Why is it bad for adults to get chickenpox?

What is chickenpox?

Chickenpox is a highly infectious disease that can have severe complications in adults. Adults are 25 times more likely to die from chickenpox than children are.

Chickenpox is an infection caused by the varicella zoster virus. It's a highly contagious disease that used to be very common. Before the vaccine became available in the United States in 1995, about 90% of children got chickenpox by the age of 15.

Chickenpox is far more severe in adults than in children. Adults are 25 times more likely to die from chickenpox than children are. Adults are also more likely to have more serious complications with chickenpox.

There are additional risks if you’re pregnant. If a person is infected with chickenpox in early pregnancy, the infant may have low birth weight or problems with their limbs. If chickenpox is contracted in the week before birth or within a couple of days after giving birth, the baby has a higher risk of a life-threatening infection.

The most effective way to prevent chickenpox is to get the vaccine. Some people who have been vaccinated may still get chickenpox, but they tend to have fewer or milder symptoms and their illness may be shorter.

Another way to prevent chickenpox is to get it. Once a person gets chickenpox, they cannot get it again. Before the vaccine, people used to intentionally make sure their children got chickenpox so that they couldn’t get it again as adults, when the disease would be more dangerous. However, the virus remains inactive in the body and may reactivate in adulthood as shingles.

Signs and symptoms of chickenpox

A person with chickenpox is contagious one to two days before the rash appears. They’re considered contagious until all the blisters are scabbed.

All symptoms of chickenpox are more severe in adults. Watch out for the following:

Rash

A rash appears about seven to 21 days after a person has been exposed to chickenpox. The rash typically appears on the face, chest, and back, and sometimes on the arms and legs. Some people may have only a few spots, while others may have spots everywhere on their body, including their mouths. The rash will last about five to 10 days, with the spots going through three phases:

Flat red spots that become raised within six to eight hours
Small blisters filled with fluid that form and then break
Scabs and crusts that cover the broken blisters

The rash will continue to appear for several days, so all the different stages may be seen at the same time.

Pneumonia

Chickenpox can cause serious problems. There is a higher risk of severe complications for newborns, adults, and those with weakened immune systems.

Pneumonia occurs in about one in 400 adults with chickenpox, leading to coughing and breathing difficulties. It very rarely happens in young children.

Encephalitis

Encephalitis, or swelling in the brain, is a less common symptom, occurring in one to two cases out of 1,000, but it can be life threatening in adults. It causes confusion, dizziness, headaches, seizures, and unsteadiness when walking.

Sepsis

Sepsis is when germs get into the bloodstream and the infection triggers a chain reaction in the body. If not treated quickly, it can lead to organ failure and death.

Mild symptoms

Other mild symptoms that may appear one to two days before the rash include:

Fever
Fatigue
A general feeling of being unwell (malaise)
Loss of appetite
Headache

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Causes of chickenpox

Chickenpox is caused by the varicella zoster virus, which is highly contagious. Someone with chickenpox can pass it to others by sneezing or coughing, or by coming into direct contact with infected skin. It can also be passed to your baby if you’re pregnant.

It’s very difficult to avoid getting chickenpox if you haven’t been immunized. People are contagious before they have visible symptoms. Children’s early symptoms, especially, can be mild enough that they don’t tell an adult they feel sick, exposing those around them to the virus without anybody realizing what’s happening.

Diagnosing chickenpox

Your doctor will examine the rash and consider the symptoms, which are distinctive. Very rarely, a blood test may be done. To avoid infecting others in the doctor’s office, call ahead and let your doctor know that you may have chickenpox.

Treatments for chickenpox

For mild cases, the symptoms can be relieved at home. For moderate to serious cases, antiviral drugs may be prescribed.

There are some ways you can help relieve chickenpox symptoms at home.

To help relieve the itching, soak in a cool bath with some added baking soda, uncooked oatmeal, or colloidal oatmeal, a special finely ground oatmeal for soaking.

Wet compresses on the skin can help with the itchiness. Calamine lotion can be dabbed gently on the spots. It also helps if you keep your fingernails short or wear gloves at night to avoid scratching, which will cause scarring and may infect the sores.

Over-the-counter medications can also help with some symptoms. Antihistamines such as Benadryl can help with the itching, and acetaminophen can help lower a mild fever. While adults can deal with fevers by using aspirin or products containing aspirin, children can’t due to its association with Reye’s Syndrome.