Text_Files/Chickenpox_and_Shingles.txt

CHICKENPOX (VARICELLA) AND SHINGLE 
(cont.)  
Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
CHICKENPOX (VARICELLA) AND 
SHINGLES 
 
Chickenpox is a very contagious disease caused by 
the varicella -zoster virus.  It usually begins with a 
mild fever and an itchy rash.  The rash starts with 
crops of small red bumps on the stomach or back 
and spreads t o the face and limbs.  The red bumps 
rapidly become blistered, oozy and then crust over.  
People may have only a few bumps or may be 
totally covered. 
 
Once a person has had chickenpox, the varicella-
zoster virus stays without symptoms in the body’s 
nerve cells.  In some people (for unknown reasons), 
the virus can become active again at some later time 
as “shingles” or zoster.  This problem includes a 
red, painful, itchy, blistery rash, usually in the line 
along one side of the body.  There is no fever.  The  
virus is shed in the blister fluid of the rash and can 
cause chickenpox in a person who has not had it, if 
that person has direct contact with the infected 
shingles blisters. 
 
Who gets this disease? 
Anyone who is exposed to chickenpox and has not 
had it before has a very good chance of developing 
chickenpox.  It is most common in school -aged 
children.  If you have had chickenpox once, second 
attacks are very rare.  Shingles is most common in 
adults, as a person must have already had 
chickenpox to develop shingles. 
 
When a pregnant woman or a person with a weak 
immune system who has not had chickenpox is 
exposed he/she should contact a physician. 
 
Chickenpox does not cause serious illness in 
healthy children.  Adults may, occasionally, be 
seriously ill with chickenpox. 
 
How is it spread? 
Chickenpox is contagious from 1- 2 days before the 
rash appears to  until the blisters have become 
crusted over .  It is spread by close contact (i.e., 
sharing breathing space or direct touching contact) 
with infected secretion s from the nose, throat or 
rash. 
 
How soon do symptoms appear? 
The symptoms generally appear from 14- 16 days 
after exposure but in some cases can occur as early 
as 10 days or as late as 21 days after contact.  
Chickenpox and shingles are usually diagnosed by 
the typical appearance of the rashes. 
 
What is the treatment? 
The chickenpox symptoms may be treated with 
anti-itching medicine and lotions, fever control, 
fluids and rest.  Because of a possible association 
with Reye’s Syndrome (i.e., vomiting, liver 
problems and coma), salicylate- containing products 
(i.e., aspirin) should not be used for fever control.  
Acetaminophen may be used for fever control.  
Scratching should be avoided because it can cause 
infection and scarring.  A medication to decrease 
the severity of symptoms is available for high -risk 
children.  This must be given within 24 hours of the 
onset of rash.  Please consult the Division of Public 
Health Services, Bureau of Infectious Disease 
Control or the child’s physician for more 
information. 


CHICKENPOX (VARICELLA) AND SHINGLE 
(cont.)  
Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
 
How can the spread of this disease be 
prevented? 
The ACIP recommends that children attending 
daycare facilities and schools be vaccinated for 
chickenpox.  New Hampshire currently requires 
varicella vaccination for school or daycare 
attendance. The two dos e series should be 
completed at 12-15 months and again at 4-6 years. 
 
The ACIP also recommends that daycare workers, 
who have no history of chickenpox disease, be 
tested for immunity.  If testing shows susceptibility, 
2 doses of varicella vaccine should be  administered 
separated by one month. 
 
Each childcare facility should have a system so that 
it is notified if a child or staff member develops 
chickenpox or shingles.  This is so the facility may 
take appropriate measures if there is a pregnant or 
immunocompromised member in the facility.  
(Recently the Advisory Committee on 
Immunization Practice has recommended the use of 
varicella vaccine for susceptible persons who have 
been exposed to varicella). 
 
The childcare facility should watch closely for early 
signs of chickenpox in other children for three 
weeks following the most recent case.  If a child or 
staff member develops a suspicious rash, he/she 
should be sent to his/her healthcare provider so that 
the rash can be diagnosed.  However, chickenpox is 
highly contagious and in spite of your best efforts, 
you will probably have several more cases if 
children have not already had the disease. 
 
Who should be excluded? 
Children should be excluded from daycare after the 
rash eruption first appears and until the v esicles 
become dry and crusted over .  In certain situations 
exposed unvaccinated children without symptoms 
do need to stay at home.  Generally exposed 
children, who have been vaccinated, do not need to 
stay at home.  Adults with shingles should be 
excluded if vesicles/blisters cannot be covered. 
 
Reportable? 
Yes, chickenpox is reportable by New Hampshire 
law to the Division of Public Health Services, 
Bureau of Infectious Disease Control  at (603) 271-
4496