• Advise the following simple measures:
• Encourage adequate fluid intake.
• Dress appropriately to avoid shivering or overheating.
• Wear smooth, cotton fabrics.
• Keep nails short to minimize damage from scratching.
• Advise that the most infectious period is 1–2 days before the rash appears, but infectivity continues until all the lesions have crusted over (commonly about 5–6 days after onset of illness):
• During this time, advise a person with chickenpox to avoid contact with:
• People who are immunocompromised (e.g. those receiving cancer treatment or high doses of oral steroids, or those with conditions that reduce immunity).
• Pregnant women.
• Infants aged 4 weeks or less.
• Children with chickenpox should be kept away from school or nursery for 5 days from the onset of the rash.
• Air travel is not allowed until 6 days after the last spot has appeared.
• Inform the person to seek urgent medical advice if their condition deteriorates or they develop symptoms of complications (e.g. cough, shortness of breath, decreased consciousness). Particularly advise parents of young children to be aware of:
• Bacterial superinfection — typically presents suddenly with a high temperature (often after initial improvement), redness and tenderness surrounding the original chickenpox lesions.
• Dehydration — encourage and monitor fluid intake and seek medical attention if signs of dehydration develop (e.g. reduced urine output, lethargy, cold peripheries, reduced skin turgor).

In depth