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Chickenpox: public health management and guidance

The diagnosis, management and epidemiology of chickenpox (varicella).

Varicella zoster Immunoglobulin (VZIG) is a scarce blood product that is offered to individuals at high risk of severe chickenpox following an exposure. This includes immunosuppressed individuals, young babies in their first week of life and pregnant women.

In response to a significant shortage of VZIG due to manufacturing issues, on the advice of a PHE convened expert working group, from 8 August 2018, use of VZIG is restricted to susceptible women exposed in the first 20 weeks of pregnancy and neonates.

Antiviral agents are recommended for post exposure prophylaxis for pregnant women exposed after 20 weeks and immunosuppressed individuals.

See the detailed guide Updated restrictions on the use of VZIG during supply shortage: advice for health professionals.

Chickenpox is an acute, infectious disease caused by the varicella-zoster virus (VZV) and is most commonly seen in children under 10 years old. This virus can also cause shingles (herpes zoster) which tends to be more common in adults. The disease can be more serious in adults, particularly pregnant women.

For symptoms and general information on chickenpox, visit NHS.UK.

Epidemiology and data collection

Chickenpox is not a notifiable disease in England and Wales. Data on cases reported in the UK is available from the Royal College of General Practitioners Research and Surveillance Centre by sentinel GP practices in England and Wales.

Laboratory confirmation of cases of chickenpox is rarely sought as the diagnosis can, in general, be reliably made on clinical grounds. Therefore no laboratory data is available on this website.

Clinical management

Information and guidance for health professionals managing cases of chickenpox (varicella) is available below. Further information on clinical management of chicken pox is available on the NICE Clinical Knowledge Summaries website.

Laboratory testing for confirmation of chickenpox is not normally required but can be performed in Public Health England public health laboratories (PHLs).

Vaccination

There is no specific treatment for chickenpox. It is a viral infection that will therefore not respond to antibiotics.

There are 2 vaccines available to prevent chickenpox: Varilrix® (Oka-RIT) and Varivax® (Oka/Merck).

  1. Varicella: the green book, chapter 34
Published 31 July 2014
Last updated 9 August 2018 + show all updates
  1. Added updated details of restrictions on use of VZIG during supply shortage.
  2. Added details of VZIG restrictions due to shortage.
  3. First published.