Chickenpox is one of the most common infectious diseases in children around the world. They are transmitted by the varicella zoster virus and are highly contagious. Typical of chickenpox is a vesicular, itchy rash that spreads over the whole body in batches.
What is chickenpox?
The whole body itches and is covered with a vesicular rash - many adults know the symptoms from their own childhood. The chicken pox are among the classic childhood diseases . The disease is not limited to children, however, chickenpox can also occur in adults. They are caused by the varicella zoster virus and are highly contagious. About 95 percent of all children are infected with chickenpox by the age of 14, and antibodies against the chickenpox virus are detectable in over 95 percent of all adults.
Chickenpox: A typical rash
Typical of chickenpox is a very red, itchy rash that can spread over the whole body in batches . The scalp and mucous membranes are also often affected. In the beginning, red spots form, especially on the back and stomach, which later develop into very itchy blisters and pustules that are filled with secretion. These burst easily, dry out and become encrusted in the further course. Because chickenpox occurs in multiple attacks, different stages of development of the rash always occur at the same time. This gives it a characteristic appearance that doctors also call a starry sky.
Transmission of chickenpox
As the name suggests, chickenpox is transmitted through the air . When breathing or coughing, infected people excrete tiny droplets containing viruses, which the pathogen uses to spread to the surrounding area. Doctors also speak of a droplet infection. In addition, the chickenpox virus is contained in the secretion of the vesicles and pustules. If other people come into contact with the secretion, a smear infection can occur. This does not necessarily require direct physical contact. The chickenpox virus is very resistant outside the body and is easily transmitted via infected toys, school supplies or other objects, for example. The risk of infection is only averted again when all the blisters are encrusted and no more new blisters appear.
Lifelong immunity
Chickenpox usually leaves you with lifelong immunity. So most people only get chickenpox once in their lifetime. However, the virus remains in the body for life. It nests in nerve cells near the spinal cord and can become active again in certain situations. In this case, however, no new chickenpox disease is triggered, but shingles (herpes zoster) , which, in contrast to chickenpox, predominantly affects adults.
Unproblematic course
Chickenpox is almost always unproblematic and without complications in healthy children. If the children scratch themselves very hard, the scratched chickenpox sometimes become infected with bacteria, which can leave typical chickenpox scars. The disease rarely becomes severe. This is especially the case in newborns and in patients with a weakened immune system. You can reliably protect yourself against chickenpox with a vaccination .
Chickenpox - the cause is a herpes virus
Chickenpox is caused by an infection with the varicella zoster virus, a very contagious representative of the herpes viruses. The virus can be transmitted by a smear or a droplet infection and thus initially gets into the respiratory tract.
The incubation period, i.e. the time that elapses between infection and the first symptoms of the disease, is around two to three weeks for chickenpox . During this time, the virus settles in the mucous membranes of the respiratory tract, multiplies, eventually penetrates the blood vessels and spreads through the blood throughout the body. In this way it gets into the skin and mucous membranes, where it triggers the typical rash. This usually heals after a few days without complications.
Chickenpox: dormant virus
Unlike the rash , the chickenpox virus does not go away from the body on its own . Most of the time, however, those affected do not notice anything. The virus lodges in certain nerve cells near the spine and "sleeps" there for many years or even a lifetime without causing symptoms. In some cases, however, the virus can reawaken. It then multiplies and migrates into the skin along the nerve cells in which it has lodged. The result is shingles with the typical, often belt-like and extremely painful rash. A shingles get basically just people who previously suffered from chickenpoxwere. It is much less contagious than chickenpox, but here too the virus can be transmitted to other people and cause chickenpox.
Chickenpox: The symptoms primarily affect the skin
Due to the long time between infection and outbreak (incubation period), the first symptoms of chickenpox only appear after two to three weeks. Here you can read the most important chickenpox symptoms.
Rash all over the body
severe itching
a general feeling of illness with headache and body aches
slight fever
The most typical chickenpox symptom is the characteristic rash . This often appears suddenly in the form of red spots that initially appear mainly on the stomach and back and can then spread to the whole body. Within a few hours, the red spots develop into vesicles and pustules, which are filled with a liquid and surrounded by a bright red border. Children with chickenpox in particular often complain of severe itching at this stage. The vesicles burst very easily, dry out and a brownish-red crust forms.
Chickenpox rash
Since chickenpox spreads in batches and new spots and pustules appear over the course of several days, all manifestations of the rash occur at the same time. Due to the special appearance of the skin changes, doctors also refer to them as the starry sky. After about five days no new blisters will form, but it may take about two more weeks for the last crusts to fall off and the rash to heal completely.
In children, chickenpox is usually mild and without severe symptoms. One of the most common complications is bacterial skin infections, which can occur when children scratch the itchy chickenpox. The pustules are easily inflamed and abscesses, i.e. accumulations of pus in the tissue, and the typical chickenpox scars can develop.
With a weakened immune system
A severe clinical picture with serious complications occurs in chickenpox mainly in newborns or in children and adults whose immune system is weakened by another disease. Immunocompromised patients can have very severe symptoms of chickenpox . There are often many attacks with a particularly high number of chickenpox, which are very large and do not heal well. It is not uncommon for secondary diseases to develop, for example pneumonia , liver inflammation or inflammation of the brain.
Because of the typical rash, diagnosis of chickenpox is straightforward
In the case of chickenpox, the doctor can usually make the diagnosis based on the typical rash. Its appearance is so characteristic that, as a rule, the doctor does not need to conduct special examinations.
This also applies to shingles , which is also triggered by the varicella zoster virus. If the symptoms are unclear, however, the doctor can use special methods to detect virus components or antibodies that the body forms against the virus in the blood and thus make a reliable diagnosis of chickenpox .
How does chickenpox therapy work?
If your child is healthy, chickenpox is usually straightforward and mild. The doctor will therefore usually not prescribe your child a drug that fights the chickenpox virus itself, but will opt for a so-called symptomatic chickenpox therapy.
The main aim of this is to alleviate symptoms that may be very unpleasant for your child. This includes in particular the severe itching all over the body. To relieve the itching and to reduce the risk of bacterial infections, the doctor can prescribe various medications for your child as part of the chickenpox therapy . There are also a number of other measures you can take to make this annoying illness a little more comfortable for your child.
Offer your child airy and loose-fitting clothing. Many children with chickenpox find tight, skin-tight clothing uncomfortable.
Since chickenpox is easily infected, you should keep your child's fingernails as short as possible during chickenpox so that they cannot scratch the itchy blisters so easily.
The doctor often uses antihistamines for chickenpox therapy, i.e. drugs that block the action of the messenger substance histamine and so relieve the painful itching.
Zinc shake mixtures that you regularly dab on the chickenpox dry out the chickenpox and the itchy blisters can heal faster.
Do not use acetylsalicylic acid
If your child experiences general symptoms and a fever , the child should take it easy. Under no circumstances should you use drugs containing the active ingredient acetylsalicylic acid to lower the fever, as this is suspected of causing what is known as Reye's syndrome in viral infections. This can lead to a high fever, vomiting , impaired consciousness and unconsciousness up to a coma.
Immunocompromised patients
Chickenpox can be very severe in children or adults with an immune deficiency. In this case, the doctor will use antiviral drugs such as acyclovir for chickenpox therapy to fight the varicella zoster virus itself and contain the infection as quickly as possible.
Can You Prevent Chickenpox?
Since the chickenpox virus is highly infectious and there is a risk of infection before the typical symptoms of chickenpox appear, it is very difficult to take precautionary measures to prevent chickenpox.
If you or your child have chickenpox, you should avoid contact with other people as much as possible during the contagious phase. Conversely, you should avoid contact with infected people if you have not yet had chickenpox yourself. However, these precautionary measures never offer 100% protection and cannot safely prevent chickenpox .
Prevention through immunization
Active immunization takes place through a chickenpox vaccination. A weakened, harmless chickenpox virus is used for this.
Passive immunization takes place with the help of antibodies that are directed against the chickenpox virus.
Recommended chickenpox vaccination
Child with chickenpox vaccinationA vaccination can reliably protect your child from chickenpox infection© Fotolia
Active immunization through a chickenpox vaccination has been recommended for all children and adolescents by the Standing Vaccination Commission (STIKO) of the Robert Koch Institute since 2004 . It consists of two individual vaccinations and is usually given in the first two years of life. Of course, a chickenpox vaccination is also possible for adolescents and adults at any time.
Chickenpox: risk groups
Of course, it is at your own discretion whether you want to have yourself or your child vaccinated. However, the chickenpox vaccination is particularly recommended for the following people who have not yet had chickenpox:
Women who want to have children
People with a weakened immune system
People who are about to have an organ transplant
Patients who suffer from severe atopic dermatitis
People who have contact with people from one of these groups (e.g. relatives, doctors, nurses or obstetricians)
People who work in kindergartens and schools
Chickenpox in pregnancy
If you have never had chickenpox as a woman and would like to have children, a vaccination is particularly recommended, as chickenpox infection can lead to complications during pregnancy :
In rare cases, the virus is transmitted to the child via the placenta and causes fetal varicella syndrome, which can cause skin changes, neurological diseases, eye damage and malformations of the skeleton and muscles.
In neonatal chickenpox, the chickenpox virus is only transmitted to the child shortly before or immediately after the birth. This is particularly problematic because the newborn no longer receives sufficient protective antibodies from the mother and only has a very immature immune system with which it cannot fight off the infection effectively. The course of the disease in neonatal chickenpox is therefore usually very difficult.
Passive immunization
In contrast to active immunization, in which the own immune system is stimulated to produce antibodies against the chickenpox virus, passive immunization only provides short-term protection against chickenpox infection . With passive immunization, the doctor gives antibodies that are directed against the chickenpox virus and are intended to prevent the onset of the disease. However, passive immunization is only promising a maximum of 96 hours after infection and is particularly useful for the following risk groups:
unvaccinated pregnant women without immunity
unvaccinated patients with weakened immune systems
Newborns whose mother had chickenpox shortly before or after birth
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