Chickenpox (Varicella)

ExitCare ImageChickenpox (Varicella) is a viral infection that is more common in children. It tends to be a mild illness for most healthy children. It can be more severe in:

  • Adults.

  • Newborns.

  • People with immune system problems.

  • People receiving cancer treatment.

CAUSES

Chickenpox is caused by a virus called Varicella-Zoster Virus (VZV). VZV causes both chickenpox and shingles. To get chickenpox, a susceptible person (able to catch an infection) must be exposed to either someone with chickenpox or shingles. A person is susceptible if:

  • They have not had the infection before.

  • They were not immunized against VZV.

  • An immunization did not give complete protection against VZV (breakthrough chickenpox).

Chickenpox is very contagious. It is contagious from 1 to 2 days before the rash appears. It is also contagious until the blisters are crusted. The blisters usually become crusted 3 to 7 days after the rash begins. It usually takes about 2 weeks before symptoms show up.

SYMPTOMS

Typical chickenpox symptoms include:

  • Fever.

  • Headache.

  • Poor appetite.

  • An itchy rash that changes over time:

  • It starts as red spots that become bumps.

  • Bumps become blisters.

  • Blisters turn into scabs.

Breakthrough chickenpox happens when an immunized person still gets chickenpox. The symptoms are less severe. The rash may only be red spots or bumps, with no blisters or scabs. Fever may be low or absent.

DIAGNOSIS

Typical chickenpox is diagnosed by physical exam. A blood test can confirm the diagnosis, when the disease is not certain.

TREATMENT

Most of the time, in healthy children, only home treatments are needed. In some cases, in the early stages of chickenpox, your caregiver may prescribe antiviral medicines. These medicines may decrease the severity of the illness and prevent complications. In the rare complicated case, treatment in the hospital is needed. Intravenous (IV) medicine and other treatments can be given in the hospital. Your caregiver may prescribe medicine to relieve itching.

To prevent the spread of chickenpox to at risk people, your caregiver may prescribe:

  • Immunization.

  • Antiviral medicine.

  • Immune globulin.

HOME CARE INSTRUCTIONS

  • For fever:

  • Do not give aspirin to children. This could lead to brain and liver damage through Reye's syndrome. Read the label on over-the-counter medicines used.

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • For itching:

  • If your caregiver prescribed medicine, take as directed.

  • You may use plain calamine lotion on the itching sores. Follow the directions on the label. Do not use on sores in the mouth.

  • Avoid scratching the rash or picking off the scabs. Keep fingernails cut short and clean. Put cotton gloves or socks on your child's hands at night.

  • Keep a child with chickenpox quiet and cool. Sweating and overheating makes itching worse. Stay out of the sun.

  • Cool compresses may be applied to itchy areas.

  • Cool water baths with baking soda or oatmeal soap may help.

  • For painful sores in the mouth; pain medicine and cold foods, like frozen pops, may feel good.

  • Drink plenty of fluids. Avoid salty or acidic liquids (tomato or orange juice). These irritate mouth sores and cause pain.

  • People with chickenpox should avoid exposure (being in the same room) with:

  • Pregnant women (especially if they have not had chickenpox or been immunized against it).

  • Young infants.

  • People receiving cancer treatments or long-term steroids.

  • People with immune system problems.

  • The elderly.

  • Any child or adult with chickenpox should stay home until all blisters have crusted. If there are no blisters, the child or adult should stay home until no new spots show up.

SEEK MEDICAL CARE IF:

  • You or your child has an oral temperature above 102° F (38.9° C).

  • Your baby is older than 3 months with a rectal temperature of 100.5° F (38.1° C) or higher for more than 1 day.

  • The sores are infected. Look for:

  • Swelling.

  • Increasing redness.

  • Red streaks.

  • Tenderness.

  • Yellow or green pus coming from blisters.

  • Cough.

  • New symptoms develop that concern you.

SEEK IMMEDIATE MEDICAL CARE IF:

You or your child develops:

  • Vomiting.

  • Confusion, unusual sleepiness or odd behavior.

  • Neck stiffness.

  • Seizures (convulsions).

  • Loss of balance.

  • Chest pain.

  • Trouble breathing or fast breathing.

  • Blood in urine.

  • Rectal bleeding.

  • Bruising of the skin or bleeding in the blisters.

  • Blisters in the eye.

  • Eye pain, redness or decreased vision.

  • You or your child has an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • Your baby is older than 3 months with a rectal temperature of 102° F (38.9° C) or higher.

  • Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.