Chickenpox in Adults: Risk Factors, Symptoms, Complications, Treatment

But vaccination has dramatically changed how chickenpox affects the entire population. According to the Centers for Disease Control and Prevention, vaccination rates are more than 90 percent among young children and 85 percent among teenagers. And overall, since the national chickenpox vaccine program started, the rate of new cases of chickenpox has decreased about 97 percent.

That’s created a new disease landscape. Unlike in the past, when nearly everyone got chickenpox before they reached adulthood, most young adults now haven’t had the disease. That means there’s a small but significant number of at-risk adults who aren’t protected by either the vaccine or exposure to the virus.

This is not considered to be a significant public health concern, but it may be an individual concern for you or someone you know. Here’s what you should know about how chickenpox affects adults and what you can do to limit your risk of infection and possible complications.

While chickenpox was never common in adults, it’s become even less common since widespread vaccination began in 1995, according to Deborah S. Clements, MD, the chair of the department of family and community medicine at Northwestern University’s Feinberg School of Medicine in Chicago.

“Where we see it is in people who were not vaccinated after 1995 and in those who are immunocompromised,” says Dr. Clements. In some cases, a disease itself may weaken your immune system, such as HIV, AIDS, and certain types of cancer. In other cases, a treatment for your disease can have this effect, such as chemotherapy for cancer and immunosuppressive drugs for an autoimmune disease like rheumatoid arthritis.

• People with a weakened immune system (due to a health condition or medical treatment)
• People who take steroid medications, such as for asthma
• Pregnant women who haven’t had chickenpox

The disease is spread by respiratory droplets, Clements explains. This means that you’re more likely to get chickenpox from someone who is coughing or sneezing, but it’s possible that even talking could spread the disease.

Because you can’t get the chickenpox vaccine while you’re pregnant, it’s especially important for pregnant women who haven’t been vaccinated or had the disease to limit their exposure risk.

“Anyone who is pregnant should avoid contact with people who have chickenpox or a shingles outbreak,” Clements says.

When adults get chickenpox, it tends to cause symptoms in the same way as when the disease affects children — up to a point.

This means that in the beginning, a fever and some upper respiratory symptoms (such as a runny nose) typically develop before a chickenpox rash sets in, according to Clements. Symptoms usually begin 10 to 21 days after you’re exposed to the chickenpox virus.

A typical chickenpox blister is sometimes described as resembling “a dewdrop on a rose petal, because it’s a small, clear blister on a red surface on the skin,” says Clements. “That helps differentiate it from lots of other kinds of rashes.”

Within five to seven days, the blisters usually break and develop a crust that turns into a scab. These scabs fall off when the skin under them has healed.

Chickenpox pneumonia “can be very, very serious,” says Clements. “It’s a viral pneumonia that is not easily treated because of how the virus behaves. We can use an antiviral to a certain extent, but it’s not really very effective.”

This type of pneumonia tends to develop and worsen rapidly. The good news, says Clements, is that “we hardly see it anymore.”

Another major concern, says Clements, is that a pregnant woman can pass problems on to her child by catching chickenpox. Getting chickenpox in the earlier part of your pregnancy can cause low birth weight or birth defects in your newborn, such as limb abnormalities.

• Brain infection (encephalitis)
• Liver inflammation
• Bleeding problems

For most people, the best way to prevent chickenpox is to get vaccinated.

If you develop chickenpox symptoms as an adult, it’s important to recognize them early so that you can get treated with an antiviral drug, says Clements. This is done so that you don’t go on to develop more complicated symptoms, she says.

Be sure to call ahead to your doctor’s office about your symptoms, since you may be asked to use a different entrance at your appointment to avoid exposing others to chickenpox.

In terms of self-care, Clements recommends taking ibuprofen (Advil) or acetaminophen (Tylenol) for discomfort as needed, as well as taking an oatmeal or colloid bath to help reduce itching.

You’ll pose an infection risk to others from shortly before you develop the rash until all your blisters have crusted over, for a total of about 7 to 10 days. During this time, Clements says, you should stay home from work and keep other outings to a bare minimum.

If you have to be around other people for a sustained period while you’re contagious, Clements recommends wearing a face mask.

When it comes to chickenpox prevention, the best news is that because of widespread vaccination, you’re unlikely to get it.

During earlier periods of her career, Clements says, “It was not at all uncommon to have residents work in the pediatric wards and come down with chickenpox.” But now, thanks to the vaccine, “it’s very, very rare to see it anymore.”

• Because of widespread childhood vaccination, chickenpox is no longer common. But adults who haven’t had the disease or the vaccine are at risk.
• The disease can be especially serious if you have a weakened immune system or are pregnant.
• Possible complications of chickenpox include pneumonia, encephalitis, and serious harm to a fetus.
• If you haven’t had the varicella vaccine, getting one is the best way to keep from being infected.
• Tell your doctor right away if you think you have chickenpox. Antiviral treatment can prevent serious complications.