What are the symptoms of chickenpox?

Chickenpox is most common in young children. It usually starts with mild fever and listlessness. A spotty red rash appears 1 or 2 days later, starting on the head or torso. The red bumps turn into very itchy blisters. The blisters are mainly found on the torso, face and scalp. After a few days, the blisters dry up and scab over. Sometimes the blisters also form inside the mouth, which can be very painful.

The symptoms last about 10 days. If the chickenpox blisters break open, a bacterial skin infection may occur. Chickenpox can sometimes lead to serious illness, such as pneumonia or meningitis.

Who can become very ill from chickenpox?

Some people can become very ill from chickenpox:

• newborn babies of mothers who had chickenpox right before or after childbirth
• babies born too early (preterm)
• unborn babies of a person who has chickenpox during pregnancy
• people with impaired immunity
• people over 12 years old who are not protected against chickenpox, especially during pregnancy

It is advisable for these people to stay away from anyone who has chickenpox. This is only necessary for people who have never had chickenpox before. People who have already had chickenpox once cannot get it again. However, the virus does stay present in the spinal cord. For people who have had chickenpox, the virus could cause problems again at a later age. If that happens, it could cause shingles.

If you are in one of these groups and have had contact with anyone who has chickenpox, contact your GP. It may be possible to arrange extra protection against the virus by getting a vaccination, receiving antibody treatment, or taking antivirals (medication against the virus).

Is chickenpox dangerous during pregnancy?

Are you pregnant? And have you never had chickenpox? Then you have a higher risk of becoming very ill from chickenpox.

• The risk of severe symptoms increases as your pregnancy progresses.
• 5% to 10% of people who have chickenpox during pregnancy develop severe pneumonia.
• Depending on how long the person has been pregnant, the chance of death from this complication could be as high as 14%.
• In rare cases, chickenpox during pregnancy could also cause other health problems, such as liver infection, joint inflammation or encephalitis. But this almost never happens.
• People who have chickenpox during pregnancy are more likely to experience premature birth during the first 20 weeks of pregnancy, compared to people who do not have chickenpox during pregnancy.
• If a person contracts chickenpox in the first 20 weeks of pregnancy, the unborn baby may be exposed to the virus while still in the womb. Among other complications, this could lead to skin or eye problems or brain abnormalities.
• If the mother contracts chickenpox in the two weeks surrounding the birth (7 days before until 7 days after childbirth), the baby could become very seriously ill.

This only applies to pregnant people who have never had chickenpox before. A person who has ever had chickenpox before cannot get it again.

How does chickenpox spread?

Chickenpox is highly infectious, starting from 2 days before the infected person develops a rash.

The virus is found in the nose and throat of a person who has chickenpox. When they cough, sneeze or talk, tiny droplets containing the virus are expelled into the air. If other people inhale these droplets, they may contract the virus. You can also become ill through skin contact with the fluid from the chickenpox blisters.

Chickenpox remains infectious until all blisters have scabbed over. This usually happens within a maximum of 7 days after the blisters appear.

How can I prevent chickenpox?

It is difficult to prevent chickenpox. This is because a person can already transmit the virus before the first symptoms appear. Good hygiene (information in Dutch) does help protect you and/or your child against chickenpox. This includes coughing and sneezing into a paper tissue, and washing your hands regularly.

A vaccine that protects against chickenpox is available. In the European part of the Netherlands, the chickenpox vaccination is not included in the National Immunisation Programme. It is included on Bonaire, St Eustatius and Saba. The vaccination is covered by health insurance in the Netherlands for some medical risk groups (information in Dutch). Other people would need to pay for this vaccination themselves. If you would like to be vaccinated against chickenpox, contact your GP or doctor, the Municipal Public Health Service (GGD) or a vaccination centre.

Is there any treatment for chickenpox?

Chickenpox goes away on its own. It does not usually need any treatment from a doctor. A doctor could give you or your child something to help with the itching. It is also important not to scratch the blisters. If they are scratched open, they could get infected. It is a good idea to keep the nails short.

How common is chickenpox in the Netherlands? 

Chickenpox is common in the European part of the Netherlands. Over 95% of children growing up in the European Netherlands have had chickenpox by the time they are 6 years old. Between 200 and 350 patients with chickenpox end up in hospital every year in the European Netherlands. Most of them are children under 4 years old.

Chickenpox is less common on Bonaire, St Eustatius and Saba. That is why vaccination against chickenpox is included in the National Immunisation Programme on the BES islands.

Can a person with chickenpox go to childcare, school or work?

Chickenpox is already contagious before a person starts showing symptoms. There is no point in staying home, since it does not help keep others from becoming ill. Children with chickenpox who feel fine can go to childcare or school as usual. Do tell the childcare worker or teacher that your child has chickenpox. The childcare facility or school can notify other parents and take additional measures as needed.

Children who have chickenpox should preferably avoid swimming. The warm bathing water could make the itching worse. Any chickenpox blisters that are open could also get infected after swimming.