Clinical features of varicella-zoster virus infection: Chickenpox
- Mary A Albrecht, MD
Mary A Albrecht, MD
- Associate Professor of Medicine
- Harvard Medical School
- Section Editors
- Martin S Hirsch, MD
Martin S Hirsch, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Viral Infections
- Professor of Medicine
- Harvard Medical School
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
Varicella-zoster virus (VZV) is one of eight herpesviruses known to cause human infection and is distributed worldwide. VZV infection causes two clinically distinct forms of disease: varicella (chickenpox) and herpes zoster (shingles). Primary VZV infection results in the diffuse vesicular rash of varicella, or chickenpox. Endogenous reactivation of latent VZV typically results in a localized skin infection known as herpes zoster, or shingles.
Primary varicella infection in children is generally a mild disease compared to more severe presentations in adults or immunocompromised patients of any age. The rates of infection, hospitalizations, and mortality have all declined in the US since the introduction of the varicella vaccine in 1995; immunization is recommended in all children before the age of five years and in nonimmune adults. (See "Vaccination for the prevention of shingles (herpes zoster)" and "Epidemiology of varicella-zoster virus infection: Chickenpox".)
The major clinical manifestations and complications of chickenpox will be reviewed here. Infection in the neonate and the treatment and prevention of this infection, including the varicella vaccine, and herpes zoster are discussed separately. (See "Varicella-zoster infection in the newborn" and "Treatment of varicella (chickenpox) infection" and "Vaccination for the prevention of chickenpox (primary varicella infection)" and "Measles, mumps, and rubella immunization in adults" and "Clinical manifestations of varicella-zoster virus infection: Herpes zoster" and "Vaccination for the prevention of shingles (herpes zoster)".)
TRANSMISSION AND VIROLOGY
Chickenpox is highly contagious, with secondary household attack rates of >90 percent in susceptible individuals [1,2].
Infection control issues within hospitals are discussed elsewhere. (See "Prevention and control of varicella-zoster virus in hospitals".)
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- TRANSMISSION AND VIROLOGY
- Transmission routes
- Incubation period
- CLINICAL MANIFESTATIONS
- Uncomplicated varicella
- Impact of vaccine on clinical manifestations
- COMPLICATIONS OF VARICELLA
- Skin/soft tissue infections
- Neurologic complications
- - Encephalitis
- - Reye syndrome
- IMMUNOSUPPRESSED HOSTS
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS