What is the infectious period for varicella (chickenpox)?

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Last updated: April 28, 2025 • View editorial policy

From the Guidelines

The infectious period for chicken pox typically begins 1-2 days before the rash appears and continues until all lesions have crusted over, which is usually about 4-7 days after the rash first appears. This period of contagiousness is estimated based on the average time it takes for the lesions to crust over, as stated in the study by 1. During this time, the virus can spread through direct contact with fluid from the blisters, through respiratory droplets when an infected person coughs or sneezes, or by touching contaminated items.

Key Points to Consider

  • The varicella-zoster virus that causes chicken pox is highly contagious, with a transmission rate of up to 90% among susceptible household contacts.
  • People with chicken pox should stay home from school, work, or other public places until all blisters have crusted over to prevent spreading the infection to others.
  • Immunocompromised individuals may have longer periods of viral shedding and should follow their healthcare provider's guidance about isolation, as suggested by 2.
  • The study by 1 provides the most recent and highest quality evidence for the infectious period of chicken pox, and its findings should be prioritized in clinical decision-making.

Clinical Implications

  • Healthcare providers should advise patients with chicken pox to stay isolated until all lesions have crusted over to prevent transmission to others.
  • Immunocompromised individuals should be closely monitored and provided with guidance on isolation and prevention of transmission.
  • The high contagiousness of the varicella-zoster virus emphasizes the importance of vaccination and preventive measures to reduce the risk of transmission.

From the Research

Infectious Period of Chicken Pox

The infectious period or transmission period for chicken pox is not directly stated in the provided studies. However, some studies provide information on the treatment and management of varicella-zoster virus (VZV) infections, which cause chicken pox.

Treatment and Management

  • The treatment of VZV infections includes the use of antiviral agents such as valacyclovir, famciclovir, and acyclovir 3, 4, 5, 6.
  • These antiviral agents can help reduce the severity of the infection, the duration of the eruptive phase, and the intensity of acute pain 3, 5.
  • The use of valacyclovir and famciclovir has been shown to be effective in preventing post-herpetic neuralgia (PHN), a common complication of herpes zoster 3, 4, 5.

Varicella-Zoster Virus Infections

  • VZV infections can cause a primary infection (varicella or chickenpox) followed by establishment of latency in sensory ganglia 4.
  • The virus can reactivate, causing herpes zoster (HZ, shingles) and leading to significant morbidity but rarely mortality 4.
  • Immunocompromised hosts are at greater risk for complications and recurrence of VZV infections 3, 4, 6.

Resistance to Antiviral Agents

  • Long-term use of acyclovir can result in the emergence of VZV strain resistant to acyclovir 6.
  • Famciclovir may be effective in treating VZV infections resistant to acyclovir, at least in the early resistant phase 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.