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Varicella Complications Chicken pox is usually a mild disease, but it has some serious complications. Infection of the skin blisters, which may progress to cellulitis and septicemia. Encephalitis. Cerebellar ataxia. Pneumonia. This is usually seen in teens and adults, and is often fatal. Reye syndrome. A serious disease, causing fits, unconsciousness, and sometimes death. Chicken pox is one of the diseases it is associated with, especially if salicylates (aspirin have been used for treatment. Rare complications affecting liver, nervous system, blood, and other body systems.

Chicken Pox (Varicella)

Chicken pox is a viral disease, caused by infection from a person already having the disease.   It affects almost everyone at some time in a lifetime, but usually occurs only once.  It is believed to be a mild disease, but is associated with dangerous complications, especially in teenagers, persons with reduced immunity, and pregnant women.  Children with reduced immunity, for example children with leukemia, or those taking anti cancer or steroid treatment, are also at high risk for severe varicella.

Spread of Chicken Pox

Chicken pox is spread from person to person. The spread can be by air borne droplets (by sneezing, coughing, or even breathing) and by direct contact with the liquid from the skin rash.  It is infectious a day or two before the typical skin rash appears, and for five days after.  Thus, a child with chicken pox can spread the disease to others before he is diagnosed.

Chicken Pox — The Disease

Chicken pox appears 10-21 days after contact with a person who has it. The disease starts with fever, and the typical rash appears after a day or two.  The rash starts with red spots which become fluid filled blisters before bursting or subsiding.  Children often lose their appetites, and may complain of headache and sore throat.

Itching is a common feature, and is often severe.   After a few days, the blisters will show crust formation, which dry and fall off. The person with chicken pox is infectious to others from 1-2 day before the rash appears, to the time the skin blisters all dry up.

Chicken pox is severe in teenagers, adults, newborn babies, children with immune deficiency diseases. children on drugs that reduce immunity, etc. Many years after chicken pox, the person can get a painful rash on the body called Shingles (herpes zoster).

Treatment of Chicken Pox

Paracetamol for fever, and a drug to reduce itching are all that is usually required.  A drug that must not be used is aspirin, because it has been linked to a dangerous condition called Reye's syndrome.  

There is no need to restrict the child's activity in simple chicken pox.  Appetite is often reduced, but no dietary restrictions are necessary.  The child should be encouraged to take a lot of fluids, especially if the drug acyclovir has been prescribed.

Acyclovir is a specific antiviral drug available for chicken pox.  It can reduce the severity if given within 24 hours of onset, but the effect is only of slight benefit in normal children.  It is recommended for adolescents, children with reduced immunity, and in other special situations.

Complications of Chicken Pox

The most common is infection of the skin blisters.  This can lead to a spreading infection under the skin called cellulitis.  Other infections are also more common with chicken pox.  The disease is also associated with potentially fatal complications like encephalitis and pneumonia.  These are more likely in adolescents and adults.

A late complication is zoster, a painful rash along a segment of the body.  This may occur several years after the original infection.

Also read: The Varicella Vaccine

For a more detailed description of chicken pox, please see the Varicella chapter in the Emedicine Pediatric Textbook, also authored by Dr. Parang Mehta.

Last revision: June 21, 2008

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