What You Need to Know About Contracting the Chickenpox as an Adult
Chances are, you've heard of chickenpox, a contagious illness that's caused by the varicella-zoster virus (VZV); you may have even had this condition when you were a child. The disease used to be very common in the United States, with an average of four million people contracting it each year, which led to 10,500 to 13,000 hospitalizations and 100 to 150 deaths, per data from the Center for Disease Control and Prevention (CDC). Thankfully, a vaccine became available in 1995, which has led to a stark decrease in cases. As we age, however, chickenpox becomes less of a concern, and we worry more about its counterpart, shingles. Ahead, three medical experts walk us through the basics of chickenpox and its connection to shingles—and explain your vaccine options.
What does chickenpox look like?
The disease usually begins with cold-like symptoms, such as a mild fever, and then turns into a rash of red itchy bumps that can appear all over the body—even in the mouth and throat, explains Krupaben Patel, M.D., a family medicine physician at Austin Regional Clinic based in Austin, Texas. "A person is generally ill for five to 10 days, but it can sometimes last up to two weeks," she says. "Most cases are mild, but for some it can be quite serious, especially for those with weak immune systems."
How does chickenpox spread?
Chickenpox is an airborne virus, which means it is very contagious and can spread via droplets that result from coughing or sneezing. "A person infected with the virus can spread it to other people for up to 48 hours before the rash appears and stay contagious until all broken blisters have crusted over. This usually means that, over the course of the disease, a person can be contagious for up to 14 days," says Dr. Patel.
What is chickenpox's connection to shingles?
Children tend to fare better with chickenpox, so it is much more of a concern for adults. Here's the thing: Even if you have already had this disease as a kid, you're still at risk for getting its nefarious cousin, shingles—also known as herpes zoster (there is no affiliation to genital herpes)—which can occur many years after you've been infected with the original strain; in essence, shingles is a "reactivation" of the varicella-zoster virus. "Chickenpox never leaves our bodies once we've become infected—it hides out in the body. When we get stressed, develop another infection, or age, we are at increased risk of experiencing a shingles outbreak," notes Alexea M. Gaffney-Adams, M.D., an internist with additional subspecialty training in infectious diseases at Stony Brook Medicine.
What does shingles look like?
"Unlike chickenpox, where the rash occurs all over the body, with shingles, the rash is limited to one area of skin—only on your right or left side," continues Dr. Gaffney-Adams; the painful sores, which appear in stripes, are most commonly found on the torso, "but they can even occur on the face or involve the eyes, ears, or nose, causing serious neurological complications."
Is shingles contagious?
Transferring the virus also differs slightly with shingles, note our experts. A patient with shingles can pass on the varicella-zoster virus to someone who isn't immune to chickenpox; this usually happens via direct contact with an open sore, which is why keeping scabs covered until they crust over (which can take up to four weeks) is critical. The newly-infected person won't develop shingles, however—they will succumb to chickenpox (remember, shingles is a reactivation!).
What are our chickenpox vaccination options?
Since 1995, the chickenpox vaccine has been routinely recommended for children and administered widely throughout the States. "The vaccine is extremely effective in preventing chickenpox. For those who do experience chickenpox after full vaccination, the cases are typically significantly milder," affirms Scott Kaiser, M.D., a board certified geriatrician and Director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint John's Health Center in Santa Monica, California.
The vaccine is also available to adults, however Dr. Kaiser points out that it is not typically given to those born in the United States before 1980, as the vast majority of adults have had a childhood case and likely have lasting immunity. "The recommendations are different for healthcare workers, pregnant women, and certain other high-risk groups and depend upon evidence of immunity—something that can typically be demonstrated with a simple blood test to detect antibodies," he adds.
What about a shingles vaccine?
If you know that you have never had the chickenpox, discuss getting the vaccine with your healthcare provider. Whatever the case—and whether or not you remember ever having the chickenpox—you should absolutely be vaccinated against shingles when you turn 50 years old, notes Dr. Patel, as this disease is more prevalent the older you become—and you can get it more than once.