A spotty situation: Chickenpox in adults

by Matthew D. Sims, M.D. Ph.D., Director of Infectious Diseases Research at Beaumont Hospital, Royal Oak, Associate Professor of Medicine and Biomedical Sciences at Oakland University William Beaumont School of Medicine

Barbara WaltersYesterday, it was announced that popular television host Barbara Walters was hospitalized with chickenpox. This has raised concerns about the occurrence of chickenpox in adults of all ages.

Here are some basic facts:

Chickenpox is caused by the Varicella Zoster Virus. The infection is characterized by the classic rash with many itchy fluid filled blisters across the entire body, fever and fatigue. At one time it was very common in children and most children developed the infection by the age of 13.  These days it is actually a fairly rare occurrence as we have had an effective vaccine for chickenpox in the US since 1995.

Chickenpox has always been very rare in adults. In general, once a person is infected, they have lifelong immunity. Still, it is quite rare to see chickenpox in anyone older than 40 and incredibly rare to see it at the age of Barbara Walters (83).

When the virus infects a person it enters their nerves and can lay dormant there for their entire lifetime.  However, what many adults do get is shingles, which is when the Varicella Zoster Virus reactivates in one of their nerve roots and it leads to a painful, burning, blistering rash generally in a wedge shaped pattern on one side of the body.  If the person has a poor immune system, sometimes the shingles can emerge at many places at once which will appear more like the classic chickenpox infection.

There is protection against shingles in the form of a vaccine, which has been available in the U.S. since 2006.  The vaccine is similar to a high dose version of the chickenpox vaccine and decreases both the chance of developing shingles and the painful sensations that often come after having a shingles outbreak.

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