Chickenpox is caused by initial infection with varicella zoster virus, a DNA virus of the Alphaherpesvirinae subfamily. The virus naturally infects only humans, but some other primates have been infected artificially. Symptoms appear 10–21 days after exposure: an itchy vesicular skin rash, and small ulcers in the oral cavity and tonsil areas. The rash usually resolves by 7 days, but the virus remains latent in nerve cell bodies, and can emerge years or decades later to cause shingles. Chickenpox is transmitted by the respiratory route, as well as direct contact with lesions.
A classic disease of childhood, the highest prevalence occurs at 4–10 years. Chickenpox is rarely fatal in people with a normal immune system, with around 6,400 deaths worldwide in 2015, about 1 in 60,000 infections. Adults often have more severe symptoms than children, and are at higher risk of complications such as pneumonia, bronchitis, hepatitis and encephalitis. Pregnant women and people with a suppressed immune system have the highest complication risk. Chickenpox during the first 28 weeks of gestation can lead to foetal malformations. Infection in adults is usually treated with antiviral drugs, such as aciclovir or valaciclovir, which reduces symptom severity and the risk of complications. A vaccine is available.