Chickenpox is a common infectious disease caused by a virus. It is very contagious and most people already have chickenpox as a child. Common symptoms are fever and fluid-filled blisters, which can itch a lot. The symptoms are often more troublesome the older you are when you get chickenpox. The disease usually heals itself.

You can only get chickenpox once. Once you have had the disease you become immune. Then you can meet people who have chickenpox without getting sick. Also, you can’t get a  shingle from meeting a person who has chickenpox, even though the diseases are caused by the same virus.

Symptoms of chickenpox

These are the most common symptoms of chickenpox:

  • fever
  • headache
  • tiredness
  • red rash on upper body, arms, and legs.

It usually takes between ten and twenty days from the time you are infected until the first symptoms of chickenpox are noticed. They are usually fever, headache, and fatigue. After a few days, red rashes are formed, usually on the upper body. They can spread to the face, scalp, arms, and legs. The rash can occur anywhere on the body. They can come on mucous membranes, such as in the mouth, throat, rectum, pubic lips or penis.

Rashes and blisters that itch

The rashes start out as red dots, which become knots and eventually blisters with a transparent liquid in. If you have dark skin, the rashes can be difficult to see before the blisters arrive. The blisters often itch. The rash can come in several rounds, for four to five days. At each bullet, you can get a little fever.

How many blisters you get may vary. Some get only a few blisters, while others get blisters all over the body. After someday they burst and small scabs form. After a few days the crusts dry and roll off. The blisters usually heal nicely, without forming scars.

Symptoms are milder in children than adults

Chickenpox is a viral disease that tends to be alleviated the earlier in life you get the disease. Symptoms often become more difficult when the child is older. Adults often get more rashes and more itching than children. Children usually get healthy a week after the first symptoms show up, but for adults, it may take longer.

When and where should I seek care?

In children, chickenpox usually passes by itself, without the child having to see a doctor. But there are exceptions when you should contact a health care center :

  • If the child is under six months and the mother has not had chickenpox.
  • If the child is very tired and included.
  • If the child has a reduced immune system.
  • If the child has a persistent fever over 38 degrees for more than three to four days.
  • If the child gets many infected cups, with red and tender skin.
  • If the child is allowed to cough and fever again after the blisters have healed.
  • If the child has severe problems with itching and non-prescription drugs will not help.

Always seek care if you are 18 years of age or older

If you are 18 years or older, you should always contact the healthcare provider if you have been infected with chickenpox. Especially if you have a reduced immune system. Treatment for chickenpox must be started as soon as possible in order to have a good effect. Preferably within 24 hours after the blisters have arrived.

You should also seek care at a health care center if you get a cough and fever again after the blisters have healed. It may be a sign of pneumonia.

If you are pregnant, you have not had chickenpox before and suspect that you have come in contact with the infection should contact a health care center or a midwife reception.

Always call first

If you need to seek care, call before you go in. Contact a health care center first. To avoid infecting others, you may be shown directly to an examination room to see a doctor, without first sitting in the waiting room. This also applies to sick children.

So chickenpox is infected

Chickenpox is very contagious. The time it takes for the disease to spread out is usually about two weeks but can vary from ten to twenty days. You become immune when you have had the disease once. Then there is no danger in meeting someone with chickenpox. This is true even if you are pregnant.

Chickenpox is spread through direct contact from person to person or through the exhaled air and when you cough or sneeze, for example. You can spread the virus even before you notice any symptoms. Therefore, it is difficult to avoid passing on the infection. Often, a whole preschool group or school class can get chickenpox at the same time.

Chickenpox infects most from a few days before the rash appears until about six days after they start to appear. But it can get infected until all the chickenpox has dried in and become sores.

How long should children stay at home?

When a case of chickenpox is detected, for example at a preschool, the infection has often already spread. Therefore, it is difficult to stop the infection by keeping the baby at home.

The child can go back to preschool or school when they are fever-free and feel good, and are able to be in a children’s group all day and participate in the usual activities. Children usually get healthy one to two weeks after the symptoms show up.

Notify preschool or school if your child has chickenpox, as more may have been infected.

Read more at  Försäkringskassan about the rules that apply to the care of sick children.

You do not get shingles from meeting someone with chickenpox

You can only get chickenpox once in a lifetime. When you have the disease, antibodies are formed against it and you become immune. The virus that causes chickenpox stays in the body for the rest of life. Sometimes it can be activated again and then cause the disease shingles, which also causes blisters on the skin.

You can’t get shingles from meeting someone with chickenpox.

In contrast, the virus in a shingles bladder can, through direct contact, infect a person who has not previously had chickenpox, so that the person gets chickenpox. It is very uncommon for this to happen because most people have had chickenpox as a child.

How can I prevent chickenpox?

It can be difficult to prevent chickenpox from spreading because you are contagious even before you get any symptoms.

You can vaccinate yourself if you pay yourself

There are smallpox vaccines, which provide good protection and have few side effects. It is a so-called live vaccine. This means that a small dose of weakened chickenpox virus is injected into the body, which then builds up antibodies to the disease.

In several other European countries and in the United States. You can choose to vaccinate yourself or your child if you pay yourself. Anyone who wants can be vaccinated if you do not have a severely impaired immune system or are pregnant.

The vaccine can be given to children from the age of nine months, as well as to adolescents and adults. 

The protective effect against chickenpox after two injections is very good. If you still get the disease despite vaccination, the problems will be alleviated more easily than if you have not been vaccinated.

What can I do for myself?

The most common trouble with chickenpox is that the rashes itch. You can do several things yourself to relieve the hassle.

Keep your skin clean

Wash skin with soap and water. By keeping your skin clean you can prevent bacteria from getting into the chickenpox so that they become infected. It can easily happen if you itch a lot.

Relieve the itching

You can relieve the itching with a cold conditioner, alcohol, and cool water.

Cooling balm and spirits can be bought at a pharmacy without a prescription. Coldwater can also feel cool and comfortable on the skin. Cooling conditioner and cool water can also be used against itchy rash on mucous membranes on the body.

Some non-prescription antihistamines can be used for itchings, such as Loratadine and Clarityn. There is an age limit for many of the medicines and it is stated on the package.

Avoid hydrocortisone

Avoid using cream or ointment with hydrocortisone against itching of chickenpox, as it can make the bladders more easily infected by bacteria.

Medication for pain and fever in children

  • You can give medicines containing paracetamol to children from three months of age. 
  • You can give medicines containing ibuprofen from the age of six months. Do not give ibuprofen for chickenpox due to the risk of complications.

The drugs are available in several different forms that are suitable for children, such as orodispersible tablets and solutions. Ask a pharmacy what is right for your child.

Follow the instructions on the package carefully and do not combine different medicines. Here you can read about combining paracetamol and ibuprofen. 

You can read more about medicine in the package leaflet that comes with the package. You can also lookup the drug at fass.se and read the package leaflet there.

Drugs for pain and fever in adults

There are several different prescription drugs. Examples are drugs containing paracetamol and drugs belonging to the NSAID group, or cox inhibitors.

Here you can read about which prescription drugs are available and which may be right for you. 

Treatment of chickenpox

Children rarely need to be treated by the healthcare system. The disease heals by itself.

Medication on prescription for itching

Unless the non-prescription alternatives help with the itch, doctors can prescribe prescription drugs. Antihistamine drugs used to treat allergic itching usually help. For example, Travel tablets or Atarax solution and tablets. You often get tired of the drugs. It can be an advantage if it is difficult to sleep because of the blisters itch.

Adults are treated with antiviral drugs

If you are over 18, you are advised to receive antiviral treatment. The treatment of chickenpox should preferably be started already during the first day the chickenpox begins to appear to give a good effect.

Treatment with finished antibodies

In some cases, newborn babies or those with a reduced immune system can be treated with medicines with ready-made antibodies, also called immunoglobulin. The drug fights the virus and prevents you from getting sick if you have been infected.

Pregnancy and chickenpox

The risk of birth defects and other complications is very small.

Seek care if you are pregnant, unsure if you have had chickenpox in the past and have come in contact with someone who is infected. If blood tests show that you have no chickenpox protection, you can receive preventative treatment, which reduces the risk of getting sick.

If you get chickenpox during early pregnancy, antibodies are transferred from you to the baby through the placenta.

However, if you get chickenpox at the end of pregnancy, no antibodies can be formed and transmitted to the baby. To avoid the baby getting chickenpox, you are recommended as pregnant to receive treatment. This applies from week 35 until birth.

If you get chickenpox before week 35, you may also receive treatment, even if the child cannot get chickenpox.

Children under six months and chickenpox

The risk of children up to six months getting chickenpox is affected by whether or not the baby’s mother has had chickenpox before.

When the child’s mother has had chickenpox

The usual thing is that the child’s mother has had chickenpox earlier in life and is immune. Then antibodies against the disease are transferred to the baby in the uterus during the end of pregnancy. The child will then receive some protection against chickenpox up to about six months of age. The protection is not entirely safe, but it usually prevents the youngest children from getting the disease. If the child is still getting chickenpox in the first six months, the symptoms tend to be mild. However, avoid allowing such young children to meet a person with chickenpox, if possible.

Breastfeeding provides no protection against chickenpox. The antibodies against the disease are not transmitted into breast milk, but through the placenta during the end of pregnancy.

When the child’s mother has not had chickenpox

When the mother has not had chickenpox, no antibodies against the disease have been transferred to the baby during pregnancy. Then the child can get the disease. Children who have no protection and get chickenpox for the first six months can have troublesome symptoms. Especially newborns who fall ill during the first weeks after childbirth. The youngest children can be treated with ready-made antibodies, which help fight the virus.

Sequelae

When you have chickenpox and itch, your skin may become infected by bacteria entering the bladder. Persistent fluid in the blisters and red and tender skin may be a sign of a skin infection. The fever may come back if you get a skin infection.

Unusual complications

Chickenpox can sometimes cause disease. It is most common in adults. It can be a sign of pneumonia if you get the disease and fever again after the chickenpox has healed. Then contact a health care center.

If you have a severely impaired immune system, such as in a cytostatic treatment against cancer, your body cannot produce enough antibodies to fight the virus. In very rare cases, chickenpox can lead to meningitis or inflammation of the brain. Although it would happen, you usually recover without complications.

Influence and participate in your care

You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral  to the open specialized care is required.

You should understand the information

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. For example, you should get information about treatment options and how long you may have to wait for care and treatment.

Children should also be involved in their care. The older the child, the more important it is.

Your consent is important

Once you have received information about what options and options for the care you have, you can give your consent or in some other way express a yes. This also applies to you who are not of legal age.  

You may choose not to give your consent to the care you are offered. You may also withdraw your consent at any time.

You can get a new medical assessment

You may get a  new medical assessment from another doctor if you have a life-threatening or particularly serious illness. Obtaining another doctor’s assessment can help you, for example, if you are unsure of which treatment or treatment is best for you.

Ehtisham Nadeem

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