Chickenpox

What is Chickenpox?

1. Chickenpox is a common viral infection caused by the varicella-zoster virus.

2. Highly contagious (spreads very easily and quickly from one person to another).

3. It start with small red spots (Itchy rash) that turns into fluid-filled blisters all over the body, eventually scabbing over.

It is usually a mild illness in healthy children.

However, it can sometimes lead to complications, which can be categorized as immediate (occurring during or shortly after the acute illness) and late (occurring months or even years later).

How Does Chickenpox Spread?

• Airborne droplets: When an infected person coughs, sneezes, or talks, tiny virus-containing droplets spread in the air. Others nearby can inhale these and get infected.

• Direct contact: Touching the fluid from chickenpox blisters or rash can spread the virus to others.

• Contaminated surfaces: The virus can survive briefly on objects like clothes, bedding, or toys. Touching these and then touching your face or mouth can cause infection. Very Rare

• Highly contagious: A person with chickenpox can spread the virus 1 to 2 days before the rash appears and remains contagious until all blisters have crusted over (usually upto 5–7 days after rash starts).

Can Chickenpox Spread Through Contaminated Surfaces?

Yes, the Varicella-zoster virus (which causes chickenpox) can survive for a short time on surfaces like:

• Clothes

• Bedding

• Toys

• Door handles

However, this is not the most common way it spreads.

How Common Is Surface Transmission?

➡ Rare but possibleMost infections happen through airborne droplets (coughing, sneezing) or direct contact with blisters.

➡ The virus on objects doesn’t stay alive long (usually minutes to a couple of hours), especially on dry surfaces.

➡ Surface transmission is more likely:

• In crowded or closed environments

• If a person touches fresh blister fluid on clothes or bedding

• If they then touch their nose, mouth, or eyes

Symptoms and Stages:

Incubation Period

• Duration: 10–21 days after exposure (average ~14 days)

• Symptoms: None — the virus is replicating silently

Prodromal Phase (mostly in older children and adults)

• Duration: 1–2 days before rash appears

• Symptoms:

  • Low-grade fever

  • Malaise

  • Loss of appetite

  • Headache

  • Occasionally mild abdominal pain

Note: Young children may skip this phase entirely.

Rash Phase (Exanthem Stage)

• Duration: 5–10 days

• Progression:

  1. Starts as macules (flat red spots)

  2. Evolves into papules (raised bumps)

  3. Then vesicles (fluid-filled blisters)

  4. Vesicles become pustules

  5. Finally, they crust over and scab

• Key Feature: Lesions appear in "crops", meaning different stages may be present at the same time.

• Distribution: Starts on the face, chest, and back, then spreads to extremities

• Associated Symptoms:

  • Itching (pruritus)

  • Fever spikes

  • Irritability, especially in children

Recovery Phase

• Crusts fall off in 1–2 weeks

• Usually leaves no scars unless scratched or infected

Contagious Period

• Highly contagious from 2 days before rash onset until all lesions have crusted over

Treatment

In Children (Uncomplicated Cases)

✅ Supportive Treatment

💊 Antiviral Treatment

For whom?

Antivirals like Acyclovir may be prescribed if started within 24–48 hours of rash onset in:

• Children at high risk of complications (e.g., skin conditions, lung issues)

• Adults (especially >13 years old)

• Pregnant women

• Immunocompromised individuals

🛡️ Prevention of Spread

• Isolation: Until all vesicles have crusted over

• Avoid school/daycare during active stage

• Hygiene: Frequent handwashing, separate towels/clothes

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💉 Vaccination (Preventive Only)

• First dose: 12–15 months

• Second dose: 4–6 years ( 6 months after first dose in endemic region like India)

• Can prevent or reduce severity if given within 3–5 days of exposure

Complications (not common but serious)

• Secondary bacterial infections (skin)

• Pneumonia (especially in adults)

• Encephalitis (rare but severe)

• Reye's syndrome (especially with aspirin use)

• Severe disease in immunocompromised or pregnant individuals

Reactivation: Herpes Zoster (Shingles)

• Varicella virus stays dormant in nerve roots

• Can reactivate years later as shingles, especially:

  • With age

  • In immune suppression

  • During stress

• May cause post-herpetic neuralgia (chronic nerve pain)

How to Protect Yourself?

• Avoid close contact with infected people.

• Wash hands often.

• Don’t share personal items.

• Get vaccinated!