How Chicken Pox is Spread

Chicken pox is usually spread by breathing in droplets coughed, sneezed, or exhaled by an infected person. After exposure, it can take 10 to 21 days before symptoms appear. A person usually develops the symptoms 14 to 16 days after being exposed.

A person can spread the disease to others before he or she even has any symptoms of chicken pox. The contagious period begins about 2 days before the rash appears and continues until new sores stop appearing. Once all the sores have turned to scabs, the contagious period is over.

Symptoms

The early symptoms of chicken pox are cold symptoms, fever, abdominal pain, headache, and a general feeling of illness. These can come with the rash or a day or two before it. The fever may be higher the first few days after the rash appears.

The rash appears as small, itchy, red bumps and spots on the face, scalp, shoulders, chest, and back. It is also normal for it to appear inside the mouth, on the eyelids, and in the genital area. Some people may have just a few bumps, while others are covered with them.

The early bumps are usually flat, red marks with central, clear blisters. The blisters quickly dissolve and become dry crusts or scabs, which fall off within
2 weeks. New sores continue to appear for the first 4 to 5 days, so all stages of the rash may be present at the same time.

Complications of Chicken Pox

It is rare for a person to have more than one case of chicken pox in a lifetime. Although a case of the pox brings immunity to the virus, the virus may lay quiet and later be reactivated in some adults, causing a rash. This rash, called shingles (or herpes zoster), is more common in people older than age 60.

Chicken pox may leave permanent scars, especially in teenagers and young adults. Temporary marks may remain for 6 months to a year before fading.

Chicken pox can cause cellulitis, viral pneumonia, or encephalitis. Cellulitis is a serious bacterial infection affecting the skin, which becomes red, swollen, and unusually warm. Viral pneumonia is an infection of the lungs caused by certain viruses and associated with symptoms of fever, cough, and shortness of breath. Encephalitis, a viral infection of the brain, is a very rare complication of chicken pox. Still, it’s wise to be alert to its symptoms: fever, mental confusion, forgetfulness, tiredness, and a stiff neck. Take the person to the doctor’s office or emergency room at once if you notice any of the symptoms associated with these three conditions.

Prevention

If you’ve been exposed to chicken pox, call your doctor. Medication or immunization may prevent the disease.

• Avoid contact with others during the contagious period (until all sores have turned to scabs). That means anyone with chicken pox should not be at work, school, or day care while contagious. If other people may have been exposed to the disease, be sure to tell them to watch out for spots about 2 weeks from the date of exposure.
• It’s nearly impossible to prevent the spread of chicken pox within a household. Some studies find that 9 times out of 10, siblings of a person with chicken pox will get the disease.
• If you need to take the person to the doctor’s office, call ahead and tell the staff that you suspect chicken pox, so arrangements can be made to avoid spreading the disease to other clinic patients. In most cases, people with chicken pox don’t need to come to the clinic. The condition can be successfully handled at home with calls to the doctor’s office for advice. Your doctor may recommend medication that can shorten the length of the disease or result in fewer sores if taken within the first few days of the onset of the rash.

The varicella vaccine for chicken pox has been approved for general use in the United States and is also used in several other countries. It is recommended for children over a year old who have not had chicken pox.

Self-Care

• Give plenty of cold fluids.
• To reduce fever, give acetaminophen (Tylenol or Tempra). Do not use aspirin.
• To relieve mouth ulcers, prepare a soft, bland diet. Avoid salty foods and citrus fruits and juices.
• For painful or itchy pox in the genital area, apply a petroleum-based ointment or an over-the-counter local anesthetic.
• If a sore seems to be infected, wash with antibacterial soap and apply antibacterial ointment.
• Call your doctor if fever is higher than 101°F for more than 4 days.
• Children don’t have to stay in bed but should be kept cool and quiet.
• Children may return to school or day care when they have no fever and all sores are crusted over.

Scratching the scabs off chicken pox sores can lead to more itching and infection. These steps will help reduce the urge to scratch:

• Take cool baths every 3 to 4 hours.
• Add an oatmeal bath product, such as Aveeno (follow directions), or baking soda (about a half cup) to tub water to reduce itchiness.
• Give nonaspirin (acetaminophen) if symptoms are very bothersome.
• Keep fingernails trimmed short and wash hands often to prevent infection.
• Wear clean cotton gloves to bed to reduce the danger of scratching while asleep.
• Apply calamine lotion or hydrocortisone products to itchy areas. Caladryl is helpful too, but on rare occasions people can develop an allergy to it.
• If you have been exposed to chicken pox and are immunocompromised, pregnant, or have had a bone marrow transplant, see your doctor.