Chickenpox

Chickenpox (varicella) is a common, preventable childhood infection caused by the varicella-zoster virus. It causes an itchy rash, and can spread very easily. 

Chickenpox is usually mild in most children, but it can be serious for some people, including:

• People with weakened immune systems (for example, people with cancer or taking steroid medicine).
• People who are pregnant and not protected against chickenpox.
• Adolescents and adults who get varicella are more likely to have serious disease than children.

Vaccination is the best way to protect against chickenpox and/or any serious illness from it.

Can vaccination prevent chickenpox?

The best protection against chickenpox are varicella-containing vaccines. They are part of the routine vaccine schedule in Nova Scotia and offered for free to those who are eligible.

What to know about varicella-containing vaccines:

• They are safe and highly effective at keeping you protected from chickenpox.
• Varicella vaccination is available as a stand-alone vaccine (varicella vaccine) or as part of the MMRV vaccine, which also protects against measles, mumps and rubella. MMRV is authorized for use in children up to and including age 12.
• Children who have chickenpox before the age of 1 may not develop long-term immunity and are recommended to be vaccinated.
• Vaccination may cause a sore spot, mild redness, and/or swelling where the needle was given and may cause a fever in some children. These are expected reactions that should go away on their own.
• Sometimes, varicella-containing vaccine may cause a chickenpox-like rash within one to four weeks of getting vaccinated. This rash is mild and usually resolves within a few days.

Who should get vaccinated?

People born in 2006 or later:

• 2 doses of the MMRV vaccine or the varicella vaccine are strongly recommended.
• These doses are usually given at 12 and 18 months as part of Nova Scotia’s routine vaccine schedule.
• People who missed these vaccines can catch up for free, if they have not had chickenpox after turning 1. 

People born between 1996 and 2005:

• 1 free dose of the varicella vaccine is recommended if you have not had it before, or if you have not had chickenpox after turning 1.

All others

• Most people who were born prior to the introduction of the varicella vaccine in Nova Scotia (1996) will have natural immunity from infection in childhood.
• Some people who are not immune may be eligible for the vaccine, including post-partum individuals found not to be immune during pregnancy. Please talk with a healthcare provider to learn more.

How to get vaccinated:

• Go to a Public Health Immunization Clinic
• Find a mobile vaccine clinic in your area
• Contact your local Public Health Office
• Contact your local Community Pharmacy Primary Care Clinic
• Contact your primary healthcare provider
• Check your vaccine records online (vaccination may appear as MMRV or Varicella in your records)

How does chickenpox spread?

Chickenpox spreads through the air, and by direct contact with fluid from the blisters that make up the rash.

• It can start spreading up to 2 days before the rash appears.
• It stops spreading when all blisters have dried and scabbed over. This usually happens 5–7 days after the rash began.

What are the symptoms of chickenpox?

Signs and symptoms of chickenpox usually start 10-21 days after contact with the virus.

Symptoms:

• Fever
• Tiredness
• Sore throat
• Aches and pains
• Headache
• Loss of appetite
• Rash

About the rash:

• Usually starts 1-2 days after other symptoms
• Often begins on the scalp or face, then spreads down the body
• Starts as pink spots, then turns into small, itchy blisters
• Blisters dry up and form scabs in 4-5 days
• New spots can appear while others are healing
• Spots often appear in “crops” - several spots grouped together in an area of the body

What complications can happen from chickenpox?

While chickenpox usually resolves without any serious issues, complications can occur. These are more likely in the groups mentioned above at higher risk for serious disease. Complications can include:

• Bacterial skin infections, including invasive infections, which can be life-threatening.
• Brain infections (encephalitis), which are life-threatening and/or at serious risk of causing permanent neurological damage.
• Pneumonia.
• Liver infections.
• Pregnant people can transmit the chickenpox virus to their fetus, leading to a condition called Congenital Varicella Syndrome. Congenital Varicella Syndrome may cause serious problems with the brain, eyes, limbs and skin of a baby, and frequently leads to death. 

What to do if symptoms start?

A person who has chickenpox symptoms should do the following:

• Stay home from school, work, daycare or other public places until the last blisters have scabbed over (usually 5 days).
• Contact a primary care provider or Public Health so that:
  • any close contacts can be quickly identified and preventative treatments given where needed,
  • you can receive support if needed.
• If you need to seek medical attention, please call ahead so staff can prepare for your arrival and lower the risk of spreading the virus to others.

How is chickenpox treated?

While some people who have or are at higher risk for severe illness from chickenpox may be treated with antiviral medications, in most cases chickenpox resolves on its own. The following options can help alleviate symptoms and promote recovery:

• Rest and drink lots of fluids.
• Try not to scratch. Scratching can cause infection from bacteria that get into the skin.
• Add baking soda to bathwater, it can have a soothing effect.
• Ask a healthcare provider about topical creams that can reduce itching.
• If you want to control your child’s fever, use acetaminophen-based products, like Tylenol. Do not give aspirin (ASA) or any products that contain aspirin. Giving aspirin to a child with chickenpox can trigger Reye’s syndrome, a life-threatening condition that involves brain and liver swelling. 

When should you seek medical assistance?

• A new fever starts after the first few days.
• A chickenpox spot looks infected (very red, swollen, or painful).
• You are worried that the person is very sick or their symptoms are getting worse.
• The person with chickenpox/suspected chickenpox is at risk for severe disease and/or may benefit from antiviral treatment (infants, adolescents, adults, immunocompromised, pregnant).

Questions?

If you have questions about chickenpox or vaccination, you can call 811, speak to a primary care provider or pharmacist, or call Public Health.