About chickenpox

What is chickenpox?

Chickenpox (varicella) is a viral infection that causes an itchy rash with small, fluid-filled blisters. Chickenpox is highly contagious to people who haven't had the disease or been vaccinated against it. Before routine chickenpox vaccination, virtually all people had been infected by the time they reached adulthood, sometimes with serious complications. Today, the number of cases and hospitalizations is down dramatically.

For most people, chickenpox is a mild disease. Still, it's better to get vaccinated. The chickenpox vaccine is a safe, effective way to prevent chickenpox and its possible complications.



What are the symptoms for chickenpox?

Chickenpox infection appears 10 to 21 days after exposure to the virus and usually lasts about five to 10 days. The Rash is the telltale indication of chickenpox. Other signs and symptoms, which may appear one to two days before the rash, include:

  • Fever
  • Loss of appetite
  • Headache
  • Tiredness and a general feeling of being unwell (malaise)

Once the chickenpox Rash appears, it goes through three phases:

  • Raised pink or red Bumps (papules), which break out over several days
  • Small fluid-filled Blisters (vesicles), forming from the raised Bumps over about one day before breaking and leaking
  • Crusts and scabs, which cover the broken Blisters and take several more days to heal

New Bumps continue to appear for several days. As a result, you may have all three stages of the Rash — bumps, Blisters and scabbed Lesions — at the same time on the second day of the rash. Once infected, you can spread the virus for up to 48 hours before the Rash appears, and you remain contagious until all spots crust over.

The disease is generally mild in healthy children. In severe cases, the Rash can spread to cover the entire body, and Lesions may form in the throat, eyes and mucous membranes of the urethra, anus and vagina. New spots continue to appear for several days.

When to see a doctor

If you suspect that you or your child has chickenpox, consult your doctor. He or she usually can diagnose chickenpox by examining the Rash and by noting the presence of accompanying symptoms. Your doctor can also prescribe medications to lessen the severity of chickenpox and treat complications, if necessary. Be sure to call ahead for an appointment and mention you think you or your child has chickenpox, to avoid waiting and possibly infecting others in a waiting room.

Also, be sure to let your doctor know if any of these complications occur:

  • The Rash spreads to one or both eyes.
  • The Rash gets very red, warm or tender, indicating a possible secondary bacterial skin infection.
  • The Rash is accompanied by dizziness, disorientation, rapid heartbeat, shortness of breath, tremors, loss of muscle coordination, worsening cough, vomiting, stiff neck or a Fever higher than 102 F (38.9 C).
  • Anyone in the household is immune deficient or younger than 6 months old.



What are the treatments for chickenpox?

In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course.

If you're at high risk of complications

For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications.

If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears.

Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. In some instances, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity.

Don't give anyone with chickenpox — child or adult — any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome.

Treating complications

If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary.



What are the risk factors for chickenpox?

Chickenpox, which is caused by the varicella-zoster virus, is highly contagious, and it can spread quickly. The virus is transmitted by direct contact with the rash or by droplets dispersed into the air by coughing or sneezing.

Your risk of catching chickenpox is higher if you:

  • Haven't had chickenpox
  • Haven't been vaccinated for chickenpox
  • Work in or attend a school or child care facility
  • Live with children

Most people who have had chickenpox or have been vaccinated against chickenpox are immune to chickenpox. If you've been vaccinated and still get chickenpox, symptoms are often milder, with fewer blisters and mild or no fever. A few people can get chickenpox more than once, but this is rare.



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