Chickenpox

Chickenpox (varicella) is a highly contagious viral illness. It spreads by droplets and contact and causes fever with an itchy rash of fluid-filled blisters that crust over. It is usually mild in healthy children, but can be severe in adults, pregnant women, newborns, and people with weakened immunity. A vaccine prevents it.

Symptoms

• Fever, tiredness, headache, loss of appetite — 1-2 days before rash.
• Itchy rash — small red bumps → clear blisters → pustules → crusts; new crops appear over 3-5 days. Commonly on face, trunk, scalp first.
• Mouth ulcers.
• Infectious from 1-2 days before rash until all lesions have crusted.

Who needs urgent medical care

• Newborns.
• Pregnant women (particularly in the 2nd/3rd trimester, or near delivery).
• Adults — tend to have more severe illness.
• Immunocompromised people (cancer, HIV, steroid therapy, transplant).
• Any child with: severe headache, neck stiffness, confusion, persistent vomiting, severe breathing difficulty (possible pneumonia), spreading red/warm skin around lesions (bacterial superinfection), dehydration.

Care at home

• Rest, fluids, simple pain relievers for fever. Avoid aspirin in children — linked to Reye syndrome.
• Calamine lotion, cool baths, loose cotton clothing for itch.
• Keep nails short (prevent infection from scratching).
• Oral antihistamines for severe itch if advised.
• Isolate at home until all lesions have crusted — usually 5-7 days after the last new spot.
• Keep away from pregnant women, newborns, and immunocompromised people.

Treatment

• Antivirals — recommended for adults, pregnancy, immunocompromised, newborns; sometimes for children over 12 or with severe illness. Work best started within 24 hours.
• Post-exposure prophylaxis — vaccine or antibody (VZIG) within days of exposure can reduce severity in high-risk people.

Prevention

Varicella vaccine is safe and effective. It is not part of UIP but is widely available in private practice in India (usually 2 doses, first after 12 months). Adults without immunity may consider catching up — especially before pregnancy, or if working with children, or immunocompromised households. Once had chickenpox, the virus can reactivate later in life as shingles — another reason vaccination matters.