Understanding Chickenpox

Chickenpox is a viral illness that spreads very easily from person to person. In the past, the virus was very common. Most children would get chickenpox from another infected person at some point. Then a vaccine to prevent the virus became available in 1995. Now it's not a common childhood illness.

Most people who have had chickenpox once don’t get it again. That’s because they become immune to the virus. But the virus stays in the body and can show up later in life as shingles. Shingles causes a painful skin rash. A vaccine is available to prevent shingles.

What causes chickenpox?

Chickenpox is caused by the varicella-zoster virus. It can easily spread to people who haven't had chickenpox and haven't been vaccinated. The virus spreads when:

• You breathe in the virus from the air. This can happen when someone with chickenpox or shingles sneezes or coughs near you.

• You get the virus on your hands. This can happen if you touch someone’s chickenpox or shingles blisters.

Someone with chickenpox can pass the virus on to others before they have any symptoms This is one reason why chickenpox spreads so easily.

What are the symptoms of chickenpox?

Chickenpox is often a mild illness, especially in young children. But it can sometimes be serious enough to cause severe illness or even death. This is especially true for older adults and anyone who has a weakened immune system.

Chickenpox often starts with symptoms that feel like the flu, including:

• Fever

• Headache

• Sore throat

• Feeling tired or unwell

• Loss of appetite

A day or 2 later, red spots appear on your body. This rash is often itchy. The red spots turn into small blisters. Then they scab over and go away. Blisters may also appear in your mouth or throat. A chickenpox rash often goes away within 2 weeks.

How is chickenpox treated?

Treatment for most children with chickenpox focuses on easing symptoms. These treatments may include:

• Over-the-counter pain medicines (such as acetaminophen). These can help with mild pain, especially if blisters are inside the mouth. Don’t give aspirin (or medicine that contains aspirin) to a child younger than age 19 unless you're told to by your child’s healthcare provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious condition. It most often affects the brain and the liver.

• Over-the-counter antihistamine medicines such as diphenhydramine or loratadine. These can help ease itching.

• Skin treatments to ease itching. These include calamine lotion and oatmeal baths.

In most cases, a provider won't give a child antiviral medicine or antibiotics for chickenpox. These medicines don't shorten the illness or ease its symptoms.

Follow all directions for using medicines, especially when giving them to children. Call your child's provider if you have any questions about using medicines safely.

Having chickenpox virus is risky for:

• Pregnant women

• Babies

• Children older than 12

• Adults

• People with a weak immune system

• People with certain long-term (chronic) skin or lung diseases

For these people, treatment is aimed at helping the body fight the virus. Their treatment is likely to include antiviral medicine, either by mouth or through an IV (intravenous) line. This can help shorten the illness or make it less severe. This is especially true if you take this medicine very early in the illness.   

How can I prevent chickenpox?

The best way to prevent the spread of chickenpox is to make sure that you and your family members are immune to it:

• Talk with your provider about getting the vaccine if you didn't have chickenpox as a child or if you haven't had the vaccine.

• Make sure your children have all their vaccines on schedule.

Ask your provider about getting the vaccine if you've been exposed to the virus and haven't had the infection in the past or been vaccinated against it. This can prevent illness or make it less severe.

What are the possible complications of chickenpox?

Complications of chickenpox include:

• Skin infection. This can happen when scratching allows bacteria to get into the blisters.

• Infection of the brain or spinal cord. This can cause severe headache, unsteady movements, severe sleepiness, seizures, or stroke.

• Lung infection (pneumonia). This causes a cough, shortness of breath, or chest pain.

When should I call my healthcare provider?

Call your provider right away if you have any of these:

• Fever of 100.4°F ( 38°C) or higher, or as directed by your provider

• Any of the complications listed above

• You can't eat or drink because of painful sores in your mouth or throat

• You can't retain fluids

• You don’t start to feel better after 5 to 7 days