Chickenpox is a highly contagious illness caused by the Varicella-zoster virus. Prior to the introduction of the Varicella vaccine in 1995, roughly 4 million cases of chickenpox occurred annually in the U.S., mostly among children. As a result, most adults have already been exposed to chickenpox and have immunity. Nonetheless, chickenpox still occurs sporadically in the U.S., and adults are more likely to have severe disease and complications than are children.
Rash
Chickenpox causes an itchy rash with small red blisters. The rash typically occurs on the trunk, face and scalp, but spots may occur inside the mouth, nose and ears. The blisters usually scab over in a few days and heal without scarring. The chickenpox rash usually lasts for approximately 5 to 10 days.
Fever
Adults with chickenpox typically have a moderate fever, which often begins 2 to 3 days before the rash appears. The fever is generally 100 degrees F to 103 degrees F (37.8 C to 39.4 C).
Malaise and Weariness
Chickenpox typically causes weariness (lassitude) and a general sense of being unwell (malaise). These symptoms are often more pronounced in adults than in children.
Headache
Mild headache often precedes the onset of the chickenpox rash by 24 to 36 hours. A headache that gets progressively worse may indicate the brain has been affected by the virus, a complication called encephalitis.
Cough and Shortness of Breath
Varicella pneumonia is a serious and potentially life-threatening complication of chickenpox. In a 2003 review article, "Varicella pneumonia in adults" published in the "European Respiratory Journal," Drs. Mohsen and McKendrick stated that pneumonia is the most common and serious complication of chickenpox infection in adults. They elaborated by noting that healthy adults have a 25-fold greater risk of developing chickenpox-associated pneumonia than do children. Varicella pneumonia symptoms include cough, rapid breathing and shortness of breath.
Altered Mental Status and Seizures
Encephalitis--inflammation of the brain caused by invasion of the virus--is a potentially life-threatening complication of chickenpox, especially among adults. Symptoms include a decreased level of consciousness, confusion and seizures.
Chest Pain
Although uncommon, the Varicella-zoster virus can invade the heart muscl,e setting up an inflammatory response that damages the heart, a condition called myocarditis. Chest pain may occur, though this condition often has no symptoms.
Severe Abdominal or Back Pain
Chickenpox can invade the liver, causing acute hepatitis (inflammation of the liver). Severe abdominal pain--especially on the right side--or back pain may be the first symptom of Varicella-related hepatitis.
References
- "Principles and Practice of Infectious Diseases, Sixth Edition"; Gerald L. Mandell, M.D., John E. Bennett, M.D., Raphael Dolin, M.D., Editors; 2004
- Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report: Prevention of Varicella
- "Journal of Medical Virology"; Varicella in Americans from NHANES III: implications for control through routine immunization; Paul E. Kilgore, M.D., M.P.H., et al; March 2003
- Penn State College of Medicine, Milton S. Hershey Medical Center: Chickenpox
- ournal of the American Medical Association: Chickenpox patient page
