Chickenpox in Adults

What is chickenpox?

Chickenpox is a very contagious disease caused by the varicella virus. Chickenpox is also called varicella.

How does it occur?

The chickenpox virus is spread through the air by infected people when they sneeze or cough. The disease also spreads from touching the chickenpox blisters without careful handwashing afterwards.

If you have already had chickenpox, you are probably immune. Being immune means that if you are exposed to chickenpox again, your body can fight off the infection and you will not get sick. If you had a very mild case of chickenpox with just a few blisters, it is possible to have chickenpox again, but this is very rare.

After infection, the virus stays in your body for life. The virus can later cause shingles, which causes a painful, blistering rash on one side of the body. Touching the fluid in the shingles blisters can spread chickenpox to someone who has not had chickenpox.

Less than 5% of adults are at risk of having chickenpox. Most are immune because they have had chickenpox or the shot. However, when an adult has chickenpox, the infection can be more serious than it is in children.

What are the symptoms?

Symptoms usually appear 10 to 21 days after exposure to the virus. The symptoms include:

small blisters on the skin, which later break open, form a crust (scab), and begin to itch
tiredness
fever
aches and pains.

How is it diagnosed?

Your health care provider will ask about your symptoms and examine you. If you are pregnant and think you have been recently exposed to chickenpox, you may have a blood test to see if you are immune. Chickenpox during pregnancy can cause babies to not grow fully before birth and it may cause babies to die before or at the time of birth. It can spread to babies during childbirth.

How is it treated?

For treatment, follow the guidelines provided below under the heading "How can I take care of myself?"

Your health care provider may prescribe an antiviral medicine, such as acyclovir. The medicine helps only if you start taking it within 24 hours after the first sores appear. According to recent research, antiviral medicine has mild benefits: it reduces the number of sores and lessens the time you are sick. It does not prevent other problems caused by chickenpox.

Pregnant women who have recently been in close contact with someone who has chickenpox and are not immune may be given a shot of Varicella-zoster immune globulin (VZIG). When given within 72 hours after exposure, VZIG helps prevent chickenpox or lessens its severity. The shot is safe for mother and baby.

How long do the effects last?

Chickenpox is contagious 1 to 2 days before the rash appears. It continues to be contagious until all of the blisters have crusted over, which usually takes 4 to 5 days.

If there are no complications, adults have the chickenpox infection for 3 to 7 days.

Adolescents or adults are more likely to have complications from chickenpox than children. People who have trouble fighting infections are especially at risk for problems. This includes people being treated for cancer with chemotherapy or radiation, people who use steroids for other medical conditions, and people who have HIV infection. Possible complications are pneumonia or problems with the kidneys, heart, or joints. The nervous system may be affected, which may cause irritation and swelling in the brain (meningitis or encephalitis) or other types of nervous system problems. Sometimes an infection of the skin develops because bacteria get into sores when they are scratched.

How can I take care of myself?

Take a lukewarm bath every 3 to 4 hours for the first few days. Add 2 ounces (4 tablespoons) of baking soda, cornstarch, or oatmeal per tub of water. Use soap in one of the baths each day to clean as much bacteria off the skin as possible.
Use calamine lotion on the chickenpox sores to help relieve itching.
Put an ice pack or cool moist washcloth on itchy areas for 20 to 30 minutes.
If the itching is severe or making it hard to sleep, take a nonprescription antihistamine, such as Benadryl.
Trim your fingernails and wash your hands often to help keep the rash from becoming infected if you scratch it.
Take a nonprescription pain reliever such as acetaminophen for headache, fever, or general aches and pains.

What can be done to prevent chickenpox?

A vaccine is available to protect against chickenpox. Two shots are recommended for people 13 years or older who have not had chickenpox.

If you are exposed to chickenpox and you are pregnant and not immune, your health care provider will give you a shot of VZIG to help prevent the infection. You may also be given this shot if you have trouble fighting infections; for example, if you have cancer, HIV, or AIDS, or if you are receiving medicines that weaken the immune system.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File INF4545F.HTM Release 9.0/2006