This article will review the symptoms, management, and prevention of the acute condition chickenpox. Symptoms include a widespread rash and flu-like symptoms.
What is chickenpox?
Chickenpox is a short-term condition that usually results in a rash involving most of the body, occasionally accompanied by flu-like symptoms. Chickenpox usually affects children, although when it affects adults, especially the elderly population, it can be much more dangerous. Chickenpox is usually a self-resolving condition with symptoms mitigating over the course of a few days. Rates of chickenpox infections have gone down substantially in the last decade following the introduction of the chickenpox vaccine. Treatment options are largely supportive but may involve an antiviral medication for people who are immunocompromised.
You can safely treat this condition on your own using over-the-counter pain medications. Topical lotions containing calamine can be used on the rash or blisters and may be soothing.
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- Rash: Over the first few days of this condition, an individual will have flu-like symptoms followed by the appearance of a rash. The rash of chickenpox usually starts out as small red bumps that resemble insect bites. These vesicles appear over the course of a couple of days on the limbs, trunk, and face. These little bumps eventually become more blister-like. This rash is oftentimes very itchy. Usually, these vesicles stop forming and the rash begins to clear up by day six.
- Fever: A fever is usually one of the first symptoms to develop in this condition. It is usually in the 101-102°F range.
- Sore throat
- Stomach ache
The vast majority of chickenpox patients are children. Children who contract this condition generally improve over the course of a few days. However, this virus can be much more dangerous for adults. Adults who get chickenpox usually have immunosuppression, meaning that their body’s immune system has been compromised. The following may be causes of immunosuppression:
- Underlying cancer
- Extended usage of steroids
- HIV infection
- History of organ transplant
Despite the fact that only 0.1 percent of the cases of chickenpox develop in immunocompromised patients, this group accounts for about 25 percent of chickenpox-related deaths.
Most children who get the chickenpox have symptoms that resolve over the course of a few days and never lead to further problems down the road. The following are rare complications associated with chickenpox:
- Skin infection: Sometimes the vesicles, or blisters, that form during chickenpox can become infected. Since they are open wounds, these infections can become complicated requiring extended courses of antibiotics.
- Encephalitis: Encephalitis is the medical term used to describe inflammation in the brain. This rare complication, if it occurs, usually by the end of the first week of contracting the virus. Encephalitis can manifest as difficulty walking straight, delirium, or seizures.
- Reye Syndrome: This complication has essentially disappeared in recent years. Reye Syndrome is a rare complication that results from children with chickenpox taking aspirin for their fever. This condition is very serious and can result in liver failure or death. To avoid developing this, children should not be given aspirin.
The chickenpox are caused by a virus called varicella zoster. The varicella virus is a type of herpes virus. This virus is highly contagious, which is why children with chickenpox are usually taken out of school until the condition resolves. The virus is spread from person-to-person by either nasal or oral secretions or direct skin-to-skin contact. The period of greatest contagion is generally one to two days prior to the onset of the rash until the skin blisters have fully crusted over.
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Treatment for children under the age of 12 is usually supportive, aimed at the management of symptoms. For adults, especially pregnant women or immunocompromised patients, antiviral medications are usually given. Acyclovir, or its analogue, valacyclovir, are the antiviral medications usually prescribed. These medications are very effective in treating the virus. People with kidney problems will need their dosage of these antiviral drugs altered, as this medication can affect kidney function.
Children with the chickenpox usually need management of the itchiness of their rash. Antihistamines are useful for controlling the feeling of itchiness. Also, fingernails of individuals with chickenpox should be cut to avoid breakage of skin during inevitable itching. Children who have a fever with chickenpox can take acetaminophen (Tylenol) to control fever symptoms.
Prevention of chickenpox has become a mainstay of pediatric healthcare since the introduction of the chickenpox vaccine in 1995. Children and adults who have not previously had the chickenpox should get two doses of the vaccine to achieve full immunization. The vaccine will prevent 90 percent of cases of chickenpox. If someone who has been vaccinated does get chickenpox, they usually have less severe symptoms than someone who is unvaccinated . The vaccination schedule is as follows:
- For children under the age of 13: You should receive your first dose at age 12 through 15 months and the second dose at age 4 through 6 years.
- For people older than 13: You should receive two doses at least 28 days apart.
When to seek further consultation for chickenpox
If your child has the following symptoms, you should consult their doctor:
- A fever that lasts for more than four days or rises above 102°F (38.8°C)
- Severe cough or trouble breathing
- A rash that leaks pus (thick, yellowish fluid) or becomes red, warm, swollen, or sore
- Severe headache
- Unusually drowsy or has difficulty waking up
- Trouble looking at bright lights
- Difficulty walking
- Seems confused
- Seems very ill or is vomiting
- A stiff neck
Anyone who is pregnant, elderly, or immunocompromised and experiences any of the above symptoms should consult their doctor immediately.
Questions your doctor may ask to determine chickenpox
- Have you lost your appetite recently?
- Are you sick enough to consider going to the emergency room right now?
- Have you experienced any nausea?
- How severe is your fever?
- Has your fever gotten better or worse?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Chickenpox (Varicella) For Healthcare Professionals. Centers for Disease Control and Prevention. Reviewed Dec. 31, 2018. CDC Link
- Straus SE, Ostrove JM, Inchauspé G, et al. NIH conference. Varicella-zoster virus infections. Biology, natural history, treatment, and prevention. Ann Intern Med. 1988;108(2):221-237. PubMed Link
- Chickenpox (varicella): Vaccination. Centers for Disease Control and Prevention. Updated November 22, 2016. CDC Link
- Chickenpox vaccination: What everyone should know. Centers for Disease Control and Prevention. Updated November 22, 2016. CDC Link