Chickenpox

Definition

Chickenpox is one of the classic childhood diseases, and one of the most contagious. The affected child or adult may develop hundreds of itchy, fluid-filled blisters that burst and form crusts. Chickenpox is caused by a virus.

The virus that causes chickenpox is varicella-zoster, a member of the herpesvirus family. The same virus also causes herpes zoster (shingles) in adults.

Alternative Names

Causes

In a typical scenario, a young child is covered in pox and out of school for a week. The first half of the week the child feels miserable from intense itching; the second half from boredom. Since the introduction of the chickenpox vaccine, classic chickenpox is much less common.

Chickenpox is extremely contagious, and can be spread by direct contact, droplet transmission, and airborne transmission. Even those with mild illness after the vaccine may be contagious.

When someone becomes infected, the pox usually appear 10 to 21 days later. People become contagious 1 to 2 days before breaking out with pox. They remain contagious while uncrusted blisters are present.

Once you catch chickenpox, the virus usually remains in your body for your lifetime, kept in check by the immune system. About 1 in 10 adults will experience shingles when the virus re-emerges during a period of stress.

Most cases of chickenpox occur in children younger than ten. The disease is usually mild, although serious complications sometimes occur. Adults and older children usually get sicker than younger children do.

Children under one year of age whose mothers have had chickenpox are not very likely to catch it. If they do, they often have mild cases because they retain partial immunity from their mothers' blood. Children under one year of age whose mothers have not had chickenpox, or whose inborn immunity has already waned, can get severe chickenpox.

The pox are worse in children who have other skin problems, such as eczema or a recent sunburn.

Complications are more common in those who are immunocompromised from an illness or medicines like chemotherapy. Some of the worst cases of chickenpox have been seen in children who have taken steroids during the incubation period, before they have any symptoms.

References

Long SS. Principles and Practice of Pediatric Infectious Disease. 2nd ed. St. Louis, MO: Elsevier; 2003.

Chen TM. Clinical manifestations of varicella-zoster virus infection. Dermatol Clin. 2002; 20(2): 267-282.

Burton A. Vaccine vanquishes varicella. Lancet Infect Dis. 2002; 2(4): 202.

American Academy of Pediatrics. Committee on Infectious Diseases. Varicella vaccine update.Pediatrics. 2000 Jan;105(1 Pt 1):136-41. Review.