What are the symptoms of chickenpox?

Written by Yuan Lin Yan
Infectious Disease
Updated on September 20, 2024
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Chickenpox is caused by infection with the varicella-zoster virus and is highly contagious. The symptoms of chickenpox mainly include fever and rash. The fever is usually mild and may be accompanied by chills, headache, fatigue, sore throat, and loss of appetite. These symptoms last for one to two days, followed by the appearance of a rash. The rash first appears on the trunk, then on the head and face, with the limbs being relatively less affected. Initially, the rash starts as red maculopapular lesions, which turn into vesicles within a few hours. The chickenpox rash appears in batches. The same area can show maculopapular lesions, vesicles, and crusts. Chickenpox is a self-limiting disease that usually resolves on its own in about ten days. However, complications such as secondary bacterial infections of the rash, pneumonia, encephalitis, and hepatitis can occur, potentially worsening the condition.

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The Differences between Chickenpox and Hand, Foot, and Mouth Disease

Chickenpox and hand, foot, and mouth disease are common infectious diseases in young children. Chickenpox is a febrile rash disease caused by the varicella-zoster virus. Its rash mainly manifests as maculopapular, vesicular, and crusted lesions, which appear simultaneously. Generally, these are primarily seen on the face and trunk with a centripetal distribution. Hand, foot, and mouth disease is mainly caused by viruses, such as enterovirus EV71 or Coxsackievirus A16. It causes a febrile rash disease with rashes typically found on the hands, feet, and around the mouth. Rashes on the chest, back, and face are relatively rare. Thus, the main clinical presentations of hand, foot, and mouth disease and chickenpox are the different forms of rashes.

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Infectious Disease
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When to get the chickenpox vaccine?

Chickenpox primarily affects infants and children, and the target group for chickenpox vaccination is mainly 1-12 years old. During this age period, most children enter preschool or elementary school institutions, and the chickenpox virus is highly contagious, transmittable through droplets and contact. Once one child contracts chickenpox, the surrounding children are almost certain to be infected too. Additionally, since there are currently no effective medications to cure chickenpox, it is best to vaccinate within this age range, namely 1-12 years old. Adults can receive the chickenpox vaccine without age restrictions. The timing can be decided based on individual circumstances, but it is generally recommended to get vaccinated before the onset of the peak season for chickenpox, which is best before the spring and winter seasons.

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Symptoms and Treatment of Chickenpox

The main symptoms of chickenpox include a mild fever and rash, with some patients experiencing headaches, coughs, and other symptoms. Treatment primarily consists of general treatment, antiviral therapy, and treatment of complications.

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Written by Yuan Lin Yan
Infectious Disease
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Symptoms of chickenpox

Chickenpox symptoms are divided into two phases, namely the prodromal phase and the rash phase: 1. Prodromal phase. Infants and young children often have no symptoms or only mild symptoms, which may include mild fever, irritability, refusal to breastfeed, and the simultaneous appearance of rashes. Older children and adults may experience chills, mild fever, headache, fatigue, sore throat, cough, nausea, and loss of appetite. These symptoms last for one to two days before the rash appears. 2. Rash phase. The rash first appears on the trunk, then spreads to the face and limbs. It starts as red maculopapular rash, turns into papules within a few hours, and develops into vesicles. The vesicle fluid is initially clear but soon becomes cloudy, and itching often accompanies the vesicles. About a week later, the scabs fall off and heal, generally leaving no scars. However, if there is a secondary infection, pus-filled lesions may form, and scabbing and healing may take longer. Chickenpox rashes are distributed centripetally, mainly located on the trunk and then the head and face, with fewer on the limbs. Some patients may also develop vesicles on mucous membranes such as in the mouth, throat, conjunctiva, and external genitalia, which break open to form ulcers. The chickenpox rash often appears in successive crops, so at the same site, maculopapular rash, vesicles, and scabs can be seen concurrently. Chickenpox is generally a self-limiting disease and tends to heal naturally within about ten days. Children usually experience milder symptoms and rashes, while adults have more severe symptoms and are more prone to complications like chickenpox pneumonia. Individuals with lowered immune function are susceptible to disseminated chickenpox, where the rash may merge into larger vesicles. Infections during pregnancy can cause fetal malformations, premature birth, or stillbirth. If chickenpox occurs a few days before delivery, the newborn may contract neonatal chickenpox, which can be quite severe.

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Precautions for Children with Chickenpox

Chickenpox is caused by the varicella-zoster virus infection, which is more common in children but can also occur in adults. The peak season for this illness is spring. Therefore, after children contract chickenpox, it is crucial to isolate them to prevent contact with other children or the elderly, as it can spread to others quickly. Typically, conventional antiviral medications are sufficient for treatment. If fever occurs, it is advisable to take some fever-reducing medications appropriately. It is also recommended to have a light diet, eat more vegetables and fruits, and drink plenty of water. Adequate rest is important, and if small blisters appear on the body, avoid scratching them to prevent infection and more severe symptoms. Generally, this disease confers lifelong immunity, meaning there is no recurrence after the initial episode.