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Chickenpox (varicella zoster infection)
Further information on chickenpox from Wadsworth Center for Laboratories and ResearchVersión en españolVaricela - Medline Plus Información de Salud para Usted
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
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
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.
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