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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Chickenpox in Adults
What is adult chickenpox?
Chickenpox, also called varicella, is a very contagious
disease caused by the varicella virus.
How does it occur?
The varicella virus is spread through the air by infected
people when they sneeze or cough. The disease also spreads
through contact with infected chickenpox blisters.
If you have already had chickenpox, you are probably immune.
This means that if you are exposed to chickenpox again, your
body can fight off the infection and you will not get sick.
If you had a very mild case of chickenpox with just a few
blisters, it is possible to have chickenpox again, but this
is uncommon.
After infection, the virus stays in your body for life. The
virus can later cause shingles, which causes a painful,
blistering rash on one side of the body. Contact with the
fluid in the shingles blisters can spread chickenpox to
someone who has not had chickenpox.
Because most adults are already immune, less than 5% of
adults are at risk of infection with the chickenpox virus.
When an adult has a chickenpox infection, the disease can be
more serious than it is in children.
What are the symptoms?
Symptoms usually appear 10 to 21 days after you are exposed
to the virus. Symptoms of chickenpox include:
- small blisters on the skin, which later break open, form a
crust (scab), and begin to itch
- tiredness
- fever
- aches and pains.
How is it diagnosed?
Your health care provider will ask about your symptoms and
examine you. If you are pregnant and think you have been
exposed to chickenpox, you may have a blood test. Chickenpox
while you are pregnant may cause stillbirths or birth
defects. It can spread to babies during childbirth.
How is it treated?
Follow the guidelines provided in the section below for
taking care of yourself.
Your health care provider may prescribe acyclovir. This
medicine helps only if it is started within 24 hours of the
appearance of the first sores. According to recent research,
acyclovir has mild benefits: it reduces the number of sores
and the days of illness. It does not prevent other
complications caused by chickenpox.
How long do the effects last?
Chickenpox is contagious 1 to 2 days before the rash appears
and then continues to be contagious for 4 to 5 more days.
If there are no complications, adults have the chickenpox
infection for 3 to 7 days.
Adolescents or adults are more likely to have complications
from chickenpox than children. People who are
immunocompromised are especially at risk for complications.
This includes people being treated for cancer with
chemotherapy or radiation, people who use steroids for other
medical conditions, and people who have HIV infection.
Possible complications are pneumonia, and inflammation of the
kidneys (nephritis), heart (myocarditis), or joints
(arthritis). The nervous system may be affected, causing
such complications as inflammation in the brain (meningitis
or encephalitis) or other types of nerve inflammation.
Sometimes a bacterial infection develops because bacteria
enter the skin where it has been scratched.
How can I take care of myself?
- Use calamine lotion to help relieve itching.
- Take a lukewarm bath every 3 to 4 hours for the first few
days. Add 2 ounces (4 tablespoons) of baking soda,
cornstarch, or oatmeal per tub of water. Use soap in one
of the baths each day to clean as much bacteria off the
skin as possible.
- Put an ice pack or cold moist washcloth on itchy areas for
20 to 30 minutes.
- If the itching is severe or making it difficult to sleep,
take a nonprescription antihistamine, such as Benadryl.
- Trim your fingernails and wash your hands often to help
keep the rash from becoming infected if you scratch it
- Take a nonprescription pain reliever such as acetaminophen
for headache, fever, or general aches and pains.
What can be done to prevent chickenpox?
A vaccine is available to protect against chickenpox. Two
doses of the vaccine are recommended for people 13 years or
older who have not had chickenpox. Side effects are mild and
may include pain and redness at the injection site. A mild
rash may develop.
If you are exposed to chickenpox and you are pregnant and
have not had chickenpox or the chickenpox vaccine, your
health care provider will give you a shot of Varicella-zoster
immune globulin (VZIG) to help prevent the infection. You
may also be given this shot if you are immunocompromised; for
example, if you have cancer, HIV, or AIDS, or if you are
receiving medicines that weaken the immune system.
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