Chickenpox is highly infectious and spreads from person to person by direct contact or through the air from an infected person’s coughing or sneezing. Touching the fluid from a chicken pox blister can also spread the disease. A persons with chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs. This may take between 5-10 days[1]. It takes from 10-21 days after contact with an infected person for someone to develop chickenpox.[2]
The chicken pox lesions (blisters) start as a 2-4 mm red papule which develops an irregular outline (rose petal). A thin-walled, clear vesicle (dew drop) develops on top of the area of redness. This "dew drop on a rose petal" lesion is very characteristic for chicken pox. After about 8-12 hours the fluid in the vesicle gets cloudy and the vesicle breaks leaving a crust. The fluid is highly contagious, but once the lesion crusts over, it is not considered contagious. The crust usually falls off after 7 days sometimes leaving a craterlike scar. Although one lesion goes through this complete cycle in about 7 days, another hallmark of chicken pox is the fact that new lesions crop up every day for several days. Therefore, it may take about a week until new lesions stop appearing and existing lesions crust over. Children are not sent back to school until all lesions have crusted over. [3]
The contagious period for chickenpox begins about 2 days before the rash appears and lasts until all the blisters are crusted over. A child with chickenpox should be kept out of school until all of the blisters have dried, which is usually about 1 week, but you don't have to wait until all the scabs fall off to let your child get back to a normal schedule. [4]
Second infections with Chicken Pox occur in immunocompetent individuals, but are uncommon. Such second infections are rarely severe. A soundly-based conjecture being carefully assessed in countries with low prevalence of Chickenpox due to immunisation, low birth rates, and increased separation is that immunity has been reinforced by sub-clinical challenges and this is now less common. This is more dangerous with shingles. There have been reported cases of repeat infections.
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