An Overview of Chickenpox

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Chickenpox is a highly contagious infection characterized by an itchy rash made up of red, fluid-filled blisters (pox) and flu-like symptoms. Both the rash and the other symptoms usually can be effectively treated with over-the-counter medication and home remedies, though an antiviral drug may be prescribed. Once regarded as an inevitable disease of childhood, chickenpox has become less common since the advent of the chickenpox vaccine. Though an initial bout of chickenpox usually resolves in a few days or weeks, the virus that causes chickenpox never leaves the body and can re-emerge after decades to trigger a painful illness called shingles in older adults.

Symptoms

The most distinctive chickenpox symptom is the telltale rash, which is occurs about 14 days from exposure. Made up of hundreds of red, fluid-filled blisters, the chickenpox rash first shows up on the face, scalp, and torso, and then spreads to the arms and legs. 

Because chickenpox is a viral infection, it also causes a cluster of symptoms similar to the flu, including mild fever, headache, abdominal pain, fatigue, swollen glands, and overall malaise. Adults who come down with chickenpox tend to experience these symptoms first, and then go on to develop the rash. Children often get the spots first. "Breakthrough cases," those that occur despite vaccination against chickenpox, are usually milder and, in particular, have less rash.

Complications from chickenpox infections aren't common, and are more likely to occur in adults than children, but they can be serious. Some possible secondary problems caused by chickenpox include skin infections, pneumoniaencephalitis, and Reye's syndrome (related to aspirin use in children).

Cause

The organism that causes chickenpox is known as the varicella-zoster virus, or VZV. Varicella is a relative of the herpes virus and is present throughout the world. It's highly infectious. You can get chickenpox easily by touching the skin of someone with an active rash or simply by breathing in the varicella virus when someone who's sick sneezes or coughs, sending infected droplets of fluid into the air.

Diagnosis

A diagnosis of chickenpox usually is based on the history of viral symptoms and the characteristic appearance of the rash. However, sometimes the chickenpox rash can be confused with herpes simplex, impetigo, insect bites, or scabies.

If there's any question that a rash is the result of chickenpox, a viral culture can be taken. However, it can take longer to get the results than for the illness to resolve.

Treatment

For otherwise healthy people, the focus of treating chickenpox is on relieving symptoms. A non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or acetaminophen can help bring down a fever and ease headaches and general discomfort.

Dealing with the rash can be more challenging, especially when it comes to a small child who has a hard time not scratching their skin. Fortunately, there are lots of options, including:

  • Soaking in a tub of warm water mixed with colloidal oatmeal or baking soda
  • Applying calamine lotion directly to bothersome blisters
  • Oral antihistamines such as Benadryl (diphenhydramine)

It's also vital to keep kids' fingernails short and very clean.

Sometimes it's necessary to treat people who are at risk of becoming seriously ill from chickenpox, such as those with compromised immune systems. For example, an antiviral medication called VariZIG (varicella zoster immune globulin) may be used.

Prevention

Because the varicella virus is so highly contagious, the first obvious way to protect yourself is to steer clear of it: Stay away and keep your children or other people who care for them away from anyone who has chickenpox. As long as a person's blisters are active—that is, haven't yet opened and crusted over—he or she is still contagious. Chickenpox is also considered contagious several days before the rash appears.

For most everyone, however, the best way to prevent chickenpox is with the varicella vaccine. With the exception of certain individuals, such as women who are pregnant or people who have a compromised immune system, the vaccine is safe and effective. In fact, it's part of the recommended schedule of childhood vaccines, along with shots for measles, mumps, and other serious illnesses. Adults who did not have chickenpox as kids also are usually advised to get the varicella vaccine.

A Word From Verywell

In the early 1990s, some four million people became ill with chickenpox every year, tens of thousands got sick enough to wind up in the hospital, and 100 to 150 died, according to the Centers for Disease Control and Prevention (CDC). After the varicella vaccine was introduced in 1995, the number of chickenpox cases in the United States dropped by about 90 percent by 2005, the CDC reports.

Even so, rather than have their children vaccinated, some parents choose instead to take their kids to "chickenpox parties" so that they can get infected and develop natural immunity. The problem with this practice is that it means a child may still have to endure an illness she didn't have to. And because she has been infected with the varicella virus, she will be at risk of developing shingles as an adult.

While it is still possible to get chickenpox or shingles after having been vaccinated against the varicella virus, cases are usually milder than ones that develop in someone who is unvaccinated. Vaccination also reduces the risk of shingles complications such as skin infection, pneumonia, and ataxia (loss of control over body movements).

Purposefully allowing children to continue to spread a largely-preventable illness also negates the effectiveness of a vaccine. For an illness to be complete eradicated, as many people as possible need to become immune to it. If you're uncertain about having your child vaccinated, talk to your pediatrician to find out what's best for your family.

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