*Almost everyone gets chickenpox by adulthood. In the United States, chickenpox affects about 4 million persons per year, mostly children. In temperate climates, most cases occur in the late winter and spring.
Although most people think that chickenpox is always a mild disease, deaths from chickenpox continue to occur in the United States. Although most people recover from chickenpox uneventfully or with a few minor scars, a small percentage suffers more serious complications. Those at highest risk for complications are newborns, persons with weakened immune systems, and adults. Although adults make up fewer than 5% of chickenpox cases in the United States, they account for half of the deaths from the disease.
The most common complications of chickenpox are skin infections and pneumonia. Other complications are encephalitis (inflammation of the brain) and hepatitis. Chickenpox can also lead to severe problems in pregnant women, causing stillbirths, birth defects, or infection of the newborn during childbirth.
Chickenpox is typically a benign, self-limited disease, but serious complications can arise. About 14,000 people are hospitalized because of chicken pox and approximately 100 people die of chickenpox every year. The risk of complications is highest in people with compromised immune systems, newborns, and adults.
Chickenpox, also known as varicella, is a very contagious disease caused by the varicella-zoster virus. Infected people spread it easily through the air when they sneeze or cough. The disease also spreads through contact with an infected person’s chickenpox blisters. Because chickenpox is very contagious, it is possible for people who have never had chickenpox nor been vaccinated against it to become infected just by being in a room with someone who has the disease. However, transient exposure is not likely to result in infection.
Early symptoms may include body aches, fever, fatigue, and irritability. A rash then appears and develops into as many as 250-500 itchy blisters over the entire body, that usually last for 5-7 days and heal with scabs. The rash may even spread into the mouth or other internal parts of the body. The illness is usually not severe, but the risk of hospitalization and death is increased among adolescents and adults. Symptoms appear between 10 and 21 days after exposure to the varicella-zoster virus. Persons who were vaccinated against chickenpox may sometimes develop chickenpox, but it is usually mild, with approximately 50 or fewer red bumps that rarely evolve to blisters.
Shingles, or herpes zoster, is a common illness that strikes about 1 million Americans each year, about half of whom are 60 years of age and older. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. When people are first infected with the varicella-zoster virus, usually as children, they get chickenpox. Years or decades later, the virus can reactivate and cause shingles. Anyone who has had chickenpox is at risk of shingles. Shingles is associated with normal aging and with anything that weakens the immune system such as certain medications, cancers, or infections, but it can also occur in healthy children and younger persons.
With shingles, a painful, blistering rash tends to occur on one side of the body, usually on the trunk or face. There may be pain, numbness or tingling of the area 2 to 4 days before the rash appears. Pain or numbness usually resolves within weeks, but it can sometimes persist for much longer. Damage can occur to the eyes or other organs if they are involved. One of the most serious long-term consequences of shingles is post- herpetic neuralgia (PHN), a condition where pain persists after the rash has resolved. PHN pain can be very difficult to treat and it can diminish quality of life and functioning to a degree comparable to congestive heart failure, heart attack, type II diabetes and major depression.
Chickenpox (varicella) rarely causes complications, but it is not always harmless. It can cause hospitalization and, in rare cases, death. Fortunately, since the introduction of the vaccine in 1995, hospitalizations have declined by nearly 90%, and there have been few fatal cases of chickenpox.
Adults have the greatest risk for dying from chickenpox, with infants having the next highest risk. Males (both boys and men) have a higher risk for a severe case of chickenpox than females. Children who catch chickenpox from family members are likely to have a more severe case than if they caught it outside the home. The older a child is, the higher the risk for a more severe case. But even in such circumstances, chickenpox is rarely serious in children. Other factors put individuals at specifically higher risk for complications of chickenpox. Shingles occurs in about 20% of people who have had chickenpox. The older you are, the higher the risk for complications from either chickenpox or shingles. Adults who smoke are at particularly higher risk for pneumonia from chickenpox.
In most cases, people can treat chicken pox at home, as it works its way through the body in about a week. According to the Mayo Clinic, the following physical signs indicate that you should go to the doctor:
- Fever lasting longer than four days or exceeding 102 degrees Fahrenheit
- Rash spreads to your eyeballs
- Rash appears infected
- Stiff neck
- Increased vomiting or coughing
Although children make up a majority of chicken pox cases, they typically experience the fewest severe complications. However, kids need to be careful not to scratch the itchy blisters because about one in 20 children will get an infected rash. The bacteria from fingernails can infect the open blisters and cause a secondary infection.
Chickenpox can be spread very easily to others. You may get chickenpox from touching the fluids from a chickenpox blister, or if someone with the disease coughs or sneezes near you. Even those with mild illness may be contagious.
A person with chickenpox becomes contagious 1 to 2 days before their blisters appear. They remain contagious until all the blisters have crusted over.
Once you have had chickenpox, the virus usually remains dormant or asleep in your body for your lifetime. About 1 in 10 adults will have shingles when the virus re-emerges during a period of stress.
Remember, I’m not a doctor. I just sound like one.
Take good care of yourself and live the best life possible!
The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.
Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and is a health columnist and radio commentator who lectures, and is an active media contributor nationally and internationally on health related topics.
His second book, “Information is the Best Medicine”, was released in January, 2011.
For more good health information, visit: www.glennellis.com