Chicken pox side effects
Chickenpox - Symptoms and causes
Overview
Chickenpox
Chickenpox
Chickenpox consists of an itchy, red rash that breaks out on the face, scalp, chest, back and, to a lesser extent, arms and legs. The spots quickly fill with a clear fluid, rupture and then turn crusty.
Chickenpox is an infection caused by the varicella-zoster virus. It causes an itchy rash with small, fluid-filled blisters. Chickenpox is highly contagious to people who haven't had the disease or been vaccinated against it. Today, a vaccine is available that protects children against chickenpox. Routine vaccination is recommended by the U.S. Centers for Disease Control and Prevention (CDC).
The chickenpox vaccine is a safe, effective way to prevent chickenpox and its possible complications.
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Symptoms
The itchy blister rash caused by chickenpox infection appears 10 to 21 days after exposure to the virus and usually lasts about five to 10 days. Other signs and symptoms, which may appear one to two days before the rash, include:
- Fever
- Loss of appetite
- Headache
- Tiredness and a general feeling of being unwell (malaise)
Once the chickenpox rash appears, it goes through three phases:
- Raised pink or red bumps (papules), which break out over several days
- Small fluid-filled blisters (vesicles), which form in about one day and then break and leak
- Crusts and scabs, which cover the broken blisters and take several more days to heal
New bumps continue to appear for several days, so you may have all three stages of the rash — bumps, blisters and scabbed lesions — at the same time. You can spread the virus to other people for up to 48 hours before the rash appears, and the virus remains contagious until all broken blisters have crusted over.
The disease is generally mild in healthy children. In severe cases, the rash can cover the entire body, and lesions may form in the throat, eyes, and mucous membranes of the urethra, anus and vagina.
When to see a doctor
If you think you or your child might have chickenpox, consult your doctor. He or she usually can diagnose chickenpox by examining the rash and considering other symptoms. Your doctor can also prescribe medications to lessen the severity of chickenpox and treat complications, if necessary. To avoid infecting others in the waiting room, call ahead for an appointment and mention that you think you or your child may have chickenpox.
Also, let your doctor know if:
- The rash spreads to one or both eyes.
- The rash gets very red, warm or tender. This could indicate a secondary bacterial skin infection.
- The rash is accompanied by dizziness, disorientation, rapid heartbeat, shortness of breath, tremors, loss of muscle coordination, worsening cough, vomiting, stiff neck or a fever higher than 102 F (38.9 C).
- Anyone in the household has a problem with his or her immune system or is younger than 6 months.
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Causes
Chickenpox infection is caused by the varicella-zoster virus. It can spread through direct contact with the rash.
It can also spread when a person with the chickenpox coughs or sneezes and you inhale the air droplets.
Risk factors
Your risk of becoming infected with the varicella-zoster virus that causes chickenpox is higher if you haven't already had chickenpox or if you haven't had the chickenpox vaccine. It's especially important for people who work in child care or school settings to be vaccinated.
Most people who have had chickenpox or have been vaccinated against chickenpox are immune to chickenpox. A few people can get chickenpox more than once, but this is rare. If you've been vaccinated and still get chickenpox, symptoms are often milder, with fewer blisters and mild or no fever.
Complications
Chickenpox is normally a mild disease. But it can be serious and can lead to complications including:
- Bacterial infections of the skin, soft tissues, bones, joints or bloodstream (sepsis)
- Dehydration
- Pneumonia
- Inflammation of the brain (encephalitis)
- Toxic shock syndrome
- Reye's syndrome in children and teenagers who take aspirin during chickenpox
- Death
Who's at risk?
People who are at higher risk of chickenpox complications include:
- Newborns and infants whose mothers never had chickenpox or the vaccine
- Adolescents and adults
- Pregnant women who haven't had chickenpox
- People who smoke
- People whose immune systems are weakened by medication, such as chemotherapy, or by a disease, such as cancer or HIV
- People who are taking steroid medications for another disease or condition, such as asthma
Chickenpox and pregnancy
Low birth weight and limb abnormalities are more common among babies born to women who are infected with chickenpox early in their pregnancy.
When a mother is infected with chickenpox in the week before birth or within a couple of days after giving birth, her baby has a higher risk of developing a serious, life-threatening infection.
If you're pregnant and not immune to chickenpox, talk to your doctor about the risks to you and your unborn child.
Chickenpox and shingles
If you've had chickenpox, you're at risk of a complication called shingles. The varicella-zoster virus remains in your nerve cells after the skin infection has healed. Many years later, the virus can reactivate and resurface as shingles — a painful cluster of short-lived blisters. The virus is more likely to reappear in older adults and people who have weakened immune systems.
The pain of shingles can last long after the blisters disappear. This is called postherpetic neuralgia and can be severe.
The shingles vaccine (Shingrix) is recommended for adults who have had chickenpox. Shingrix is approved and recommended for people age 50 and older, including those who've previously received another shingles vaccine (Zostavax).
Zostavax, which isn't recommended until age 60, is no longer sold in the United States.
Prevention
The chickenpox (varicella) vaccine is the best way to prevent chickenpox. Experts from the CDC estimate that the vaccine provides complete protection from the virus for nearly 98% of people who receive both of the recommended doses. When the vaccine doesn't provide complete protection, it significantly lessens the severity of chickenpox.
The chickenpox vaccine (Varivax) is recommended for:
Young children. In the United States, children receive two doses of the varicella vaccine — the first between ages 12 and 15 months and the second between ages 4 and 6 years — as part of the routine childhood vaccination schedule.
The vaccine can be combined with the measles, mumps and rubella vaccine, but for some children between the ages of 12 and 23 months, the combination may increase the risk of fever and seizure from the vaccine.
Discuss the pros and cons of combining the vaccines with your child's doctor.- Unvaccinated older children. Children ages 7 to 12 years who haven't been vaccinated should receive two catch-up doses of the varicella vaccine, given at least three months apart. Children age 13 or older who haven't been vaccinated should also receive two catch-up doses of the vaccine, given at least four weeks apart.
Unvaccinated adults who've never had chickenpox and are at high risk of exposure. This includes health care workers, teachers, child care employees, international travelers, military personnel, adults who live with young children and all women of childbearing age.
Adults who've never had chickenpox or been vaccinated usually receive two doses of the vaccine, four to eight weeks apart. If you don't remember whether you've had chickenpox or the vaccine, a blood test can determine your immunity.
The chickenpox vaccine isn't approved for:
- Pregnant women
- People who have weakened immune systems, such as those who are infected with HIV, or people who are taking immune-suppressing medications
- People who are allergic to gelatin or the antibiotic neomycin
Talk to your doctor if you're unsure about your need for the vaccine.
If you're planning on becoming pregnant, consult with your doctor to make sure you're up to date on your vaccinations before conceiving a child.
Is it safe and effective?
Parents typically wonder whether vaccines are safe. Since the chickenpox vaccine became available, studies have consistently found it to be safe and effective. Side effects are generally mild and include redness, soreness, swelling and, rarely, small bumps at the site of the shot.
By Mayo Clinic Staff
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Causes, Symptoms, Treatment & Prevention
Overview
Chickenpox, an infectious disease, produces a blister-like rash.What is chickenpox?
Chickenpox is an infection that causes a skin rash. The disease is caused by a germ called varicella-zoster virus. (Chickenpox itself is also called varicella-zoster.) Most people will get the virus when they’re young if they haven’t had a chickenpox vaccine.
A child with chickenpox can easily give the virus to other children.
Chickenpox today is much less common because most children are vaccinated when they are young. Before the first vaccine against chickenpox was approved in the U.S. in 1995, almost everyone got chickenpox. Very few had complications.
Once you’ve had chickenpox, you won’t catch it again from another person. If you’re not vaccinated, you can get chickenpox at any age. Adults who get chickenpox may become very sick, so it's better to have chickenpox when you're 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.
What is the difference between smallpox and chickenpox?
Chickenpox and smallpox are both diseases that produce rashes on the skin, but they are different. For one thing, smallpox is a much more serious disease, causing severe illness and death. They are caused by different viruses.
While the two diseases both produce rashes, the rashes themselves develop at different times and the rashes look different. Smallpox pustules look the same as each other, while the chickenpox rash develops in waves. The individual spots don’t look the same and some form scabs while others are still blistering.
There’s another important difference. A massive global vaccination program has eradicated (wiped out) smallpox.
Symptoms and Causes
What are the signs and 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 they have chickenpox.
Management and Treatment
How can I help my child with chickenpox?
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 their fingernails so they can't scratch.
- Put a lotion with antihistamines on the rash.
These lotions are available at the drugstore. If you don't know what to buy, ask the pharmacist for help. - Give your child an over-the-counter (OTC) form of antihistamine. Diphenhydramine (Benadryl®) and cetirizine (Zyrtec®) are two examples of OTC antihistamines.
- Give your child a cool bath or shower every day. You can also give your child an oatmeal bath. When you’re drying them off, don’t rub with the towel. Pat your child dry.
Don't give your child aspirin. Aspirin can harm children who have fevers. If your child needs a pain reliever, use acetaminophen (such as Tylenol®). If you’re not sure what product 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 they have 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. Chickenpox is more dangerous to newborns than to other healthy people.
What complications are possible with chickenpox?
Complications from chickenpox are unlikely, but possible. They may include:
- 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 don’t usually have complications. However, having a severe case of chickenpox could be more dangerous for very young babies, teenagers, pregnant people 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.
Can chickenpox be fatal?
It’s very unlikely that you will die from chickenpox. Most people recover without complications. However, people have died from chickenpox. In the U.S., that number has dropped to about 20 people per year after mass vaccinations from some 100 deaths per year before vaccines were available.
Hospitalizations decreased 84% from over 10,000 per year.
Prevention
Can my child get a shot to prevent chickenpox?
Yes, there’s a vaccine for chickenpox. It’s recommended, so ask your healthcare provider about the vaccine.
What should I know about the chickenpox vaccine?
Two doses are recommended. When your child is under the age of 13, they should get one dose between the ages of 12 and15 months, and the second between the ages of four and six years.
If you’re 13 or older and never got the vaccine, you should get two doses at least 28 days apart.
There is a vaccine that’s only for chickenpox called Varivax®. There is another called ProQuad® that protects against measles, mumps, rubella and varicella (MMRV).
Vaccination is over 90% effective at preventing chickenpox.
Who shouldn’t get the chickenpox vaccine?
There are people who shouldn’t get the chickenpox vaccine. You shouldn't get the chickenpox vaccine if you:
- Are allergic to the vaccine or to any part of the vaccine.
- Are pregnant or think you might be pregnant.
- Have problems with your immune system.
- Have tuberculosis.
- Aren’t feeling well. (Get the vaccine when you feel better.)
- Recently had a blood transfusion or any other live vaccines.
Talk with your healthcare provider about whether or not you should be vaccinated.
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 your body throughout your life. If an adult comes in contact with the virus, the antibodies are there to fight the germ.
What are shingles?
In adults, the chickenpox virus (varicella zoster) can become active again. When that happens, it causes an illness caused shingles. People "catch" shingles from their own chickenpox virus. People who have shingles can spread chickenpox to people who haven’t had chickenpox.
However, you can’t get shingles unless you’ve had chickenpox.
Shingles is also called herpes zoster, but it’s not the same as genital herpes. Like chickenpox, it looks like a rash made up of small bumps. Shingles can be painful and can take a while to heal. It will usually go away on its own in a week or two. There are vaccines to prevent shingles. Talk to your healthcare provider to see which one is right for you.
Living With
When should you call your healthcare provider if your child has chickenpox?
Call your healthcare provider if your child:
- Is acting ill and has a severe headache.
- Has sores in their 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 about seven to 10 days after the rash appears. You don’t need to wait for the scabs to heal, but you do need to wait until all the blisters have scabbed over.
You’re contagious while the blisters have fluid.
Frequently Asked Questions
What are the three stages of chickenpox?
The three stages of chickenpox usually refer to the way the rash looks. Stage one is a red and bumpy rash. Stage two is the fluid-filled blistered rash. Stage three is when the blisters break and scab over.
Where does chickenpox usually start?
You usually start getting chickenpox on your face and trunk (your chest and your back). From there, it spreads to the rest of your body.
Can I get chicken pox twice?
It’s rare for anyone to get chickenpox twice, but it can happen.
How many days does it take to recover from chickenpox?
Chickenpox usually goes away after 10 to 14 days.
A note from Cleveland Clinic
Before the vaccine for chickenpox was developed, the infection caused deaths and hospitalizations. The available vaccine is over 90% effective at preventing this once-common childhood illness.
If you don’t get chickenpox, you won’t get shingles, a painful condition that happens because the virus that causes chickenpox stays in your body long after the rash is gone. While there are home remedies to deal with chickenpox and shingles symptoms, vaccination makes that unnecessary.
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Chicken pox.
Symptoms, consequences, vaccination in Novosibirsk General information
Varicella (chickenpox) is an acute, highly contagious (highly contagious) viral disease that occurs throughout the world. Once a single case occurs among susceptible individuals, it is very difficult to prevent an outbreak. While chickenpox is relatively mild in children, it becomes more severe in adults. It can be fatal, especially in newborns and in immunocompromised individuals.
The causative agent, varicella zoster virus (VZV), is transmitted by airborne droplets or direct contact, and patients are usually contagious from several days before the onset of the rash until the rash has crusted over.
VZV enters the human body through the nasopharyngeal mucosa and, almost without exception, causes clinical manifestations of the disease in susceptible individuals. In addition to chickenpox itself, the virus causes shingles or herpes zoster (so-called herpes zoster).
Chances of getting sick
People of all ages can get chickenpox.
However, this infection most often affects children. About half of the diseases in childhood occur at the age of 5 to 9 years, children aged 1–4 and 10–14 years are less likely to get sick. Approximately 10% of patients are 14 years of age or older. Among this age group, over the past 5 years, the incidence has increased from 28 to 58 per 100,000 population. Children of the first months of life are most often resistant to this infection. However, babies who are premature and weakened by other diseases can become seriously ill with chickenpox.
The maximum incidence of chicken pox is observed in the autumn-winter months, the minimum - in the summer. Epidemic outbreaks are observed in the autumn-winter period, mainly in organized groups among preschool children. Children attending kindergartens and nurseries suffer from this infection 7 times more often than children who do not attend them.
Patients with immunodeficiencies, including HIV infection, are also at risk. Severe cases of chickenpox have been described in children treated with hormonal steroid therapy.
There are also cases of congenital chickenpox in children whose mothers had chickenpox in the first half of pregnancy; perinatal infection occurs in children whose mothers fell ill 5 days before and 48 hours after the birth of the child.
Symptoms and course of the disease
The incubation period is usually 14-16 (10-21) days. Chickenpox is characterized by an itchy rash that usually begins on the head and face and is initially accompanied by fever and general malaise. The elements of the rash look like small (several millimeters in diameter) bubbles rising above the reddened surface of the skin, filled with a clear liquid (which contains the virus). As the rash gradually spreads to the body and limbs, the first bubbles (vesicles) dry up. Usually all crusts disappear in 7-10 days.
Post-mortem complications
Although varicella is a relatively benign childhood disease and is rarely considered a significant public health problem, the disease can sometimes be complicated by VZV pneumonia or encephalitis, which can lead to long-term consequences or death.
Disfiguring scars may result from secondary infection of the vesicles; in addition, necrotizing fasciitis or sepsis may occur as a result of such infection.
Complications of chickenpox are registered with a frequency of 5-6%, they serve as a reason for hospitalization in 0.3-0.5%. Of the total number of cases, this is several thousand per year. 30% of complications are neurological, 20% are pneumonia and bronchitis, 45% are local complications, accompanied by the formation of scars on the skin.
Treatment considerations
The treatment of chickenpox is mainly to prevent bacterial complications. To avoid the spread of the virus, good hygiene practices must be observed, including daily showering and cutting the nails of young children (to prevent scratching and breaking up the blisters of the rash).
The use of antiviral agents such as acyclovir is justified only in premature infants, patients with impaired immune systems and adults (due to the greater severity of the infection).
The traditional remedy for "treatment" of chicken pox - "brilliant green" - is not at all effective, much more effective than baths and baths with a small addition of soda, antihistamines and anesthetic ointments to relieve itching.
Vaccination efficacy
Varicella vaccines prepared using the Oka strain of VZV have been on the market since 1974. Positive results regarding safety, efficacy and cost-benefit analysis have confirmed the rationale for their introduction into childhood immunization programs in a number of industrialized countries. After following study populations for 20 years in Japan and 10 years in the US, more than 90% of immunocompetent individuals vaccinated in childhood were still protected from varicella.
About 95% of children will develop antibodies in response to vaccination, and 70-90% will be protected from infection for at least 7-10 years after vaccination. According to Japanese researchers (Japan is the first country in which a vaccine was registered), immunity lasts 10-20 years.
Studies show that emergency vaccination can also be effective - when the vaccine is given within 3 days of exposure to VZV, at least 90% protective efficacy can be expected. Chickenpox in people who have received the vaccine is much milder than in people who have not been vaccinated.
Vaccines
According to the current US vaccination schedule, children receive 2 doses of the vaccine (1st dose at 12 months, 2nd dose at 6 years).
The varicella vaccines currently available on the market are made using the so-called VZV Oka strain, which has been modified by serial reproduction in different cell cultures. Various formulations of these live, attenuated vaccines have been extensively tested and approved for use in Japan, the Republic of Korea, the United States, and several European countries. Some vaccines are approved for use from ages 9months and older.
The optimal age for varicella vaccination is 12-24 months. In Japan and several other countries, one dose of the vaccine is considered sufficient, regardless of age.
In the US, 2 doses of the vaccine given 4-8 weeks apart are recommended for adolescents and adults, of whom 78% seroconverted after the first dose and 99% after the second dose of the vaccine.
Variants of vaccines
In Russia, the vaccines VARILRIX and Okavax are used to prevent the disease.
Adverse reactions
The varicella vaccine is very well tolerated by people, reactions to it are very rare. Most people who report any reactions to the vaccine develop local manifestations. Local reactions include the following symptoms at the injection site: swelling, induration, redness, and slight soreness. These symptoms disappear within a few days and develop on the first day after immunization. In addition to local reactions, general symptoms develop in 0.1-5% of cases. Common reactions to the chickenpox vaccine include: fever, chickenpox-like rash, itchy skin, weakness, fever; enlargement and soreness of the lymph nodes.
Contraindications
Vaccination against chickenpox is contraindicated in people who at that time have acute illness or exacerbation of a chronic pathology.
In this case, the vaccine is given after recovery or after achieving a stable remission.
If a person has had mild respiratory or intestinal infections, the vaccine can be given after 2-4 weeks. If there were severe diseases of the nervous system (for example, meningitis), then the vaccination can be done at least six months after recovery.
Vaccination is absolutely contraindicated in severe immunodeficiency, when the number of lymphocytes in the blood is less than 1200 per 1 ml. Such a strong immunodeficiency can be observed against the background of tumor pathologies, AIDS, the use of corticosteroids, etc.
Pregnancy is also a contraindication for varicella vaccination. If surgery is to be performed, then the vaccination should be given a month before the manipulation.
Vaccines have another contraindication - the presence of an allergy to neomycin or other components of the drug, as well as a severe reaction to the previous administration of the vaccine.
