Information about Varicella (Chickenpox)
What is chickenpox? Chickenpox, also called varicella, is a viral disease that can spread easily and quickly from person to person.
- The disease is most common among children under 15 years old.
- Serious complications are rare, but are more common in newborns, pregnant women, people with weakened immune systems, and adults.
What are the symptoms?
- People with chickenpox get an itchy rash that looks like tiny blisters.
- The rash usually starts on the face, stomach, chest or back, and spreads to other parts of the body.
- A mild fever, tiredness, and slight body discomfort usually come with the rash.
Symptoms usually begin about 10-21 days after exposure to the virus.
How is chickenpox spread?
- Chickenpox is spread from person to person by coughing, sneezing, or touching the rash.
- People with chickenpox can spread the disease from 1-2 days before symptoms start until all the lesions are crusted over, which usually takes 5 days.
Under state regulations, people with chickenpox must stay out of school and work and refrain from public activities until all their blisters have dried and crusted.
Who gets chickenpox?
- Anyone who has never had chickenpox and has never been vaccinated against chickenpox can get the disease.
- Sometimes, even people who have been vaccinated will still get chickenpox (called "breakthrough" chickenpox. Breakthrough disease is usually milder, but it is still contagious.
How can you prevent chickenpox?
- A vaccine is available to prevent chickenpox and is required for school attendance.
- Additionally, when people receive chickenpox vaccine within 3 (and possibly up to 5) days of being in contact with someone with chickenpox, it decreases their chances of getting chickenpox.
Those who have already received one dose of chickenpox vaccine should talk with their healthcare provider about receiving a second dose of chickenpox vaccine. All children enrolled in school are required to have 2 doses of varicella (chickenpox) vaccine.
What should pregnant women and those with weakened immune systems do?
- Newborns, pregnant women, and some people with weakened immune systems cannot receive chickenpox vaccine.
- If you have been in contact with someone with chickenpox and you do not have a history of chickenpox, you should see a doctor immediately.
You may not be able to receive the vaccine, but you may get a shot of antibodies to chickenpox called VZIG (varicella-zoster immune globulin), or intravenous immunoglobulin (IVIG), if VZIG is not available, to lower the chances of severe complications. VZIG or IVIG should be given with 96 hours of exposure.
What should I do if my child gets chickenpox?
- Please say home, call your doctor and your supervisor at work.
- Also, keep all chickenpox lesions and other wounds clean and watch for possible signs of infection, including increasing redness, swelling, drainage and pain at the wound site.
- A person with an infected wound, especially if fever develops, should seek medical care.
- Good hand-washing and covering your mouth when coughing can help prevent the spread of infections.
- Thoroughly wash your hands and children's hands after wiping noses and before eating or preparing food.
- Do not share food, cups, spoons, or drinking straws.
What should students do?
- If your child does not have serologic proof of immunity, a history of chickenpox as verified by a healthcare provider, or documentation of at least one dose of chickenpox vaccine, you child must receive a dose of vaccine as soon as possible.
- If your child has already received one dose of chickenpox vaccine, you should talk with your provider about your child receiving a second dose of vaccine.
All students entering kindergarten, and those in grades 1 through 5 are required to have 2 doses of varicella.
If you develop symptoms of chickenpox, please stay home, follow the guidelines above, and call your doctor and the school nurse.
For more information, please call your local board of health or MDPH at 617-983-6800.
Vaccine-modified varicella syndrome (VMVS or "breakthrough chickenpox")
Breakthrough chickenpox is a form of chickenpox that occurs in vaccinated individuals. It is less severe, due to the development of "partial immunity", which, although not sufficient to prevent disease, does cause the symptoms to be less severe. This illness usually presents as a generalized rash consisting of fewer than 50 lesions. The rash is generally seen as red spots on the skin which may be flat or raised. A few fluid-filled vesicles may be present. There is often no fever and symptoms may be slight, however, people with breakthrough chickenpox are still considered infectious.
Chickenpox is transmitted person-to-person when a person coughs or sneezes or by direct contact with nasopharyngeal secretions or lesions of an infected person.
It usually takes 14-16 days from the time of exposure until a person develops the symptoms of chickenpox (may take from 10-12 days). The infectious period for chickenpox begins 1-2 days before the rash appears. If vesicles are present, individuals are considered infectious until all of the vesicles have formed scabs, usually within 5 days of rash onset.
Vaccinated persons with chickenpox may develop lesions that do not crust (red spots only). These persons are no longer contagious once the lesions have faded or no new lesions appear with a 24-hour period.
Caution: Aspirin (or products containing salicylate) should never be used in any viral illness, but particularly if influenza or chickenpox is suspected, because of the association of Reye's syndrome (vomiting, liver function abnormalities, and/or coma) with aspirin use in these illnesses.