in life.After a person has had chickenpox, the virus remains dormant (resting) in the nervous system for the rest of his life. The virus can reactivate (“wake up”) later in the form of shingles. Children who are vaccinated against chickenpox are much less likely to develop shingles as they get older.
Is chickenpox contagious?
Chickenpox is highly contagious. Most children who have an infected sibling will also become infected (if they have not yet received an infection or vaccine), showing symptoms about 2 weeks after the first child becomes infected.A person with chickenpox can spread the virus:
- through droplets in the air when coughing or sneezing
- with mucus, saliva or blister fluid
Chickenpox is contagious about 2 days before the rash appears and until all the blisters are crusty. An adult with shingles can transmit chickenpox (but not shingles) to people who have not had chickenpox.
Features of rash
Chickenpox has a characteristic rash evolution that can be divided into 3 stages:
Stage 1 – red spots appear associated with fever and itching.
Stage 2 – then the red spots turn into blisters, in which, in addition to heat and itching, the child feels a burning sensation.
Stage 3 – finally, crusts appear and the itching intensifies!
How is chickenpox treated?
Chickenpox is triggered by a virus, so antibiotics cannot cure the infection. But antibiotics may be needed if the sores are infecting bacteria. This can happen when children scratch and pick at blisters. Antiviral drugs can be prescribed for people with chickenpox who are at risk of complications.It depends on the age and general health of the child, the degree of infection.
How can I help my child feel better?
To relieve the itching and discomfort of chickenpox:
- Use cool wet compresses or warm water baths every 3-4 hours for the first few days. A bath oatmeal decoction can also help relieve itching. (Baths do not spread the rash over the body.)
- Pat (do not rub) the body dry.
- Apply calamine lotion to itchy areas (but do not use it on the face, especially around the eyes).
- Ask your doctor or pharmacist about pain relieving creams that can be applied to genital ulcers. Ask your doctor about over-the-counter medications you can take by mouth for itching.
To prevent scratches:
- Put mittens or gloves on your child’s hands to prevent scratching the child’s body and face while sleeping.
- Cut your nails and keep your hands clean.
If your child has blisters in his mouth:
- Give cold, soft, semi-liquid foods because chickenpox in your mouth makes it difficult to drink or eat.Avoid anything sour or salty, like orange juice or pretzels.
- Give your child acetaminophen to relieve pain.
- Never give aspirin to children with chickenpox. This can lead to a serious condition called Reye’s syndrome.
Chickenpox in children is usually mild, but it causes great discomfort, especially because the child will feel itching at all stages. On the other hand, a child can cause an infection when scratching.In Stage 3, as the itching increases, the crust can flake off, leaving marks on the skin for the rest of its life.
Therefore, it is very important to moisturize your baby’s skin and use the right products when washing to restore skin balance, prevent infection, and soothe symptoms, including itching.
When to call the doctor?
Most cases of chickenpox do not require special treatment. But sometimes problems can arise. Call the doctor if your child has:
90,000 causes, symptoms treatment methods – ISIDA Clinic Kiev, Ukraine
Chickenpox, or chickenpox, is an infectious disease that is transmitted by airborne droplets.It is characterized by a jerky course with fever, with the appearance of a specific rash on the skin and mucous membranes. The disease is common in organized children’s groups. Most often, children aged 3 to 6 years old are sick, less often, babies up to a year. But people of any age can get sick
Causes of occurrence
Chickenpox is highly contagious. The main source of the spread of infection is a sick person. Isolation and transfer of the virus can occur in the following ways:
- When coughing.
- While sneezing.
- Transplacental (from mother to child – in utero).
- Air current from one room to another.
- Through ventilation systems.
The patient is contagious the day before the appearance of the rash, the entire period of the presence of the rash and 5 days after the appearance of the last vesicles. The greatest danger is presented by patients with a mild course of latent forms of the disease. The largest number of cases is recorded in the autumn-winter period.
Symptoms, signs and types
Diseases, depending on the severity of the course, are mild, moderate and severe. There are such periods of illness:
- Incubation. Lasts from 10 to 21 days.
- Prodromal. The development of intoxication syndrome is characteristic, which is clinically manifested by an increase in body temperature, nausea, and vomiting. Sometimes it is possible to develop spotty rashes that precede the blisters. It may last for 1-2 days.
- Rashes.The period occurs acutely, often with an increase in body temperature. Characterized by the occurrence of maculo-vesicular rashes, which appear first on the scalp, mucous membranes, trunk. Unlike smallpox, with chickenpox, the rash on the face is the least. A vesicle with a thin wall and transparent contents turns into a crust within 1-2 days. The rash occurs jerky, within 2-5 days. Each new pouring is accompanied by an increase in body temperature.
- Period of reverse development.It may take one to two weeks.
The disease can occur in atypical forms.
- Pustular – characterized by opacity of the content of the vesicles, symptoms of intoxication are expressed, after the rash, scars remain.
- Hemorrhagic form – characterized by the occurrence of hemorrhagic contents in the vesicles, hemorrhages under the skin, mucous membranes.
- Gangrenous – foci of necrosis are formed around the hemorrhagic vesicles, ulcerative elements are formed after the crusts fall off.
- Generalized – typical for newborns, it is very difficult, there are rashes on the internal organs.
Chickenpox in adults
The course of chickenpox in adulthood is more severe. Severe symptoms of intoxication, catarrhal phenomena may occur in the form:
- Runny nose
- Difficulty breathing.
The first rashes can appear anywhere on the skin.The onset of facial rash is significantly delayed. Despite the increase in body temperature, the general condition of patients is often not affected. In some cases, the disease can be severe, with profuse rashes, high fever, anxiety, vomiting, hallucinations, and delirium. A significant increase in lymph nodes is also characteristic.
Chickenpox in children
It is much easier than in adults, but infectiousness among children is very high. During the incubation period, fever rarely occurs and a spotted rash appears.During the period of rashes, it is characteristic that vesicular elements can appear on the mucous membranes of the mouth, larynx, and genitals. Patients with severe rashes are characterized by more pronounced signs of intoxication syndrome.
Diagnosis of the disease
Chickenpox is often easy to diagnose. First of all, the doctor interviews the patient, collects complaints. conducts a full inspection. Additional diagnostic methods are carried out for complicated or atypical forms of pathology.The use of immunofluorescence analysis, laboratory blood tests, molecular biological research may be required.
Chickenpox during pregnancy
Pathology during pregnancy has its negative consequences. In the early stages, miscarriages, spontaneous abortions are possible. This is a rather dangerous disease that negatively affects the fetus. The risk of developing congenital abnormalities and deformities increases. The likelihood of developing defects is much lower than with rubella and is no more than 1%.
More serious consequences for a child are caused by a woman’s infection with chickenpox a few days before childbirth and 3-5 days after them. The risk of developing congenital chickenpox increases, which can be very severe. Since it is manifested by bronchopneumonia, damage to internal organs.
Chickenpox – treatment
Therapy of a disease with a mild course and without complications can proceed on an outpatient basis. If the therapy is ineffective or complications develop, then the patient is hospitalized in a hospital, boxing.It is advisable to follow these recommendations:
- During the period of rashes, observe strict bed rest, get a plentiful, warm drink.
- It is important to take good care of the skin and mucous membranes. If the elements of the rash itch, you can use special lotions that relieve itching.
- If you have a fever, it is important to use antipyretics.
- When a secondary infection is attached, antibacterial drugs are used.
- And most importantly, consult your doctor.
In children, the disease often has a benign course. But in some cases, the development of such side reactions is possible:
- Skin lesions. Manifested in the form of abscesses, phlegmon. A rash on the mucous membranes can be complicated by conjunctivitis, keratitis.
- Damage to the lymphatic system. The causative agent circulating in the bloodstream can enter the lymph nodes, with the formation of lymphadenitis, lymphangitis.
- Violation of the respiratory system. Perhaps the formation of pneumonia, which is characterized by a severe course, can be fatal.
- Pathology of the nervous system. Possible development of encephalitis, convulsive syndrome, damage to the cranial nerves.
- Development of inflammatory lesions of the heart, kidneys, joints is also possible.
Vaccination is the main preventive method.It is important to carry out it:
- All children in the epidemiological focus.
- People who have been in contact with chickenpox patients.
- Patients from the risk zone (with chronic diseases, metabolic pathology, employees of medical institutions).
- Equally important is the isolation of patients during the infectious period. In severe or atypical pathology, it is important to go to the hospital to isolate patients in boxes.
Chickenpox is a common disease to which the sensitivity is very high.The characteristic signs of the disease are polymorphic rashes that appear jerky. In children, the disease progresses much faster and easier than in adults. In severe cases, complications may develop with the involvement of all organs in the infectious process. Vaccination is used for prevention.
About the windmill – MC “LOTOS”
Do you know why chickenpox is so called? The varicella-zoster virus travels up to 50 meters. If a child in your house or another group of kindergarten has chickenpox, your child can become infected.
Moiseeva Tatiana Nikolaevna
Head of the Department of Pediatrics, allergist-immunologist
Do you know why chickenpox is so called? The varicella-zoster virus travels up to 50 meters. If a child in your house or another group of kindergarten has chickenpox, your child can become infected.
- Rash on the skin and mucous membranes. On the skin, at first, these are red dots, which turn into bubbles, and then become covered with crusts and fall off. If there are few rashes, the child has a mild form of chickenpox, there may be erosion on the mucous membranes.
- Itchy skin. Try not to scratch the rash. If the child scratches the bubbles, a bacterial infection may join. In addition, combed bubbles can leave marks for life.
- Refusal to eat.
- Temperature rise.
Keep your child entertained and distracted to relieve itching. Trim his nails short, wear mittens for very small ones. Do not overheat your child. If he sweats, it will itch even more. You should not bathe your baby during the period of rashes.
Check every day for new pimples or not.The child becomes non-infectious 5 days after the last rash.
Follow all your doctor’s recommendations carefully.
– Moiseeva Tatiana Nikolaevna
The Union of Pediatricians of Russia
is a highly contagious disease caused by the Varicella Zoster virus of the Herpesviridae family, belongs to the third type of herpes virus.
During initial contact with the virus, chickenpox occurs, with repeated attacks – herpes zoster – Herpes zoster (shingles).The main routes of transmission of chickenpox are airborne and contact. Sources of infection is a patient with chickenpox, or shingles. The incubation period is on average 10-14 days. The patient becomes contagious two days before the onset of the rash and within 5 days after the appearance of the last element. A few days before the rash, prodromal symptoms such as fever, general malaise, and anorexia develop.
The rash is characterized by the appearance of fresh foci of skin lesions, which progress in the period from five to seven days, turning from macules to papules and then into itchy vesicles with transparent contents that do not merge with each other, then burst with the formation of erosions, and then crusts.Usually the first elements appear on the scalp and face. The rash lasts from 3 to 7 days. Vesicular rash can be very common and affect not only the skin, but also the mucous membranes of the mouth, nose, eyes, and external genitalia.
In most cases, the first contact with a patient with chickenpox ends with the development of the disease, and more than half of cases of chickenpox have a moderate course. A disease transferred in the 1st trimester of pregnancy can lead to intrauterine infection of the fetus, the threat of interruption, miscarriage and malformations.Chickenpox before childbirth ends with infection of the newborn with a severe course of infection, a high risk of pneumonia, encephalitis and other complications. In about 5% of cases, intrauterine death of a child is recorded.
The group of high risk for the development of complications of chickenpox includes pregnant women, people with weakened immunity, cancer and chronic diseases.
The most frequent complications of the disease are suppuration of chickenpox elements, conjunctivitis, tonsillitis, possibly myocarditis, nephritis, hepatitis, arthritis, encephalitis.