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Chickenpox: public health management and guidance

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

Post exposure prophylaxis (PEP) 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.

After reviews of the effectiveness of antivirals and varicella zoster immunoglobulin (VZIG) in prevention of chickenpox, antiviral medication is now the post exposure treatment of choice for all immunosuppressed patients and pregnant women, regardless of stage in pregnancy. The only group of individuals where VZIG is recommended for PEP is those neonates exposed within 1 week of delivery, either in utero from maternal infection or post-delivery.

VZIG will only be issued for susceptible neonates exposed within 1 week of birth (either in utero from maternal infection, or post-delivery) or if oral antivirals are contraindicated due to malabsorption, or renal toxicity, or because the patient is less than 4 weeks of age

See the detailed guide ‘Guidelines on post exposure prophylaxis (PEP) for varicella/shingles’.

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 UK Health Security Agency (UKHSA) 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).

Published 31 July 2014
Last updated 27 April 2022 + show all updates
  1. Added 'Post exposure prophylaxis for chickenpox and shingles' and updated VZIG section.

  2. Added link to the updated guidelines on post exposure prophylaxis (PEP) for varicella/shingles: advice for health professionals (June 2019).

  3. Added updated details of restrictions on use of VZIG during supply shortage.

  4. Added details of VZIG restrictions due to shortage.

  5. First published.