It’s easy to dismiss chickenpox as a harmless childhood disease that merely causes itching and discomfort for a few days. But although serious complications are rare, chickenpox can lead to a range of life-threatening conditions. Here’s what you need to know about its possible complications.
Who is most likely to suffer from chickenpox complications?
“Complications of chickenpox rarely occur in healthy, immunocompetent people,” says Cape Town general practitioner Dr Mark Stodel. “They are more likely to occur in very young children, those who are pregnant, the elderly, those receiving chemotherapy, HIV-positive individuals and people receiving immuno-suppressants, like those with transplants and autoimmune conditions.”
Acute vs chronic chickenpox
According to Dr Stodel, the possible complications of chickenpox can be divided into acute and chronic complications.
Acute complications include:
- Skin infections from a bacteria known as staphylococcus aureus. “Bacterial infections are much more common in those with chickenpox than those without. This is partly due to the breaking down of the skin’s defensive barrier due to the blisters the virus causes and partly due to the decreased immune system,” explains Dr Stodel. “The bacteria that cause the skin infections are found living happily on our skin and fingers. When the conditions are right (for instance when the skin is scratched), the bacteria can invade the skin.”
Skin infections commonly affect children with chickenpox as they are more likely to scratch the blisters. If your children contract chickenpox, try to limit scratching by managing the itch associated with the chickenpox rash. - Toxic shock syndrome (TSS) can occur if the staphylococcus aureus bacteria spread inside the body, and not just on the surface of the skin. The bacteria produce toxins in the body and the immune system reacts by causing symptoms of TSS, such as a very high fever and very low blood pressure. TSS requires immediate medical attention as it can be fatal if left untreated.
- Lung conditions such as pneumonitis and pneumonia can be caused by chickenpox. “Viral pneumonitis is caused by the chickenpox virus itself and leads to multiple tiny blisters in the lungs – much like the blisters that chickenpox causes on your skin. Chickenpox can also lead to bacterial pneumonia. This occurs when bacteria take advantage of the decreased immunity that results when the virus invades your bone marrow,” says Dr Stodel. Lung abscesses (masses of dead cell tissue and cavities within the lungs) can be also caused by staphylococcus aureus and pneumonia.
- Infection and inflammation in the brain, such as encephalitis and meningitis, can be caused by the chickenpox virus itself. These cases are, however, very rare.
- “Bleeding problems can develop due to decreased production of blood platelets, which occurs when the chickenpox virus invades the bone marrow,” says Dr Stodel.
Shingles is a chronic complication of chickenpox. It is a very painful condition caused by the chickenpox virus that has hidden in the roots of the nerves. “As one gets older, or as one’s immune system deteriorates, the chickenpox virus reactivates and spreads along the nerve fibre, causing blisters wherever that nerve supplies feeling. The nerve gets inflamed, causing a nerve pain that is resistant to almost all pain medication,” says Dr Stodel.
Chickenpox and pregnancy
During pregnancy, the immune system is depressed. “This means that if you contract chickenpox for the first time, you will get it far more seriously than if you were not pregnant, including many of the complications of chickenpox,” says Dr Stodel.
In the third trimester of pregnancy you can pass the chickenpox onto your baby, which could prove fatal. Contracting chickenpox in the first trimester of pregnancy has a small chance of causing birth defects.
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