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Chickenpox (varicella zoster) fact sheet
Chickenpox is a highly contagious illness caused by the varicella-zoster virus (VZV), a type of herpes virus. It
is often a mild illness, characterized by an itchy rash on the face, scalp and trunk with pink spots and tiny
fluid-filled blisters that dry and become scabs four to five days later. Serious complications, although rare, can
occur mainly in infants, adolescents, adults and persons with a weakened immune system. These
complications include bacterial infections of skin blisters, pneumonia, and encephalitis (inflammation of the
brain). In temperate climates, such as the Northeast, chickenpox occurs most frequently in the late winter and
Chickenpox is a common childhood illness with 90 percent of the cases occurring in children younger than ten
years of age. Before the availability of the varicella vaccine in the U.S., almost everyone developed
chickenpox. Most people who are vaccinated will not get chickenpox. Those who are vaccinated and develop
chickenpox usually have a mild form of the illness. They have fewer spots and recover faster.
Chickenpox is transmitted from person to person by directly touching the blisters, saliva or mucus of an
infected person. The virus can also be transmitted through the air by coughing and sneezing. Chickenpox can
be spread indirectly by touching contaminated items freshly soiled, such as clothing, from an infected person.
Direct contact with the blisters of a person with shingles can cause chickenpox in a person who has never had
chickenpox and has not been vaccinated. Blisters that are dry and crusted are no longer able to spread
Initial symptoms include sudden onset of slight fever and feeling tired and weak. These are soon followed by
an itchy blister-like rash. The blisters eventually dry, crust over and form scabs. The blisters tend to be more
common on covered than on exposed parts of the body. They may appear on the scalp, armpits, trunk and
even on the eyelids and in the mouth. Mild or asymptomatic infections occasionally occur in children. The
disease is usually more serious in young infants and adults than in children.
Symptoms commonly appear 14 to 16 days (range of ten to 21 days) after exposure to someone with
What are the complications associated with chickenpox?
Newborn children (less than one month old) whose mothers are not immune may suffer severe, prolonged or
fatal chickenpox. Any person with a weakened immune system, including those with cancer, human
immunodeficiency virus (HIV) or taking drugs that suppress the immune system, may have an increased risk
of developing a severe form of chickenpox or shingles.
Reye Syndrome is an unusual complication of chickenpox that is linked to children who take aspirin or aspirin-
containing products during the illness. Reye Syndrome is a severe disease affecting all organ systems, but,
most seriously the brain and liver and may be fatal. The exact cause of Reye Syndrome is unknown. Aspirin or
aspirin-containing products should never be given to children under 18 years of age with chickenpox.
When and for how long is a person able to spread chickenpox?
A person is most able to transmit chickenpox from one to two days before the rash appears until all the
blisters are dry and crusted. People with a weakened immune system may be contagious for a longer period of
Acyclovir is approved for treatment of chickenpox. However, because chickenpox tends to be mild in healthy
children, most physicians do not feel that it is necessary to prescribe acyclovir. Acyclovir can be considered for
otherwise healthy people who are at risk of moderate to severe varicella. It is important to consult with your
physician for recommendations on the use of acyclovir.
Does past infection with chickenpox make a person immune?
Most people do not get chickenpox more than once. However, since varicella-zoster virus remains in the body
after an initial infection, infection can return years later in the form of shingles in some older adults and
A vaccine to protect children against chickenpox was first licensed in 1995. Children who have never had
chickenpox should routinely be administered two doses of varicella vaccine with the first dose at 12 to 15
months and the second dose at four to six years of age. Persons 13 years of age and older who have never
had chickenpox or have not received the varicella vaccine should get two doses of the varicella vaccine at least
The varicella vaccine may be given along with the measles-mumps-rubella (MMR) vaccine in a combination
called measles-mumps-rubella-varicella (MMRV) that is approved for use in children 12 months through 12
In New York State, varicella vaccine is required for children enrolled in pre-kindergarten programs and
schools. Vaccination is recommended for healthcare personnel and college students who have never had
What can be done to prevent the spread of chickenpox?
Maintaining high levels of varicella immunization in the community is critical to controlling the spread of
chickenpox. To prevent further spread of chickenpox, people infected with the disease should remain home
and avoid exposing others who are susceptible. Infected persons should remain home until the blisters
become dry and crusted. It is very important to avoid exposing non-immune newborns and persons with a
Varicella vaccination is recommended for outbreak control. During an outbreak, persons who do not have
adequate evidence of immunity should receive their first or second dose as appropriate.
In 2006, a new product called VariZIG™ became available to protect patients without evidence of immunity to
varicella who are at high risk for severe disease and complications and have been exposed to chickenpox. The
patient groups recommended to receive VariZIG include those with a weakened immune system, pregnant
women, newborns whose mothers have symptoms of varicella around the time of delivery (five days before to
two days after delivery) and certain premature infants exposed to chickenpox as newborns.
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