Chickenpox is also known as varicella. This is a viral infection which is causing an itchy rash with small and fluid – filled blisters. This is a highly contagious to people who have not been vaccinated against it or who have not head this disease. Before the routine vaccination for this condition, virtually all of us had been infected by the time they reached adulthood and in some cases it causes serious complications. Nowadays, the number of cases and hospitalizations is down dramatically. In the most cases, chickenpox is a mild disease. But it is better for every single person to be vaccinated. The chickenpox vaccine is safe and effective way to prevent this condition and the possible complications of it. [1,2]
Symptoms of chickenpox
Chickenpox infection appears ten to 21 days after exposure to the virus and usually it lasts about 5 – 10 days. You should know that the telltale indication of chickenpox is the rash. Here are other signs and symptoms which can appear one to two days before the rash and they include:
- Tiredness and a general feeling of being unwell (malaise)
- A loss of appetite
Once the chickenpox appears, then it goes through 3 phases. They include:
- In the first phase there are raised pink or red bumps, known as papules, which break out over several days.
- In the second phase, small fluid – filled blisters (which are also known as vesicles) are forming from the raised bumps over about one day before breaking and leaking.
- In the third phase, crusts and scabs, which cover the broken blisters and take several more days to heal.
New bumps continue to appear for several days. As a result of this, you may have all 3 stages of the rash (which include bumps, blisters and scabbed lesions), at the same time on the 2nd day of the rash. Once you are infected, you can spread this virus for up to 48 hours before the rash appears and you remain contagious until all your spots crust over. In healthy children this condition is generally mild. There are some rare cases in which the rash can spread to cover your entire body and lesions may form in your throat, eyes and mucous membranes of the vagina, anus and urethra. New spots continue to appear in a period of several days.
Risk factors: It is known fact that the chickenpox is caused by varicella – zoster virus which is a highly contagious.  This condition can spread quickly. This virus is transmitted by direct contact with the rash. Also it can be spread by droplets dispersed into the air by sneezing or coughing. You have a risk of catching chickenpox if you:
- Live with children
- Work in or attend a school or child care facility 
- Have not been vaccinated for chickenpox [1,2]
- Have not had chickenpox
Most people who have had chickenpox or who have been vaccinated against this condition, these people are immune to it. If you have been vaccinated and if you still get chickenpox, then the symptoms are often milder and you have fewer blisters and you have mild fever or no fever. There are some cases when people can get chickenpox more than once but this is a rare condition.
People who are at a high risk of complications from chickenpox are:
- People taking drugs that suppress their immune systems
- People who are taking steroid medications for another disease or condition such as children with asthma
- People have an immune system which is impaired by medication, such as chemotherapy or another disease such as cancer or HIV 
- Newborns and infants whose mothers never had chickenpox or the vaccine
Chickenpox can also affect pregnant women. If you are not immune to chickenpox and you are pregnant, then you need to talk with your doctor about the risk for you and your unborn baby.
Complications: This condition is normally a mild disease. But also there are some cases when it can be serious and it can lead to complications or death, especially in people who have high – risk of it. Complications of chickenpox include:
- Reye’s syndrome for people who take aspirin during chickenpox
- Toxic shock syndrome
- Inflammation of the brain (encephalitis) 
- Pneumonia 
- Bacterial infections of the skin, soft tissues, bones, joints or bloodstream (sepsis)
 Lopez AS, Marin M. Strategies for the control and investigation of varicella outbreaks manual, 2008. In Centers for Disease Control and Prevention. Retrieved from www.cdc.gov/chickenpox/outbreaks/manual.html
 Kaiser Permanente. Chickenpox vaccination lowers risk of pediatric shingles. Science Daily. 2019. Retrieved from www.sciencedaily.com/releases/2019/06/190610090105.htm
 Vally H, Dowse GK, Eastwood K, Cameron S. An outbreak of chickenpox at a child care centre in Western Australia. Costs to the community and implications for vaccination policy. Australian and New Zealand Journal of Public Health. 2007;31(2):113-9.
 Noronha V, Ostwal V, Ramaswamy A, et al. Chicken pox infection in patients undergoing chemotherapy: A retrospective analysis from a tertiary care center in India. Journal of Infection and Public Health. 2017;10(1):8-13.
 Skripuletz T, Pars K, Schulte A, et al. Varicella zoster virus infections in neurological patients: a clinical study. BMC Infectious Diseases. 2018.
 Denny JT, Rocke ZM, McRae VA, et al. Varicella pneumonia: Case report and review of a potentially lethal complication of a common disease. Journal of Investigative Medicine High Impact Case Reports. 2018;6:2324709618770230.