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Registered Nurse (RN)
Pediatric Nursing
Childhood Viral Exanthems
Varicella (Chickenpox)

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Varicella (Chickenpox)

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Varicella (Chickenpox)

Chickenpox or varicella is a highly contagious communicable disease affecting children. It is communicable approximately 1 day before the eruption of the lesions to 6 days after the first crop of vesicles when crusts have formed. Typical incubation is 14-16 days. The disease is transmitted by direct contact [skin lesions, not the scabs], droplet (airborne) spread, and via contaminated objects.
Varicella Zoster Virus (VZV)
Varsity Zorro Virus

Chickenpox is caused by the varicella zoster virus (which also causes shingles or herpes zoster). It is also called Human Herpesvirus 3. Providers must maintain standard, airborne, and contact precautions until lesions have crusted as the virus is highly contagious.

Red Maculopapular Rash
Red Mac-glow-papule-people

Children first present with a red maculopapular rash, which progresses almost immediately to vesicles, each with an erythematous base. It is important to remember that these will all be at varying stages.

Vesicles Ooze and Crust
Vest Ooze and Pie-crust

As the virus progresses papules and vesicles crust presenting in varying stages at any one point in time.


The vesicles of this virus are extremely itchy and bothersome to the child. Encourage children not to scratch, as scarring can develop.


The rash has a centripetal distribution meaning it spreads to the face and proximal extremities; less on distal limbs and areas not exposed to heat.

Varicella Immunization
Varsity Syringe

Immunization is available to decrease incidence of this viral infection.

Skin Care to Minimize Itching
Calamine-lotion and mitts

Priorities of treatment involve skin care to decrease pruritus or itching. Encourage children not to scratch, as it could result in scar formation. Applying calamine lotion to the skin or placing young ones in mittens can help prevent scratching.

Isolate until Vesicles Crust
Vest Pie-crust leaving Isolation

Children should be isolated from contact with others until the vesicles have crusted. The virus is no longer contagious when the vesicles have dried or crusted and children can return to school, which is about a 1 week after the onset of the disease.


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