Chickenpox
(Varicella)
What is chickenpox?
Chickenpox is a common childhood disease caused by a virus. The virus is called the varicella-zoster virus. 
Most people contract chickenpox by age 15, the majority between age 5 and 9, but all ages can contract it. Chickenpox is usually more severe in adults than children. Winter and spring are the most common times of the year for chickenpox to occur.
Chickenpox is very highly contagious. It is easily passed between members of families and school classmates through airborne particles, droplets in exhaled air and fluid from the blisters or sores. Indirect transmission also occurs through contact with articles of clothing and other items exposed to fresh drainage from open sores. Patients are contagious up to 5 days (more commonly, 1 to 2 days) before and 5 days after the date that their rash appears. When the sores have crusted over, the person is usually no longer contagious.
What are the symptoms?
Symptoms tend to appear 14 to 16 days after initial exposure but can occur any time from 10 days up to 21 days after contact with the virus. Chickenpox is characterized by 1 to 2 days of mild fever up to 102 degrees F, general weakness, and a rash, often the first sign of the disease. Rarely, a person may have the disease without the rash. The rash of chickenpox develops in crops with raised red spots arriving first, progressing to blisters that burst, creating open sores, before crusting over. This process usually starts on the scalp, then the trunk (its area of greatest concentration), and finally the arms and legs. Any area of skin that is irritated (by diaper rash , poison ivy , eczema, sunburn, etc.) is likely to be hard hit by the rash. The rash is typically very itchy (pruritic).
What are the possible complications?
Complications can and do occur from chickenpox. The most prominent is bacterial infection of the open pox sore, sometimes causing scarring, especially if the patient scratches the inflamed area. In fact, among children, bacterial skin infection is the most common complication of chickenpox. The next most common complications in children affect the central nervous system and include a disorder of the cerebellar portion of the brain (cerebellar ataxia with wobbliness, dizziness , tremor , and altered speech), encephalitis (inflammation of the brain with headaches, seizures, and decreased consciousness), damaged nerves (nerve palsies) and Reye's syndrome (a potentially fatal combination of liver and brain disease). Especially serious complications can occur in patients with AIDS, lupus, leukemia , and cancer . Complications also occur in people taking immune-suppressing drugs, such as cortisone-related medications. Newborn infants whose mothers have chickenpox in the last trimester of pregnancy are at increased risk from the disease. If the mother develops the disease from 5 days before to 2 days after delivery, the fatality rate for the baby is up to 30%.
Conclusion
Most people develop lifetime immunity to chickenpox after the first occurrence and never experience it again. But the virus can sometimes resurface later in life as shingles (zoster). The current aim in the U.S. and many other countries is to achieve universal (or nearly universal) immunization of children with the chickenpox vaccine. The vaccination requires only one shot given at about one year of age. If an older person has not had chickenpox, the shot may be given at any time. There have been few significant adverse reactions to the chickenpox vaccine. All children, except those with a compromised immune system, should have the vaccination.
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