Chickenpox is one of the most contagious childhood infections. It is caused by the varicella-zoster virus, which does not disappear after recovery but stays dormant in nerve cells. Years later in some people it wakes up as shingles. The virus spreads through the air and through contact with the fluid in the blisters. A person who has not had chickenpox and is not vaccinated is very likely to catch it after exposure: the CDC says about 90% of unvaccinated household contacts get infected.
Chickenpox symptoms
Symptoms begin 10 to 21 days after exposure. At first there may be a slight fever, tiredness, headache, and poor appetite, and sometimes nothing else for the first hours or a day. Then the typical rash appears:
- red spots turn into raised bumps and then into blisters filled with clear fluid;
- after a day or two the blisters dry out and form scabs;
- new spots keep appearing in waves for 3 to 5 days, so the body shows spots at different stages at the same time;
- the rash itches a lot and can appear on the body, face, scalp, and inside the mouth.
A person is contagious from 1 to 2 days before the rash appears until all the blisters have crusted over, which usually takes about a week. In vaccinated people chickenpox is often milder, with only a few spots, but they can still spread it.
Why chickenpox can be dangerous
In healthy children the illness usually passes without lasting effects. The most common complication is a bacterial infection of scratched blisters, which can leave scars. Adults get pneumonia more often than children and have a harder time overall. Severe illness is possible in newborns, in people with weak immune systems, and in pregnant women who never had chickenpox. Infection in the first half of pregnancy can lead to congenital varicella syndrome (damage to the baby's skin, eyes, and nervous system), and infection of the mother shortly before birth is dangerous for the newborn.
How chickenpox is treated
Healthy children do not need specific treatment. The illness clears up on its own in 1 to 2 weeks. The goal is to ease symptoms and prevent complications.
- Bring down fever and pain with medicine your doctor recommends. Never give aspirin (acetylsalicylic acid) for chickenpox, because of the risk of Reye syndrome.
- Keep a child's nails short and explain that the blisters must not be scratched, since that causes scars and infection. Dress the child in light, soft clothes.
- Give a warm shower every day without a washcloth, and pat the skin dry instead of rubbing.
- For adults, pregnant women, people with weak immune systems, and newborns, a doctor may prescribe an antiviral medicine or immunoglobulin. These need to be started as early as possible.
A doctor decides which creams and solutions to use on the spots. A sick person stays isolated until all the blisters have dried and stays out of daycare and school.
Chickenpox vaccine in Georgia
Chickenpox is not part of Georgia's routine national immunization calendar (Minister's Order No. 01-60/n, version of July 13, 2023), so children do not get this vaccine under the state program. The order recommends it from 12 months for specific risks: health workers, people exposed to a patient, and people with chronic illnesses (including blood disorders) or immune problems. This vaccination is paid for by the person, the employer or a special program, so it is usually given for a fee at private clinics. Check with the clinic in advance that the vaccine is in stock.
The BigMed catalog lists the Varivax vaccine (MSD), a course of two doses. Vaccine prices at clinics in Georgia are listed further down this page. The vaccine can be given from 12 months of age. Adults who never had chickenpox should discuss it with a doctor, especially women planning a pregnancy, health workers, and people who live or work close to people with weak immune systems. The vaccine is live, so it is not given during pregnancy or to people with severe immune deficiency. A doctor decides on the schedule.
If you were in contact with a sick person and have not had chickenpox or the vaccine, see a doctor right away: in the first days after exposure, vaccination or immunoglobulin may help, especially for people in risk groups.
When to see a doctor urgently
- a fever above 39 °C (102 °F) lasts more than three days or comes back after improving;
- redness, swelling, pus, or growing pain around the blisters;
- shortness of breath, cough, or chest pain;
- severe headache, drowsiness, seizures, or unsteady walking;
- a rash on the eyelids, near the eye, or in the ear;
- a newborn, a pregnant woman, or a person with a weak immune system falls ill;
- a pregnant woman who never had chickenpox has been in contact with a sick person.
If the condition is severe, call an ambulance at 112.
