Chickenpox (Varicella): Causes, Symptoms, Treatment, and Prevention An interview with neonatologist Dr. Narmin Azizova

Recently, concerns among parents about viral infections accompanied by rashes in children have increased. One of the most common of these infections is chickenpox — also known as varicella. To learn more about how this illness develops, how it spreads among children, and how to prevent it, we spoke with Dr. Nərmin Əzizova, neonatologist at the K.Y. Farajova Scientific Research Institute of Pediatrics.

– Dr. Nərmin, what exactly is chickenpox, and why does it occur in children?

Chickenpox is one of the most common viral diseases in children. It is caused by the Varicella-zoster virus. The disease typically occurs in children between the ages of 2 and 10, but it can also affect unvaccinated adults. The virus can remain dormant in the body for many years and later manifest as shingles (herpes zoster).

– How does a child become infected? Where does the virus come from?

Chickenpox is highly contagious. The virus spreads mainly through the air when an infected child coughs, sneezes, or talks. It can also spread through direct contact with the rash or blisters. In some cases, contaminated items such as towels, clothing, or toys can transmit the virus as well.

– Does chickenpox have an incubation period — a time when the child is infected but shows no symptoms?

Yes, it does. This is called the incubation period. The virus enters the body but remains inactive for a while. In chickenpox, this period lasts 10–21 days. During this time, the child may appear healthy, even though the virus is already multiplying inside the body.

– What are the first signs of chickenpox in a child?

At the onset, the child may develop a mild fever, fatigue, loss of appetite, and sometimes a runny nose. A day or two later, rashes appear. They start as small red spots, then turn into clear, fluid-filled blisters, and eventually scab over within a few days. The distinctive feature of chickenpox is that different stages of the rash—new spots and scabbed lesions—can appear simultaneously on the body.

– Why do these rashes spread all over the body? Where do they usually appear?

Initially, the rash appears on the face, chest, and scalp, then spreads across the entire body. It can also appear inside the mouth, on the eyelids, and around the genital area. The spots are itchy, but scratching should be avoided, as it may leave scars or cause bacterial infections.

– For how long is an infected child contagious?

A child becomes contagious two days before the rash appears and remains so until all the blisters have crusted over—usually 5–10 days. During this period, the child should be kept at home and away from other children, including in daycare or school settings.

– How should parents care for a child with chickenpox at home? What should they avoid?

The child should rest at home and stay in a well-ventilated room. They should drink plenty of fluids, keep their nails short, and clean the rash areas with antiseptic solutions. For itching, the doctor may prescribe topical creams or soothing lotions. Aspirin must not be given, as it can be dangerous for children. The child should not attend public places until fully recovered.

– Are antiviral medications necessary for all children?

No, not for everyone. Antiviral medications are recommended only in specific cases—such as for infants under one year old, children over ten, those with weakened immune systems, or those experiencing severe illness. In most cases, symptomatic treatment—managing fever, itching, and hygiene—is sufficient.

– Does the vaccine really prevent chickenpox?

Yes, it does. Vaccination is the most reliable method of prevention. The first dose is administered at 12–15 months, and the second at 4–6 years of age. The vaccine not only significantly reduces the risk of infection but also ensures that if infection does occur, the disease will be mild. However, the vaccine is not recommended for pregnant women or individuals with immune deficiencies.

– What does the World Health Organization (WHO) say about this?

According to WHO, chickenpox is highly contagious—if one child in a household becomes infected, 60–100% of unvaccinated children are likely to contract it. Worldwide, over 80 million people are infected each year, and thousands die from complications. The implementation of vaccination programs has significantly reduced these numbers.

– Some people believe it’s good for a child to “get it over with” and develop natural immunity. What is your opinion?

It’s true that after having chickenpox, a person gains lifelong immunity, but this does not mean parents should deliberately expose their children to infection. Vaccination provides the same immune protection without the risk of complications. So, vaccination is the safer option.

– Can a child with chickenpox take a bath?

If the child’s temperature is normal and they feel well, a quick bath with lukewarm water is acceptable. However, the skin should not be rubbed with a towel, and the blisters must not be damaged. Gentle cleansing actually helps reduce itching and maintain skin hygiene.

– Can a child get chickenpox more than once?

Almost never. After the initial infection, the body develops permanent immunity. However, the virus can remain dormant and later cause shingles (herpes zoster)—this usually occurs in adults.

– How can parents protect other children at home?

If one child is infected, parents should check the vaccination status of the others. Unvaccinated children should be kept in a separate room, and personal items such as towels and dishes must not be shared. Regular handwashing and ventilation of rooms also help prevent transmission.

– Finally, what is your main advice to parents?

My most important advice is that parents should rely on credible medical sources, not on “folk remedies” circulating on social media. I recommend following the guidelines of the Ministry of Health of the Republic of Azerbaijan, the World Health Organization, and international medical protocols.

If a child shows the early signs of chickenpox—fever, fatigue, or rashes—parents should immediately consult a doctor. The child must not attend school or public places, as this poses a risk to others. The child should remain at home until all lesions have crusted over, rest adequately, and follow all medical recommendations.