Chickenpox

Chickenpox (varicella) is a highly contagious viral disease caused by varicella-zoster virus (VZV). Outbreaks are more common in winter and early spring. A vaccine is available.

Chickenpox is spread by air-borne droplets from the upper respiratory tract (coughing, sneezing) or from the fluid in the skin lesions. An infected person is contagious for 1–2 days (possibly five days) before the onset of rash and remains infectious until the blisters form scabs (usually around day five of the illness).

For most healthy people, chickenpox is mild and self-limiting. However, complications occur in approximately one per cent of cases. It is more severe in adults and anyone of any age with impaired immunity.

Symptoms
The symptoms of chickenpox include:

• The person develops a low grade fever.
• The person experiences general discomfort, illness or lack of wellbeing (malaise).
• A skin rash appears as little blisters surrounded by irregular-shaped patches of inflamed skin (‘dew drop on a rose petal’).
• The rash usually starts on the body, then progresses to include the head and limbs.
• Ulcers may develop in certain areas, including the mouth and vagina.
• The rash is intensely itchy.
• The little blisters burst and develop crusts, usually about day five.

• Scarring – chickenpox can leave pockmark scars on the skin.
• Cellulitis – a type of bacterial infection of the skin.
• Pneumonia – infection and inflammation of the lung can occur in adults and can be fatal.
• Encephalitis – usually mild, but sometimes severe.
• Bleeding disorders – these are rare but can be fatal.
• Death.

• Newborns – there is an increased risk of severe illness in the first 28 days of life.
• Pregnant women – who have not had chickenpox or been vaccinated for chickenpox. If a pregnant woman acquires chickenpox in the first 20 weeks of pregnancy, there is risk of congenital varicella syndrome and this can cause abnormalities. After 20 weeks the risk is lower. However, having chickenpox around the time of delivery (five days prior to or within two days after delivery) can result in a high mortality rate of the newborn.
• People who have depressed immunity – such as people with leukaemia or Hodgkin’s disease, or those taking immunosuppressive drugs, are at risk of longer and more serious illness.

• Bed rest
• Medication to bring down the fever (aspirin should be avoided because of a possible increased risk of complications)
• Lukewarm baths with baking soda or oatmeal added to the water (A cup of oatmeal can be put into part old, clean pair of panty hose, tied and left in the bath while the water runs.)
• Calamine lotion to reduce the itching
• Avoidance of salty or citrus foods
• Babies and young children may need to wear mittens to prevent scratching
• Acyclovir – a type of antiviral medication, for more serious illness.

• Children at 18 months, unless they have already had the chickenpox infection
• Year 7 secondary school students who have not had chickenpox or received the vaccine.

• People in high-risk occupations such as health care workers, teachers and childcare workers
• Women prior to pregnancy, to avoid congenital or neonatal chickenpox
• Women immediately after delivery
• Parents of young children
• Household contacts of persons with impaired immunity.

• Your doctor
• Local council
• Nurse-on-Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)

• Chickenpox (varicella) is a highly contagious viral disease.
• The main symptom is the characteristic blistering skin rash.
• In most cases, chickenpox is mild and self-limiting.
• Treatment options include bed rest, calamine lotion and lukewarm baths.
• A vaccine is available to protect against chickenpox.