Adult varicella: symptoms, isolation, and urgent care

The infection spreads readily through respiratory particles and direct contact with blister fluid. Call a healthcare service before attending in person so staff can prevent exposure to other patients and decide whether antiviral treatment should be considered.

Fever, tiredness, headache, and loss of appetite may appear around the time of the rash. Spots develop in successive crops, becoming fluid-filled blisters and then crusts, so several stages can be visible together. The rash may involve the scalp, mouth, eyelids, and genital skin as well as the trunk and limbs.

A person can transmit chickenpox before the rash is obvious and remains contagious until every blister has crusted. Shingles comes from reactivation of the same virus later in life; exposure to shingles can cause chickenpox in a susceptible person, but it does not directly give that person shingles.

Stay away from work, social settings, and shared indoor spaces until all lesions have crusted. Avoid contact with pregnant people, newborn babies, and anyone with a weakened immune system, because infection can be particularly harmful for them. Do not share towels, bedding, or clothing, and keep rooms comfortably cool.

Drink fluids, wear loose clothing, keep nails short, and use cool bathing or soothing preparations to reduce scratching. A pharmacist or clinician can advise on suitable medicines for fever and itch. Avoid aspirin, and do not use ibuprofen unless a clinician who knows about the chickenpox recommends it. Antiviral medicine works most effectively when clinical advice is obtained early in the illness.

Seek urgent medical help for difficulty breathing, chest pain, severe cough, confusion, unusual drowsiness, a stiff neck, problems walking, repeated vomiting, dehydration, or a severe headache. Eye pain, visual change, or blisters close to the eye also need prompt assessment.

Increasing redness, heat, swelling, tenderness, or pus around a blister can indicate bacterial infection. Contact a clinician promptly if fever returns after improving or the overall illness is worsening. Anyone who is pregnant, immunocompromised, taking immune-suppressing medicine, or living with significant lung disease should obtain advice as soon as exposure or symptoms are recognised.

Tell the clinician when fever and rash began, whether new blisters are still appearing, and whether breathing, alertness, hydration, vision, or skin pain has changed. Mention pregnancy, immune conditions, lung disease, regular medicines, prior chickenpox or vaccination, and any recent close contact with chickenpox or shingles. Ask whether antiviral medicine or testing is appropriate and how to protect vulnerable household members.