In the United States, children are routinely vaccinated against varicella-zoster beginning at 12 months of age (see Vaccinating Infants and ChildrenFigures). Anyone without immunity may also be vaccinated. Susceptible people who are at high risk of complications—such as those with an impaired immune system and pregnant women—and have been exposed to someone with chickenpox may be given antibodies against the varicella virus (varicella-zoster immune globulin).
Isolation of an infected person helps prevent the spread of infection to people who have not had chickenpox. Healthy children nearly always recover from chickenpox without problems; only about 2 of 100,000 children die. However, even this low rate means that before routine immunization, 100 children died annually in the United States because of complications of chickenpox. The infection is more severe in adults, of whom about 30 of 100,000 die. Chickenpox is fatal in up to 15% of people with an impaired immune system.
Mild cases of chickenpox require only the treatment of symptoms. Wet compresses on the skin help soothe itching, which may be intense, and prevent scratching, which may spread the infection and cause scars. Because of the risk of bacterial infection, the skin is bathed often with soap and water, the hands are kept clean, the nails are clipped to minimize scratching, and clothing is kept clean and dry. Drugs that relieve itching, such as antihistamines, are sometimes given by mouth. If a bacterial infection develops, antibiotics may be needed.
Doctors may use antiviral drugs, such as acyclovirSome Trade Names
ZOVIRAX
, valacyclovirSome Trade Names
VALTREX
, and famciclovirSome Trade Names
FAMVIR
, for adolescents and adults as well as for groups at high risk of complications—premature infants and children with immune system disorders. The drugs must be given within 24 hours of onset of disease to be effective. These antiviral drugs are not given to pregnant women.
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