Vaccine
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Varicella

Chickenpox (varicella) is very contagious. It typically causes an itchy, blister‑like rash plus fever and malaise. Most people who get chickenpox once develop lifelong immunity; reinfection is uncommon but can occur.

Signs and symptoms

A classic rash progresses from macules → papules → fluid‑filled vesicles that crust into scabs. Often begins on chest/back/face, then generalizes. Up to ~500 vesicles may occur; most lesions crust within ~1 week. Breakthrough varicella after vaccination is usually milder.

Who is at risk?

Anyone unvaccinated and without prior disease. Severe disease/complications are more likely in pregnant people, infants, adolescents, adults, and the immunocompromised.

How it spreads

Varicella‑zoster virus (VZV) spreads readily by respiratory droplets/aerosols and direct contact with lesions. Up to 90% of susceptible close contacts become infected. A person is contagious from 1–2 days before rash until all lesions have crusted. Vaccinated cases without crusting are contagious until no new lesions for 24 hours.

Prevention

The two‑dose varicella vaccine is the best protection. All children, adolescents, and adults without evidence of immunity should receive 2 doses. CDC strongly discourages "chickenpox parties"; disease can be severe or fatal, and severity is unpredictable.

Varicella in Egypt

Egypt has high seroprevalence (immunity from prior infection) despite the absence of a routine national program. In tropical climates, acquisition can occur later in childhood, increasing adult susceptibility compared with temperate regions.

Post‑COVID studies (e.g., Mansoura Medical Journal) report higher incidence and unusual presentations: older age at infection, second attacks, more severe disease, genital pruritus/pustular lesions, and dysuria.

Implications and recommendations

• Consider routine varicella vaccination given rising incidence and severity.
• Targeted vaccination for women of reproductive age (especially primigravidas) and other susceptible adults per local sero‑epidemiology.

References: CDC – Chickenpox; regional Egyptian studies (Fayoum University, Mansoura Medical Journal; Springer Open reviews on sero‑epidemiology).

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