Chickenpox (Varicella)

Chickenpox: Symptoms, Causes, Complications, and Prevention

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Chickenpox, also known as varicella, is a highly contagious viral infection that causes an itchy rash with fluid-filled blisters. Learn about its symptoms, causes, complications, and how vaccination can prevent infection.

Keywords: chickenpox, varicella virus, chickenpox symptoms, varicella vaccine, chickenpox prevention, contagious diseases, varicella complications, herpes zoster

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Overview

Chickenpox is a contagious disease caused by the varicella-zoster virus (VZV). It leads to an itchy rash with small, fluid-filled blisters and spreads easily among people who have never been infected or vaccinated.
Before the vaccine was developed, chickenpox was a common illness, but today, vaccination has made it largely preventable.
The varicella vaccine is a safe and effective way to protect children and adults from chickenpox and its potential complications.

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Symptoms

Chickenpox symptoms usually appear 10 to 21 days after exposure to the virus and last for about 5 to 10 days.
Before the rash appears, early symptoms may include:

• Fever

• Loss of appetite

• Headache

• Fatigue and general malaise

Once the rash appears, it progresses through three stages:

1. Red bumps (papules): Small raised spots appear over several days.

2. Blisters (vesicles): Within about a day, bumps turn into fluid-filled blisters that may break and leak.

3. Scabs (crusts): After the blisters burst, they form scabs that heal in a few days.

New spots may continue to appear for several days, so you might have papules, vesicles, and scabs all at the same time.
The virus can spread up to 48 hours before the rash appears and remains contagious until all blisters have crusted over.

In most healthy children, chickenpox is mild. However, in some cases, the rash can cover the entire body, including the throat, eyes, and genital area.

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When to See a Doctor

Contact your doctor if you suspect you or your child has chickenpox.
Diagnosis is usually made based on the rash and other symptoms.
Your doctor may prescribe antiviral medication or other treatments to reduce symptoms and prevent complications.

Seek medical attention immediately if:

• The rash spreads to the eyes.

• The skin becomes very red, swollen, or painful (possible bacterial infection).

• You experience confusion, dizziness, rapid heartbeat, difficulty breathing, muscle weakness, severe cough, vomiting, stiff neck, or a fever higher than 102°F (38.9°C).

• A household member is pregnant or has a weakened immune system.

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Causes

Chickenpox is caused by the varicella-zoster virus (VZV).
It spreads through:

• Direct contact with the rash or blisters

• Airborne droplets from an infected person’s coughs or sneezes

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Risk Factors

You are at higher risk of infection if:

• You have never had chickenpox

• You have not been vaccinated

• You work with children, such as in schools or childcare centers

Most people who have had chickenpox or received the vaccine develop lifelong immunity.
If vaccinated individuals get chickenpox, the symptoms are typically mild and short-lived.

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Complications

Although chickenpox is usually mild, it can cause serious complications such as:

• Bacterial infections of the skin, bones, joints, or bloodstream

• Dehydration

• Pneumonia

• Encephalitis (inflammation of the brain)

• Toxic shock syndrome

• Reye’s syndrome (especially in children taking aspirin)

In rare cases, chickenpox can be life-threatening.

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Who Is at Higher Risk of Severe Chickenpox?

Certain groups are more vulnerable to severe complications:

• Newborns and infants whose mothers never had chickenpox or the vaccine

• Teenagers and adults

• Pregnant women who have never had chickenpox

• Smokers

• People with weakened immune systems (such as cancer patients or those with HIV)

• Organ transplant recipients

• People taking immune-suppressing medications or long-term steroids

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Chickenpox and Pregnancy

If a woman contracts chickenpox early in pregnancy, the baby may be born with low birth weight or limb abnormalities.
If infection occurs near delivery, the newborn may develop a life-threatening infection.
Pregnant women without immunity should speak to their doctor about the risks and precautions.

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Chickenpox and Shingles

After recovering from chickenpox, the virus can remain dormant in nerve cells.
Years later, it may reactivate and cause shingles (herpes zoster) — a painful blistering rash.
Adults over 50 and people with weakened immunity are at higher risk.

The shingles vaccine (Shingrix) is recommended for:

• Adults aged 50 and older

• Adults 19 and older with weakened immune systems

Even those who have had shingles or the older Zostavax vaccine can benefit from Shingrix.

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Prevention

The varicella vaccine is the best way to prevent chickenpox.
Two licensed vaccines are available in the U.S.:

1. Varivax: Protects only against chickenpox.

2. ProQuad (MMRV): Combines vaccines for measles, mumps, rubella, and varicella.

Vaccination schedule:

• Children (12–15 months): First dose

• Children (4–6 years): Second dose

• Unvaccinated teens (7–12 years): Two doses at least 3 months apart

• Unvaccinated adults (13 years and older): Two doses at least 4 weeks apart

People at high risk (healthcare workers, teachers, military personnel, and childcare staff) should ensure they are vaccinated.
If unsure about prior infection or vaccination, a blood test can check immunity.

Important:

• Pregnant women should not receive the vaccine.

• Avoid pregnancy for at least one month after the last vaccine dose.

• People with weak immune systems, certain allergies, or recent blood transfusions should consult a doctor before vaccination.

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Is the Chickenpox Vaccine Safe and Effective?

Yes. Studies confirm that the varicella vaccine is safe and highly effective.
Most side effects are mild, including soreness, redness, or slight fever at the injection site.
Severe reactions are extremely rare.

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