Chickenpox: symptoms, contagion and video visits in Puerto Rico

Chickenpox is caused by the varicella-zoster virus. It spreads through close contact with a sick person and is very contagious: up to 9 in 10 people who are unvaccinated and have never had it catch it after close contact. The rash appears 10 to 21 days after exposure.

In children it is usually mild, but babies, teenagers, adults, pregnant women and people with weakened immunity are at higher risk of complications. Vaccinated people who catch it usually have a milder illness, with few blisters or just red spots. After chickenpox the virus stays in the body and years later can cause shingles.

Video doctor visits 24/7 — book online and choose your time right away. A video visit means you do not have to leave home or expose anyone in a waiting room.

To help the doctor evaluate you well by video, have these ready. Not sure whether a video visit or an in-person visit is right for you? Read telehealth or in-person visit: how to choose and how to prepare for your video visit. When you are ready, book your visit.

• Since when there has been a rash or fever, and whether new blisters keep appearing
• Whether the person was vaccinated against chickenpox or already had it
• Whether there is a baby, a pregnant person or someone with a weakened immune system at home
• Well-lit photos of the rash, and the temperature
• Any medicine already taken for fever (no aspirin)

Chickenpox is handled in a doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. We do not bill insurance. See all prices.

For 1 to 2 days before the rash there may be fever, tiredness, poor appetite and headache. Then come:

• An itchy rash, first on the chest, back and face
• Small fluid-filled blisters that later scab over
• Fever
• Tiredness and poor appetite
• Headache

According to the CDC, the chickenpox rash goes through three stages: first red spots or bumps, then small fluid-filled blisters, and then they dry into scabs. New spots keep appearing for several days, so it is normal to see all three stages at once on different parts of the body.

It usually starts on the chest, back and face and then spreads over the whole body, sometimes including the inside of the mouth, the eyelids or the genital area. According to the CDC Pink Book, a healthy unvaccinated child usually has 250 to 500 blisters in 2 to 4 crops.

• For itching: calamine lotion and cool baths with baking soda, uncooked oatmeal or colloidal oatmeal.
• Keep nails short so scratching does not lead to a skin infection.
• For fever, use acetaminophen as the label directs.
• Do not give aspirin to a child with chickenpox: it is linked to Reye’s syndrome, a serious illness. The AAP also advises avoiding ibuprofen, which has been linked to serious skin infections.

Most healthy children recover with this care. Antivirals are for people at higher risk, and only if the doctor thinks they are appropriate.

Chickenpox is contagious from 1 to 2 days before the rash until every blister has crusted, which usually takes about a week. During that time stay home: no school, childcare or work, and avoid contact with pregnant women, babies and people with weakened immunity. You can go back once every spot has crusted.

If you are pregnant or have weakened immunity and have never had chickenpox or the vaccine, call your doctor promptly after the contact, even without symptoms. If the mother broke out with chickenpox from 5 days before to 2 days after delivery, or a premature baby was exposed, call the baby’s doctor or get seen in person right away. According to the CDC, in these cases people can be given a preventive medicine (varicella immune globulin), given in person as soon as possible and up to 10 days after exposure. The doctor can guide you by video on what to do and where to go.

The best prevention is the chickenpox vaccine: according to the CDC, everyone who has never had chickenpox or been vaccinated should get 2 doses. The vaccine is given in person; ask your pharmacy or vaccination site. If your child has a different kind of rash, see rash in children. Measles also causes fever and a rash; read how to tell it apart.

For your safety, go to the emergency room or call 911 if you see any of these signs. Get medical care soon if the fever lasts more than 4 days or goes above 102 °F (38.9 °C), or if a blister turns red, warm, swollen or full of pus. See when to go to the ER.

• Trouble breathing or a severe cough
• A stiff neck
• Confusion, or very sleepy and hard to wake
• A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher