Specific Complications Of Chickenpox
Aside from itching, the complications described below are usually rare.
Itching
Intense itching is the most common complication of chickenpox. It can be very distressing, particularly for small children. Many home remedies can help relieve the discomfort. It is important not to scratch the scabs because this can lead to scarring.
Bacterial Skin Infections
In some cases, a secondary bacterial infection may develop at sites that were scratched. If the skin around the scab becomes red, swollen, or warm, this may be a sign of a secondary bacterial infection. If you or your child develops these symptoms contact your health care provider because in rare cases, serious bacterial complications can occur.
Varicella Pneumonia
Varicella pneumonia is an uncommon but serious complication of chickenpox. It usually develops 1 to 6 days after the chickenpox rash appears. Fever and cough may be signs of varicella pneumonia. Pregnant women, people who are immunocompromised, and smokers are at increased risk for this lung complication.
Encephalitis and Meningitis
Encephalitis and meningitis are rare but serious neurological complications of chickenpox. Meningitis is inflammation of the lining of the spinal cord and brain. Encephalitis is the inflammation of the brain itself. Signs and symptoms include:
- Nausea and vomiting
- Sensitivity to light
In encephalitis, seizures and coma can occur. Meningitis and encephalitis are very serious conditions that require immediate medical treatment.
Ruling Out Other Disorders
Ruling out Disorders that Resemble Chickenpox
Chickenpox, particularly in early stages, may be confused with herpes simplex, impetigo, insect bites, or scabies.
Ruling out Disorders that Resemble Shingles
The early prodrome stage of shingles can cause severe pain on one side of the lower back, chest, or abdomen before the rash appears. It may be mistaken for other disorders, such as gallstones, that cause acute pain in internal organs.
In the active rash stage, shingles may be confused with herpes simplex, particularly in young adults, if the blisters occur on the buttocks or around the mouth. Herpes simplex, however, does not usually generate chronic pain.
A diagnosis may be difficult if herpes zoster takes a non-typical course in the face, such as with Bell palsy or Ramsay Hunt syndrome, or if it affects the eye or causes fever and delirium.
What Happens When Someone Gets Chickenpox
- The tell-tale symptom of chickenpox is a rash that develops into itchy blisters over the entire body. The rash can spread into the mouth or other areas inside the body.
- Chickenpox can also cause body aches, fever, and fatigue.
- Chickenpox is not usually severe, but the risk of hospitalization and death is increased in adults and adolescents.
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Chickenpox Dynamics Following Vaccination
To evaluate the impact of chickenpox vaccination, we estimated the number of cases that would have been averted had the chickenpox vaccine had been introduced in Thailands routine immunization program in 1996 under various roll-out scenarios . The simulated model without vaccination closely resembled the raw data . Model simulations that included immunization revealed a large drop in the number of chickenpox cases . Routine infant immunization was implemented by vaccinating a portion of newborns each year, a value that varied depending on coverage and uptake .
Fig. 1Fig. 2
Percent change in shingles cases compared to no vaccination, using a 20 year protection from chickenpox vaccination. Top row simulations provided 5 years of immunity from shingles vaccination and bottom row simulations provided lifetime immunity from shingles vaccination. Each column represents the number of years after vaccine introduction: a and e 25 years, b and f 50 years, c and g 75 years, and d and h 100 years. Shingles and chickenpox vaccine coverage are shown on the x– and y-axes. Color scale on the right indicates the largest decrease in shingles cases can be seen in dark blue, while the largest increase in shingles cases can be seen in red
Fig. 3Fig. 4
Redness At Injection Site
Redness at and around the injection site is common and may appear immediately or some days after receiving Shingrix. This redness commonly develops due to a localized immune system response, which shouldnt cause further concern.
Arm redness should disappear within a few days after receiving the vaccine. However, if you experience redness with a rash or severe pain, let your doctor know as soon as possible.
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What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
Everything You Need To Know About Chickenpox And Why More Countries Dont Use The Vaccine
Andrew Pollard, Professor of Paediatric Infection and Immunity, University of Oxford
Chickenpox symptoms appear 10-21 days after exposure of a person who hasnt met the disease before to an individual who is suffering from the disease. Individuals are infectious from one day before the onset of the rash until the spots have crusted over.
The first symptom is usually a high temperature, which settles over the next few days. About a day after the fever starts, the typical chickenpox rash appears. The rash appears as crops of new spots over the next few days and after five days most people stop cropping new spots and their fever has settled.
For the majority of children, chickenpox is just a rather unpleasant illness and a nuisance for their parents who have to take time off work to look after them. Most people develop the illness in childhood, but for those who dont, the illness is far more severe among adults. It is especially dangerous, and may even be fatal, if contracted in late pregnancy.
The disease can also be life-threatening for children and adults who are born with a poorly functioning immune system, in those receiving treatment for cancer and in patients with other conditions for which treatments are given to suppress the immune system .
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Chickenpox Shingles And Vaccines: Expert Shares What You Need To Know
Chickenpox and shingles generally wont kill you, but for some adults, they could result in a trip to the hospital. So with a new shingles vaccine now available, should you consider vaccination to avoid chickenpox and shingles as an adult?
Physician Sharon Orrange, MD, clinical associate professor of medicine at the Keck School of Medicine of USC, said the answer depends on a few factors.
What is chickenpox, exactly?
Its an infection caused by the varicella zoster virus. In children, its usually a mild disease that runs its course in five to 10 days and requires no medical intervention. But in those who develop chickenpox as teens or adults, theres a risk of complications, including pneumonia, skin infections and brain swelling.
Whats the difference between chickenpox and shingles?
Adults can develop shingles if theyve already had chickenpox. Also called herpes zoster, shingles is a reactivation of the virus that causes chickenpox. After you recover from chickenpox, the virus doesnt entirely disappear it lies dormant in nerve tissue near your spinal cord and brain. When it springs into action again as a painful skin rash, thats shingles.
This time, the pain will likely come before the rash some people only experience the pain without any visible symptoms. Like chickenpox, shingles usually isnt life-threatening, but it can cause complications, including neurological problems, skin infections and eye infections that lead to vision loss.
Connie Sommer
Who Should Not Be Vaccinated Against Chickenpox
Chickenpox vaccine is a live vaccine. This means that it can cause chickenpox, although it is usually milder, and it should not be used for certain groups of people who have reduced infection-fighting ability , such as if you:
- are taking high-dose oral steroids such as prednisone or dexamethasone
- are getting chemotherapy or radiation
- have a condition that reduces your immunity such as cancer or HIV
- have active untreated TB
- have had another live vaccine within the past 4 weeks.
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Why Is It Important To Receive A Vaccination Against Shingles
About 33% of adults in the U.S. will develop shingles at some point in their lives. Shingles can cause painful blisters, a rash, chills, and fever, among other symptoms. Many people who have shingles later develop PHN, which can cause long-lasting pain that is difficult to treat.
Getting the Shingrix vaccine can help individuals avoid shingles and PHN and help prevent shingles from spreading to vulnerable people.
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Can You Get Chickenpox If You’ve Been Vaccinated
Yes. About 15% 20% of people who have received one dose of varicella vaccine do still get chickenpox if they are exposed, but their disease is usually mild. Vaccinated persons who get chickenpox generally have fewer than 50 spots or bumps, which may resemble bug bites more than typical, fluid-filled chickenpox blisters. In 2006, the Advisory Committee on Immunization Practices voted to recommend routine two-dose varicella vaccination for children. In one study, children who received two doses of varicella vaccine were three times less likely to get chickenpox than individuals who have had only one dose.
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Does Chicken Pox Start With One Spot
Chickenpox may start out seeming like a cold: You might have a runny or stuffy nose, sneezing, and a cough. But 1 to 2 days later, the rash begins, often in bunches of spots on the chest and face. From there it can spread out quickly over the entire body sometimes the rash is even in a person’s ears and mouth.
Who Needs Chickenpox Vaccine
Children under age 13 years should get two doses:
- First dose at age 12 through 15 months.
- Second dose at age 4 through 6 years.
The second dose may be given at an earlier age if it is given at least 3 months after the first dose.
People 13 years of age and older who have never had chickenpox or received chickenpox vaccine should get two doses, at least 28 days apart. Chickenpox vaccination is especially important for:
- Healthcare professionals
- People who care for or are around other people whose body is less able to fight germs and sickness
- Residents and staff in nursing homes and other residential settings
- College students
- Inmates and staff of correctional institutions
- Military personnel
- Non-pregnant women of child-bearing age
- Adolescents and adults living with children
- International travelers
To check if you are protected from chickenpox, see Assessing Immunity to Varicella.
Some people with a weakened immune system who do not have immunity against chickenpox may be considered for vaccination after talking with their doctor, including:
- People with HIV infection
- People with cancer, but whose disease is in remission
- People on low dose steroids
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What If Ive Never Had Chickenpox
Almost everyone born before 1980 tests positive for exposure to varicella, Orrange said. Thats why the federal Advisory Committee on Immunization Practices considers people born before 1980 immune to the varicella virus. Even if you never broke out in the telltale rash, if youre 38 years old or older, you almost certainly have the virus lying dormant in your system.
Should Pregnant Women Worry About Chickenpox
Pregnant women who have already had chickenpox disease or the vaccine do not need to worry. However, women who are not immune, who get chickenpox while they are pregnant, are more likely than other adults to develop serious complications. The unborn baby can also be affected. Babies born to mothers with a current case of chickenpox can develop high fevers and other serious problems. Pregnant women who have been exposed to somebody with chickenpox should contact their doctor immediately. Those who are not sure if they had chickenpox can have a blood test to see if they are protected against the virus.
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An Increase In Shingles: Whats The Cause
As we age, we become more susceptible to shingles, and people who are immune-suppressed, such as people with cancer or HIV, are also at higher risk of the disease. But other hypothesized triggers, such as stress or sunburn, remain unproven, says Stephanie R. Bialek, MD, MPH, leader of the herpes virus unit at the CDCâs Division of Viral Diseases.
A study by the CDC and other scientists confirmed that since 1993, the incidence of shingles has nearly doubled in the adult U.S. population. One explanation for the increase has to do with the universal vaccination of children against chickenpox. According to this theory, because most children no longer get chickenpox disease , their parents no longer get the immunological âboostâ that comes from being exposed to the virus while caring for sick children.
âThe best explanation for the increase is that we used to get a subclinical boost when we were exposed to the chickenpox virus as adults,â said William Schaffner, MD, a pediatrician and vaccine expert at Vanderbilt University. âBecause of widespread immunization, thatâs not happening.â
Itâs possible that as the U.S. population is getting older, more people are seeing their doctors for shingles. âThere are probably different factors involved in the increase,â says Bialek. And it may take decades to sort it out. But regardless of whether shots against chickenpox increased the risk of shingles, the shot against shingles is the best way to avoid it.
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% Lower Shingles Risk In The First 2 Years
Forbes and the team analyzed data from 9,604 adults who had received a diagnosis of herpes zoster between 1997 and 2018 and had lived with a child who developed chickenpox during that period.
The scientists set out to measure the relative incidence of herpes zoster in the 2 decades after exposure to chickenpox in the household, compared with the incidence during baseline that is, during the unexposed time.
Of the participants, 6,584 were women. The adults were reexposed to varicella at the age of 38 years, on average. Overall, 4,116 adults developed herpes zoster during the baseline period and 5,055 during the high-risk period.
The researchers adjusted for age, season, and calendar time, concluding that In the 2 years after household exposure to a child with varicella, adults were 33% less likely to develop zoster, compared with the baseline period.
Furthermore, in the 1020 years after reexposure to the virus, they were 27% less likely to develop herpes zoster. Also, men were more likely to benefit from an immunity boost than women.
The relative incidence of zoster was lower in the periods after exposure to a household contact with varicella, conclude the authors, with modest but long-lasting protective effects.
This study suggests that exogenous boosting provides some protection from the risk of herpes zoster, but not complete immunity, as assumed by previous cost-effectiveness estimates of varicella immunization.
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Who Should Not Get The Chickenpox Vaccine
Some people should not get the chickenpox vaccine or may need to wait for example, if you:
- Have had a life-threatening allergic reaction to a previous dose of the chickenpox vaccine or any ingredient in the vaccine
- Have recently had a blood transfusion or were given other blood products
- Have an illness thats more serious than a cold
Be sure to tell your doctor before getting the chickenpox vaccine if you:
- Have HIV/AIDS or another immune system disorder
- Are taking medicines that can affect the immune system
- Are getting treatment for cancer.
Side effects are usually mild and go away in a few days. They may include:
- Pain, swelling, and redness where the shot was given
Serious side effects from the chickenpox vaccine are very rare.
Like any medicine, there’s a very small chance that the chickenpox vaccine could cause a serious reaction. Keep in mind that getting the chickenpox vaccine is much safer than getting chickenpox. Learn more about vaccine side effects.
The Risks Of Poor Vaccine Uptake
According to the UK NHS website, there are two key reasons why chickenpox vaccines arent routinely administered in the country. The first has a lot to do with the increasing severity of the disease as people age.
The NHS says: If a childhood chickenpox vaccination programme were introduced, people would not catch chickenpox as children because the infection would no longer circulate in areas where the majority of children had been vaccinated.
It seems highly unlikely that UK parents would reject the chickenpox vaccine for their children while consenting to all the others.
This would leave unvaccinated children susceptible to contracting chickenpox as adults when theyre more likely to develop a more severe infection or a secondary complication, or in pregnancy, when theres a risk of the infection harming the baby.
If the chickenpox vaccine were introduced for young children in the UK but uptake was low, then reduced spread and consequential immunity during the early years would probably lead to a higher number of cases among older children and adults.
These people would then experience more severe illnesses with a higher risk of complications, increasing the burden of chickenpox on the healthcare system.
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