Chickenpox

Overview

What is chickenpox?

Chickenpox is a common illness caused by a virus (germ) called varicella zoster. People often get the virus as young children if they have not been vaccinated against it. A child with chickenpox can easily give the virus to other children. Almost all children catch chickenpox but few develop any serious problems. Chickenpox today is much less common because most children are vaccinated when they are young.

Once you have had chickenpox, you will not catch it again from another person. Adults who get chickenpox may become very sick, so it's better to have chickenpox when you are a child, or prevent getting it by being vaccinated.

How is chickenpox spread?

Children can get chickenpox at any age. After being exposed to chickenpox, your child may appear to be fine for one to three weeks before feeling sick. Children can spread the virus from one day before they show signs of illness to about five days after a skin rash appears.

The virus is spread by:

  • Coming in contact with someone who has chickenpox
  • Breathing air from an infected person who sneezes or coughs
  • Coming in contact with fluids from an infected child's eyes, nose or mouth

Symptoms and Causes

What are the symptoms of chickenpox?

Signs of chickenpox are easy to see. Healthcare providers often can look at a child's skin and know if he or she has chickenpox. Signs of chickenpox usually happen in the following order:

  • Fever, feeling tired, headache
  • A stomachache that lasts for one or two days
  • A skin rash that is very itchy and looks like many small blisters
  • Bumps filled with a liquid that looks like milky water
  • Scabs after the blisters break
  • Skin that looks blotchy
  • Spots that fade away

Diagnosis and Tests

How is chickenpox diagnosed?

Signs of chickenpox are easy to see. Healthcare providers often can look at a child's skin and know if he or she has chickenpox.

Management and Treatment

How can I help my child get well?

Make sure your child gets plenty of rest and fluids. Chickenpox will go away on its own in a week or two. To help your child feel less itchy, you can:

  • Press a cool, moist rag on the rash.
  • Keep your child cool.
  • Encourage your child not to scratch. Trim the fingernails so he or she can't scratch.
  • Put a lotion with antihistamines on the rash. These lotions can be bought at the drugstore. If you don't know what to buy, ask the pharmacist for help.
  • Give your child an over-the-counter pill form of antihistamine. Benadryl® is one example.
  • Give your child a cool bath or shower every day. You can also give your child an oatmeal bath.

Don't give your child aspirin. Aspirin can harm children who have fevers. If you must give your child a pain killer, use acetaminophen (such as Tylenol®). If you are not sure what pain killer to use, ask your healthcare provider or pharmacist.

To prevent dehydration, give your child fluids. Cold fluids and a soft bland diet will help if he or she has mouth sores.

What if my baby gets chickenpox?

If your newborn baby (up to age 3 months) gets chickenpox, let your healthcare provider know right away.

What complications are possible with chickenpox?

  • Bacterial infections of the skin, blood, and soft tissues
  • Encephalitis
  • Pneumonia
  • Becoming dehydrated
  • Blood clotting or healing issues
  • Liver problems

Who is more likely to have complications from chickenpox?

Healthy people who get chickenpox do not usually have complications. However, having a severe case of chickenpox could be more dangerous for very young babies, teenagers, pregnant women and people with immunity issues, such as transplant patients. This group also includes people with cancer or HIV or people being treated with chemotherapy or steroids.

Prevention

Can my child get a shot to prevent chickenpox?

A vaccine for chickenpox is available and recommended. Ask your healthcare provider about the vaccine.

What should I know about the chickenpox vaccine?

Two doses are recommended. In children under the age of 13, one dose should be given between the ages of 12 and15 months, while the other is given at the age of 4-6 years.

If you are 13 or older and never got the vaccine, you should get two doses at least 28 days apart.

There is a vaccine that is only for chickenpox called Varivax®. There is another called ProQuad® that protects against measles, mumps, rubella and varicella (MMRV).

Who should not get the chickenpox vaccine?

  • People who are allergic to the vaccine or to any part of the vaccine
  • Pregnant women or women who think they might be pregnant
  • People with immune system problems
  • People with tuberculosis
  • People who do not feel well (Get the vaccine when you feel better.)
  • People who have recently had a blood transfusion or any other live vaccines

Outlook / Prognosis

Can adults get chickenpox?

When children get chickenpox, their bodies fight the illness by making a substance called antibodies. The antibodies fight the virus and help the body get well. These antibodies stay in the body throughout an adult's life. If an adult comes in contact with the virus, the antibodies are there to fight the germ.

Rarely, adults get chickenpox even though they've already had it. When the chickenpox virus in an adult becomes active again, the illness that results is called "shingles." People "catch" shingles from their own chickenpox virus. People with shingles can spread chickenpox to people who have not had chickenpox.

What are shingles?

Shingles also looks like a rash of small bumps. It can be painful and can take longer to heal. Shingles will usually go away on its own in a week or two.

early and late stages of shingles | Cleveland Clinic

Is there a vaccine for shingles?

A new shingles vaccine is now available. This product is called Shingrix® (recombinant zoster vaccine. Shingrix is given as a shot in the arm. You should have two shots that are given 2-6 months apart. The vaccine is only a preventive therapy and is not a treatment for those who have already developed shingles. However, if you have had shingles, you can still get the vaccine to prevent further outbreaks.

Due to high levels of demand for GSK’s Shingrix vaccine, providers should anticipate ordering limits and intermittent shipping delays for Shingrix. It is anticipated order limits and shipping delays will continue throughout 2019. GSK increased the US supply available for 2018 and plans to make even more doses available in the US in 2019. Additionally, GSK will continue to release doses to all customer types on a consistent and predictable schedule during 2019.

Who should be vaccinated with Shingrix?

This vaccine is recommended for those 50 years of age and older who are in decent health.

You should get the Shingrix vaccine even if:

  • You have had shingles already
  • You have been vaccinated with an older vaccine called Zostavax® (zoster vaccine live), but you should wait at least 8 weeks after having Zostavax.
  • You do not know for sure if you have ever had chickenpox

Who should not be vaccinated with Shingrix?

  • People who have ever had a severe allergy to this vaccine or any part of this vaccine
  • Women who are breastfeeding or pregnant
  • People who are somewhat ill or very ill

Living With

When should you call your healthcare provider if your child has chickenpox?

Call your healthcare provider if your child:

  • Is acting ill, with a severe headache
  • Has sores in the eyes
  • Has sores that get bigger or have pus in them
  • Has difficulty breathing or is breathing very fast

When can my child go back to school?

Your child can go back to school seven days after the rash appears. It is not necessary to wait for the scabs to heal.

Resources

Where can I learn more about chickenpox and vaccines?

Call your local public health department or contact the following:

National Immunization Program
Centers for Disease Control
800.CDC.SHOT
800.232.2522

Last reviewed by a Cleveland Clinic medical professional on 08/10/2018.

References

  • Whitley RJ. Whitley R.J. Whitley, Richard J.Varicella-Zoster Virus Infections. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J Eds. Dennis Kasper, et al.eds. Harrison's Principles of Internal Medicine, 19e New York, NY: McGraw-Hill; 2014.
  • Centers for Disease Control and Prevention. . Accessed 8/10/2018.Chickenpox (varicella) (https://www.cdc.gov/chickenpox/about/photos.html)
  • Immunization Action Coalition. Accessed 8/10/2018. Chickenpox (varicella). (http://www.vaccineinformation.org/chickenpox/)
  • Immunization Action Coalition. Accessed 8/10/2018. Zoster recombinant (Shingrix) VIS. (http://www.immunize.org/vis/zoster_recombinant.pdf)
  • US Department of Health and Human Services. Accessed 8/10/2018. Chickenpox (varicella). (https://www.vaccines.gov/diseases/chickenpox/index.html)
  • Centers for Disease Control and Prevention. Accessed 8/10/2018. Vaccine Information Statements (VISs): Chickenpox VIS. (https://www.cdc.gov/vaccines/hcp/vis/vis-statements/varicella.html)
  • Centers for Disease Control and Prevention. Accessed 8/10/2018.Vaccine Information Statements (VISs): Recombinant Shingles VIS. (https://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles-recombinant.html)

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