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Varicella (Chickenpox and Shingles)

General Information

Varicella (Chickenpox) is a highly contagious disease caused by the varicella-zoster virus. It mainely spreads from unvaccinated people with chickenpox to other people who have never had the virus before. It causes an itchy, blister-like rash in most people.

Varicella-zoster virus also causes shingles. After people recover from chickenpox, the virus stays dormant in the body. This virus can reactivate later in life and cause shingles.

The best way to prevent chickenpox is to get the chickenpox vaccine.

Symptoms

Common Symptoms

It takes about 10 to 21 days after exposure to a person with chickenpox or shingles for symptoms of chickenpox to start. Symptoms of chickenpox usually last about 4 to 7 days. Common symptoms include:

  • Fever
  • Tiredness
  • Loss of appetite
  • Headache
  • Rash

The rash usually turns into itchy, fluid-filled blisters that eventually become scabs. The rash may start on the chest, back, and face. Then it can spread over the entire body, including inside the mouth, eyelids, or genital area. It usually takes 1 week for all the blisters to become scabs.

Complications

Serious complications from chickenpox can occur but are not common in healthy people who get the disease. Serious complications can include:

  • Bacterial infections of the skin and soft tissues in children
  • Infection of the lungs (pneumonia)
  • Infection or swelling of the brain (encephalitis, cerebellar ataxia)
  • Bleeding problems
  • Bloodstream infections (sepsis)
  • Dehydration

Some people who experience complications from chickenpox become so sick that they have to be hospitalized. In the most dangerous cases, chickenpox may lead to death. Hospitalizations and death from chickenpox are rare today thanks to widespread chickenpox vaccination.

Spread

Chickenpox is highly contagious. Chickenpox spreads in two main ways:

  • Direct contact with fluid from a rash blister or contact with a contaminated surface
  • Breathing in virus from a blister

Varicella-zoster virus spreads mainly from unvaccinated people with chickenpox to others who have never had the virus. People can get the virus by touching contaminated surfaces and then rubbing their eyes, nose, or mouth.

Up to 9 out of 10 people who are not immune and have close contact with someone with chickenpox will get infected. A person with chickenpox is contagious from 2 days before the rash begins until all the blisters have scabbed over.

People who never had chickenpox before or did not get chickenpox vaccine can get infected with the virus from someone who has shingles. They will get chickenpox, not shingles.

People at Higher Risk

People who may be at high risk for severe chickenpox or complications include:

  • Infants
  • Adolescents
  • Adults
  • Pregnant women
  • People with weakened immune systems

Prevention

The best way to prevent chickenpox is to get the chickenpox vaccine. Everyone should get 2 doses of chickenpox vaccine if they never had chickenpox or were never vaccinated. This includes children, adolescents, and adults. Most people who get the vaccine will not get chickenpox.

Other ways to prevent chickenpox include:

  • Wash your hands frequently with soap and water
  • Do not share eating utensils
  • Clean surfaces that are frequently touched on a regular basis

You can protect yourself from shingles by getting the shingles vaccine. Adults 50 years and older can get the vaccine to help prevent shingles. People 19 years and older who have weakened immune systems can also get the shingles vaccine.

People who never had chickenpox before or are unvaccinated can get chickenpox from someone who has shingles. If you have shingles, keeping the rash covered can help lower the risk of spreading the virus to others. Keep the rash covered until after it scabs over.

Resources

General Resources

Varicella fact sheets 

Shingles fact sheet (PDF)

Varicella exclusion recommendations

Varicella surveillance reports

US CDC Chickenpox Information

Immunization Resources