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Chickenpox Infection in Pregnancy

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Chickenpox is a viral infection that can cause problems for the mother and fetus if encountered during pregnancy. Read the article to know more about it.

Medically reviewed by

Dr. Shubadeep Debabrata Sinha

Published At June 22, 2023
Reviewed AtApril 23, 2024

What Is Chickenpox?

Chickenpox is a common childhood viral disease that develops in persons not previously exposed to chickenpox, not vaccinated against chickenpox, and in recent contact with persons having chickenpox or shingles. Although it is more common in children from 5 to 12 years of age, it can occur in any age group, including adults. A vaccine that protects children is available, and the CDC (Centers for Disease Control and Prevention) recommends routine vaccination for chickenpox. This vaccine is a safe and effective method to prevent chickenpox.

Who Is at Risk?

  • Newborns whose mothers have not had chickenpox or vaccine.

  • Teenagers and adults.

  • Pregnant women who have never had chickenpox.

  • Those people who smoke.

  • People are affected by cancer or HIV (human immunodeficiency virus) and are taking medications that impact the immune system.

  • People affected by chronic conditions such as asthma are taking medications that affect the immune system.

What Causes Chickenpox?

It is an infection that classically presents with rashes and fever. It is caused by a virus called varicella-zoster. This infection has an incubation period of seven to 21 days, meaning it may take many days for symptoms to appear after the virus enters the body.

How Does It Spread?

Direct spread through skin-to-skin contact, contact with oral droplets during coughing and sneezing, or touching the fluid from the blisters. You get infected by coming in contact with an infected person. Infected people can pass on the virus to those around them before a couple of days of blisters appearing and until all blisters have crusted over.

Factors That Reduce the Risk of Chickenpox:

Previous infection and vaccination reduce the risk of infection. A mother can also pass immunity from the virus to her newborn baby, which lasts about three months.

Risk Factors:

The following factors can increase the risk of infection:

  1. If you have never got chickenpox.

  2. Recent contact with an infected person.

  3. Children under 12 years of age.

  4. Spending time in a childcare facility.

What Are the Common Symptoms of Chickenpox?

Itchy rashes are the primary symptom. Other symptoms can appear earlier, even before the appearance of rashes:

  1. Tiredness.

  2. Headache.

  3. Body pain.

  4. Fever.

  5. Loss of appetite.

When to See the Doctor?

See the doctor if:

  • you are pregnant,

  • you have unexplained rashes with fever symptoms,

  • the rash spreads to the eyes,

  • the rash is tender and warm,

  • there is dizziness or breathing difficulty.

More About the Rashes

The rashes go through different stages, namely:

  • Papules - similar to pimples or insect bites, this is how they begin.

  • Vesicles - they progress to fluid-filled blisters that form raised bumps.

  • Crusts - once the blister breaks and the fluid oozes out, they dry out, forming scabs.

This process takes about a week. They usually start to appear in the head and trunk and then spread to the arms and legs. Since the new rashes develop in waves, there are multiple rashes all over the body, each at a different stage. Most cases of chickenpox are completely cured in two weeks. Indirect spread through contact with contaminated objects such as doorknobs, clothing, and toys.

How Does a Doctor Diagnose Chickenpox?

In case you develop unexplained rashes, you should consult a doctor immediately, even more so if the rash is accompanied by flu-like symptoms. These are signs that your symptoms are due to a viral infection. The doctor will diagnose chickenpox based on the physical examination of blisters. Or the doctor will send the fluid from the blisters to confirm the cause.

What Are the Treatment Options for Chickenpox?

Home Management

The prime requirement in home management is to care for itchy blisters.

  • Keep away from daycare, school, or work to prevent spread and ensure rest and hydration.

  • A bath can be taken daily with mild, lukewarm water and no soap. Adding plain oatmeal to the bath is known to help soothe skin wounds.

  • Applying a non-scented lotion after a bath helps with the dryness, especially the rashes in the scab stage.

  • Wearing loose cotton clothes is preferred.

  • Trim nails to prevent itching and secondary infections.

  • Put mittens or socks into the hands of young kids to prevent them from scratching.

Treatment

  1. Antivirals such as Acyclovir are prescribed if the patient is in the high-risk category. If not, the infection is allowed to run its course.

  2. Acetaminophen (Tylenol) for fever and pain.

  3. Antihistamine to control the itching.

  4. Lacto Calamine to soothe the skin.

A person with chickenpox usually recovers without any antiviral treatment. But antivirals are given to people at high risk of complications, such as:

  1. Infants.

  2. Teenagers.

  3. Adults.

  4. Pregnancy.

  5. Immunocompromised (HIV).

  6. Leukemia.

  7. Cancer.

  8. Chemotherapy.

  9. Autoimmune diseases.

  10. Immunosuppressive drugs.

Complications of Chickenpox:

  1. Shingles: Once a person has chickenpox, the varicella-zoster virus stays in the nerve cells dormant. If it gets reactivated later in life, it causes a nerve infection known as shingles.

  2. Bacterial infection on skin: Since there are so many itchy open sores on the body, children tend to scratch them unknowingly, depositing the bacteria in their nails into the skin and thus causing a skin infection.

  3. Sepsis: It can occur due to bacteria entering the bloodstream from the infected blisters.

  4. Reyes's syndrome: It is a fatal complication associated with Aspirin intake during a chickenpox episode. Aspirin should not be given to children to treat fevers caused by varicella-zoster.

  5. Pneumonia: This complication is more probable in pregnant women with chickenpox infection.

  6. Other less common complications include dehydration, meningitis, and encephalitis.

Chickenpox and Pregnancy

Chickenpox during pregnancy is associated with a lot of serious risks. There is a higher risk of the mom developing pneumonia. She can pass on the infection to the fetus as well (known as fetal varicella syndrome), causing birth defects.

How Can Chickenpox Be Prevented?

Varicella vaccines are available in combination and are part of most countries' regular immunization schedules. The first dose is 1 year, and the second booster dose is 4 years. For unvaccinated adults in close contact with infected children or adults, the vaccine can be given at any time. In most cases, your body will fight off this viral infection on its own, and you or your child can return to normal activities in a couple of weeks. Once the blisters heal, you will become immune to this infection, and the virus will stay dormant in your body. In some rare cases, it may cause re-infection. For more information, consult an infectious disease doctor online.

Conclusion

The varicella-zoster virus usually causes chickenpox. Itchy and fluid-filled blisters characterize it. This condition usually spreads easily to those who have not had the vaccine. The vaccine usually helps to protect children from getting chicken pox. This condition is treatable, but it can be prevented through a vaccine.

Frequently Asked Questions

1.

What Are the Consequences If a Pregnant Woman Comes into Contact With Shingles?

It is uncommon for the illness to harm a fetus or result in hazardous consequences. A pregnant woman experiencing shingles symptoms should consult a medical expert for a diagnosis and course of therapy. A person must take precautions to shield their unborn child from the shingles rash if they have it just before or after giving birth. 

2.

What Birth Defects Can Result From Chickenpox?

A newborn with congenital varicella syndrome may experience gastrointestinal, ocular, limb, and brain problems in addition to skin scarring. Neonatal varicella, a potentially fatal illness, may be present in the newborn if chickenpox develops within 48 hours of birth or a few days. 

3.

How Long Does Chickenpox Remain Contagious?

Chickenpox is generally considered contagious from one to two days before the appearance of the rash until all the blisters have crusted over. This period usually spans about 5 to 7 days after the rash first appears. Kids should avoid going out with other kids until their blisters have healed.

4.

Does Chickenpox Manifest All at Once?

Chickenpox usually appears in phases, and the severity of symptoms varies from person to person.  This distinctive course of the rash aids in differentiating chickenpox from some other rashes or infections. The lesions undergo multiple stages of formation and healing concurrently, leaving the body covered in a mixture of blisters filled with fluid, scabs, and red spots.

5.

Where Are the Initial Chickenpox Spots Found?

The rash may begin on the face, back, and chest before spreading to every body part, including the genital area, eyelids, and mouth. Typically, it takes a week for every blister to turn into a scab. Fever is another common symptom that may appear one to two days before the rash.

6.

What Disease Follows Chickenpox in Adults?

Varicella-zoster virus (VZV) is a virus that stays dormant in the nervous system after an individual contracts chicken pox. Sometimes, the virus may reactivate and produce shingles, also known as herpes zoster, especially in older adults or those with weakened immune systems.

7.

How Does Chicken Pox Rash Differ From Measles Rash?

The first signs of chickenpox are elevated red papules or bumps. These lumps develop into painful blisters called vesicles packed with fluid; these blisters eventually burst and leak, then scab over. The measles rash usually manifests as flat red patches, though it can also occasionally include raised lumps.

8.

How Is It Possible to Experience Breakthrough Chickenpox More Than Once?

It is uncommon but possible to contract breakthrough chickenpox more than once. Breakthrough chickenpox is an outbreak of chickenpox that occurs in people who have already been infected or have gotten the chickenpox vaccine.

9.

What Blood Test Is Used to Determine Chickenpox Immunity?

A varicella titer, also known as an antibody titer test or a VZV titer, is a blood test used to determine whether prior vaccinations or infections have given immunity to chickenpox. It looks for levels of IgG antibodies, or chickenpox antibodies, in the blood. Varicella serology (VZV) may be necessary to diagnose acute or recent varicella infection and assess immunological status (vaccination or natural infection).

10.

Which Cell Does Chickenpox Infect?

The varicella-zoster virus can infect Human CD3+, CD56+, lymphocytes, T cells, and NK cells in the peripheral circulation. It multiplies efficiently in human cells such as fibroblasts. The virus is subsequently transported to cutaneous replication sites by infected T cells.

11.

What Are Effective Immunity Boosters for Chickenpox?

Varivax includes the chickenpox vaccine. It is approved for use by patients who are 12 months of age or older. Administerable to children as part of their standard two doses of the chickenpox vaccine between the ages of 4 and 6 years old and 12 to 15 months old. After two doses, the vaccine has a 90% success rate in preventing chickenpox.

12.

Which Vitamin Is Most Beneficial for Chickenpox?

Vitamin A may be administered on the first day of eruption to minimize the crusting stage and give protection against complications; it is far less expensive than antiviral treatment. Vitamin A should be administered to more kids during the illness' incubation period.

13.

What Natural Antiviral Options Exist for Chickenpox?

Some itching may be relieved with calamine lotion and a chilly bath with baking soda, colloidal oatmeal, or uncooked oatmeal. Try to keep the fingernails short to help avoid skin infections and stop the viral infection from transmitting to other people.
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Dr. Shubadeep Debabrata Sinha
Dr. Shubadeep Debabrata Sinha

Infectious Diseases

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