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Chickenpox

(Varicella)

Definition

Chickenpox is a virus that spreads easily to others. It creates an itchy rash. In most it will cause illness for 1-3 weeks. Some may have serious complications.

Chickenpox

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Causes    TOP

A virus called varicella-zoster virus (VZV) causes chickenpox. It spreads from person to person through:

  • Inhaled airborne droplets that have the VZV virus
  • Direct contact with fluid from a chickenpox rash

A pregnant mother can also pass the virus to her fetus.

Risk Factors    TOP

The main risk factor is contact with someone with chickenpox. It is also more common in winter and spring.

Factors that may increase the chance of chickenpox complications include:

  • Conditions or medications that suppress your immune system, such as cancer, HIV infection, an organ transplant, or high-dose steroid use
  • Pregnancy
  • Time of year—late winter, early spring

Symptoms    TOP

Symptoms break out about 10-21 days after contact. They tend to be more severe in adults than they are in children.

First symptoms include:

  • Mild headache
  • Moderate fever
  • Cough
  • Sore throat
  • Severe itch
  • Lack of appetite
  • General feeling of discomfort
  • Abdominal pain

The rash appears within 1-2 days after the first symptoms. The rash:

  • Begins with small, flat, red spots:
    • Spots become raised and form a round, intensely itchy, fluid-filled blister
    • Blisters develop in clusters, with new clusters forming over 5-6 days
  • Usually develops into patches on the skin above the waist, including the scalp
  • May also appear on the eyelids, in the mouth, upper airway, voice box, or on the genitals
  • Typically crusts over by day 6 or 7 and disappears within 3 weeks

Diagnosis    TOP

The doctor will ask about your symptoms and health history. A physical exam will be needed. The doctor can often diagnose based on the rash.

Treatment    TOP

Chickenpox is mild in most people. It will pass on its own. Home care can help to relieve symptoms.

To Reduce Itching

The rash can be very itchy. However, scratching can damage the skin. It can also increase risk for infection. Itchiness can be reduced with:

  • Wet compresses
  • Over-the-counter anti-itch creams or lotions
  • Oatmeal baths
  • Oral antihistamine medication

Note : Do not use aspirin in children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

High Risk Support

Some people have a higher risk of complications including:

  • Adolescents, adults, and individuals with weak immune systems
  • Individuals with chronic skin or lung diseases and those taking aspirin or steroids

Medicine or treatment may help shorten the infection. It may also reduce how severe the symptoms are. Options include:

  • Antiviral medications
  • Varicella-zoster immune globulin—reserved for newborns and people with weak immune systems

Prevention    TOP

Avoid contact with anyone who has chickenpox.

There is a chickenpox vaccine. This can prevent illness even if you have been in contact with someone who is sick. Vaccines may be given:

  • To children—as a combination MMRV
  • To adults—if they did not receive vaccine as child or have chickenpox
  • After exposure—in adults or children who have not had vaccine; may help to decrease or prevent illness

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca
College of Family Physicians of Canada
http://www.cfpc.ca

References:

Chickenpox. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116084/Chickenpox. Updated September 8, 2015. Accessed September 29, 2016.
Gales SA, Sweet A, Beninger P, et al. The safety profile of varicella vaccine: a 10-year review. J Infect Dis. 2008;197(Suppl2):S165-9).
Immunization schedules. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated February 7, 2017. Accessed May 22, 2017.
Marin M, Meissner HC, Seward JF. Varicella prevention in the United States: a review of successes and challenges. Pediatrics. 2008;122(3):e744-e751.
A New Product (VariZIG) for Postexposure Prophylaxis of Varicalla Available under an Investigational New Drug Application Expanded Access Protocol. MMWR. 2006;55(8): 209-210.
Skull SA, Wang EE. Varicella vaccination: a critical review of the evidence. Arch Dis Child. 2001;85(2):83-90.
Varicella (chickenpox) vaccination. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated April 5, 2012. Accessed May 29, 2015.
Vazquez M, LaRussa PS, Gershon AA, et al. Effectiveness over time of varicella vaccine. JAMA. 2004;291(7):851-855.
10/14/2008 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T116084/Chickenpox: Macartney K, McIntryre P. Vaccines for post-exposure prophylaxis against varicella (chickenpox) in children and adults. Cochrane Database Syst Rev. 2008;(3):CD001833.
Last reviewed May 2018 by David Horn, MD
Last Updated: 5/7/2018

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