Chickenpox is an illness that's almost always associated with children. But that doesn't make adults immune to it. In fact, one of the most horrifying facts about chickenpox in adults is that it appears in its worst possible form. This is why it's important to know about symptoms of chickenpox in adults, especially for those more vulnerable to it such as the elderly.
Even though adults reportedly only make up about five percent of those suffering from chickenpox, it is still one of the most dangerous illnesses they can contract.
Facts about chickenpox in adults
It's important to know certain facts about chickenpox in adults. These include symptoms of chickenpox in adults, treatment and prevention. So let's take a look at all of these and more, in depth.
Causes and transmission
What causes it?
Adult chickenpox (varicella) is an illness that is caused by the varicella-zoster virus (VZV).
Transmission
Chickenpox is highly contagious. It is spread through air when an infected person sneezes or coughs. It is also spread by direct contact through saliva, mucus and the fluid inside the blisters.
The period in which an infected person becomes contagious depends on the window when chickenpox symptoms appear. A person is contagious two days before the rashes manifest until the blisters develop into scabs or crusts.
It is advisable that infected persons stay indoors in order to avoid passing the infection to others. You need to be extra cautious if you fall into any of these categories described below.
Who is most at risk of contracting chicken pox?
The following run the highest risk of contracting the chickenpox virus.
- People who haven’t contracted the virus before
- Those who have not been vaccinated against chickenpox
- Pregnant women and others with compromised immune systems, e.g. those undergoing chemotherapy
- Individuals who are on steroids for certain conditions or diseases
One fact about symptoms of chickenpox in adults is that it generally results in similar symptoms as that of childhood chickenpox. But the symptoms of chickenpox in adults are usually more severe, and the risk of complications higher.
Symptoms of Chickenpox in Adults
As per the University of Oxford's Vaccine Knowledge Project (VKP), the symptoms of chickenpox in adults appear after almost 10 days to three weeks after exposure to the varicella-zoster virus.
"People usually feel generally unwell and have one to two days of fever, although young children do not always get these early symptoms," VKP notes.
Some of the earliest and most prominent symptoms of chickenpox in adults include the following:
1. Fever and body aches
One of the earliest symptoms of chickenpox in adults (similar to chickenpox contracted by kids) includes fever of 38.3 to 38.8 C. This is in addition to body aches, fatigue, and even irritability.
All of these combined can make the illness almost unbearable for the first few days. One may feel extremely tired at all times, and the fever might make taking a bath or even eating difficult.
That is why most adults who contract chickenpox are advised to stay quarantined till the chickenpox blisters dry out. This is so that the infection doesn't spread among those who may have never had chickenpox before.
2. Red itchy rashes
You may notice a red, itchy rash that appears on the abdomen, back and face. After around two days, these develop into as many as 250 to 500 itchy liquid-filler blisters over the entire body.
They last for anywhere between five to seven days and then turn into dry scabs as they heal. These blisters may spread into the mouth or other internal parts of the body — even the genitals.
There are three stages of the chickenpox rash, as mentioned in our previous article:
- Rashes look like pimples or insect bites; they are raised bumps (papules) that are either pink or red.
- Over the next two to four days, they appear in groups and develop to look like blisters (vesicles) with flimsy walls that have fluid.
- When the walls break, the open rashes develops a crust. They then dry out and turn into scabs.
Out of all the chicken pox symptoms, the rashes bring greatest discomfort since they are itchy and painful. One of the other facts about chickenpox in adults is that the three stages (bumps, blisters and scabs) can occur simultaneously.
When should you call your doctor?
It is advisable to not wait for just the two symptoms of chickenpox in adults we mention above to manifest before seeing your doctor. If you notice any of the following, you should also see a medical specialist.
- A fever that persists for more than four days and is above 38.8° C
- Difficulty in breathing
- Severe cough
- An area of rashes that is red, swollen, sore or warm
- The rash spreading to your eyes
- Rashes that discharge pus or white liquid
- Difficulty in walking
- A constant and severe headache
- If you feel confused
- Sensitivity to bright light
- Drowsiness and finding it hard to wake up
- Having a stiff neck
- Feeling queasy or frequent vomitting
Now, although chickenpox usually runs its course over 10 days, in many adults it can further lead to more illnesses and complications. This is one of crucial facts about adult chickenpox that not many people are aware of.
Serious complications of symptoms of chickenpox in adults
One of the crucial facts about chickenpox in adults is that it can pose serious medical complications to those with low immunity as well as pregnant women.
These complications include the following:
1. Skin infections
An adult with skin disorders such as eczema or weak immune systems may experience severe rashes. Though rare, one can also develop bacterial infections in the bones, joints and even the brain.
2. Pneumonia
This is an infection in the lungs, specifically in one or both air sacs. The sacs may become filled with pus which causes the following signs of pneumonia: fever, laboured breathing and chills.
Other symptoms include flu or cold-like symptoms such as sore throat, chills, headache, frequent dry cough, rapid breathing with wheezing sounds, stomach pain, chest pain and shaking.
Other signs include chills, vomiting, mucus tinged with blood or that has a greenish or rust colour, and decreased appetite.
3. Encephalitis
This illness is characterised by swelling in the brain due to a viral or bacterial infection. It may be life-threatening if not treated in a timely manner.
Medical News Daily says, "Encephalitis generally begins with fever and headache. The symptoms rapidly worsen, and there may be seizures (fits), confusion, drowsiness, and loss of consciousness, and even coma."
4. Shingles
The chickenpox virus can remain dormant in the nervous system for a very long time. Later in life, there is a risk of the virus reactivating as shingles, which is a painful skin rash. In most cases, it appears on one side of the body. It is also known as zoster or herpes zoster.
Although it is not fully known why the varicella-zoster virus re-awakens, experts say that stress and decreased immunity as one ages could trigger the onset of shingles.
5. Joint inflammation
The fever and body aches caused during adult chickenpox can often lead to joint inflammation. This might cause redness in joints, swelling, stiffness and even loss of joint functions.
In some cases, inflammation can also result in autoimmune diseases where the body fights off its own immune system.
6. Septicaemia
This is a life-threatening illness wherein the blood's immune defenses react in an unusual manner. So, instead of protecting the body, the immune system starts fighting it.
WebMD explains septecaemia as "invasion of bacteria into the bloodstream." Usually, the common symptoms of septicaemia include fever, chills and an increased heart beat.
Based on the prognosis, doctors usually advise hospitalisation and may place the patient on intravenous medications till they get better.
7. Necrotising fasciitis
This "flesh-eating infection" is a serious bacterial infection that destroys the body's soft tissues. However, according to the Centres for Disease Control and Prevention (CDC), necrotizing fasciitis is rare.
Your chances of getting it are extremely low if you have a strong immune system and practice good hygiene and proper wound care.
Most people who get necrotizing fasciitis have other health problems that may lower their body’s ability to fight infection. Some common symptoms include fever, chills, shaking and even fatigue.
You should note that people suffering from this condition need immediate medical intervention. In addition to antibiotics, such people may also need surgery.
8. Toxic shock syndrome
Toxic shock syndrome is also a life-threatening illness. Mayo Clinic advises, "Toxic shock syndrome can affect anyone. About half the cases of toxic shock syndrome associated with Staphylococci bacteria occur in women of menstruating age; the rest occur in older women, men and children. Streptococcal toxic shock syndrome occurs in people of all ages."
So after recovering from a chickenpox infection (or while you have it), you should also consult with your doctor to make sure your body doesn't have any signs of the Staphylococci bacteria.
9. Birth defects
Pregnant women who develop chickenpox risk health complications and birth defects in their child. If a woman develops chickenpox after birth, the newborn is at risk of health complications.
10. Reye's syndrome
Reye’s syndrome may be uncommon but it is an illness that can be fatal if undetected and untreated. It is linked to the use of aspirin, especially when given to children and teens who are recovering from a viral infection such as chicken pox or the flu.
The symptoms appear three to seven days after the start of a viral infection and may include lethargy and vomiting.
While there is no test to determine the condition, tests to determine fatty acid oxidation disorder along with other metabolic disorders can be requested by the doctor. Those who have Reye’s syndrome are usually treated in hospital.
In order to avoid these complications, it's best to consult your doctor immediately after you contract the illness and experience any of their symptoms.
VKP advises, "It is important to contact a doctor immediately if anyone with chickenpox develops pain in the chest or has difficulty breathing. Two other rare but serious complications are chickenpox meningitis and inflammation in the brain (encephalitis and cerebellar ataxia). Serious complications occur most often in certain high-risk groups."
Diagnosis
As mentioned earlier, doctors can determine the infection from one of the chief symptoms of chickenpox in adults: the rash. If more confirmation is required, then you may have to take a few laboratory tests, as advised by your doctor.
Treatment
One of the important facts about chickenpox in adults is that antibiotics won’t kill the virus. The only time you may be prescribed an antibiotic is when the rashes or sores develop a bacterial infection.
Remember that apart from the skin, bacterial infection may occur if you frequently scratch and/or pick at the blisters.
Doctors also prescribe antiviral medications to those who may be at risk of developing the aforesaid health complications.
Home remedies
This contagious disease can become quite uncomfortable due to the fever and rashes. There are a few things you can do at home to ease the discomfort and the symptoms of chickenpox in adults.
1. Sponge baths
Instead of taking a full-fledged shower, opt for a sponge bath using lukewarm water. Have the bath in intervals of three to four hours during the first few days of infection. This may help relieve itching.
You can also try baths with uncooked oatmeal or water with baking soda. This relieves itchiness as well.
2. Pat the body dry
Once you are through with the sponge bath or towel bath, make sure to pat yourself dry. Never rub yourself dry, this may inflame the rashes or blisters and cause you more pain.
Plus, any kind of rubbing of the rashes can leave a permanent mark on the body. So always dab and use a clean towel after you are done cleaning yourself. This is another one of the most important facts about chickenpox in adults.
3. Apply calamine cream
Your doctor might give you a calamine lotion to help relieve itchiness that is caused by the rashes. While you can apply it all over your body, avoid doing so on the face and near the eyes.
Do not try this by yourself and without properly consulting with your doctor.
4. Eat cold food
Include cold foods such as yogurt, ice cream and fresh fruit shakes in your daily diet. You can also try banana, porridge, and soup based meal such as noodles, Mee Sua, Kway Teow. These foods help soothe mouth sores, which make eating and chewing difficult.
While preparing these foods remember that a bland diet is better if you have mouth sores. You should also stay away from food that is salty and acidic.
5. Take acetaminophen (paracetamol)
Your doctor may also recommend that you take acetaminophen to help relieve any pain from mouth sores. Do not take aspirin because it can cause Reye’s syndrome.
Make sure to ask your doctor about creams for rashes near the genital area.
Prevention
The best way to avoid contracting chickenpox is to get vaccinated against it. This is one of the most important facts about chickenpox in adults.
With this, even if you catch the virus, you will experience milder forms of chickenpox symptoms. It can also aid in faster recovery.
In Singapore, it is not compulsory to vaccinate children against chickenpox. So there are chances that as an adult you might contract it. It is recommended for children between 12 to 18 months to obtain the vaccination for life-long immunity:
- As mentioned in our previous article, for children below 13 years of age, MOH’s Expert Committee on Immunisation recommends two doses - with an interval of at least three months. They should get the first dose at 12 months of age and then the second dose three months later, by 18 months of age.
- Those who are 13 years and above should take two doses, at six-week intervals.
Another one of the crucial facts about chickenpox in adults involves its prevention at home.
- Practice proper hygiene. Ask everyone at home to wash their hands properly. Try to follow the 20 second rule in doing so. And, clean hands before eating and after coming from the bathroom. Also, encourage caregivers to use masks inside the room and wash their hands after leaving the room.
- Cut your nails. Keep your nails cut and properly clean so any accidental scratching doesn't tear into the blisters and/or cause bacterial infection.
- Isolate yourself. Isolate yourself from others at home so. This will protect them from catching the infection. Make sure you stay away from your children so the infection does not pass on to them as well.
- Ask for help. Have somebody come over to take care of you or get hospitalised, if you live alone.
- Cover your hands and feet. Cover your hands and feet with mittens or socks so you do not end up scratching yourself.
Although chickenpox is rarely fatal, proper care and precaution can make recovery easier. If you haven't had any chickenpox vaccines yet, visit polyclinics in Singapore for it, or speak to your doctor about getting it.
We hope these facts about chickenpox in adults have been useful to you.
Sources: WebMD, University of Oxford, NHS
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