Varicella (Chickenpox) Information for Schools and Child Care

Information on varicella (chickenpox), reporting, surveillance, and disease control recommendations for school health personnel and child care providers.

On this page:
Varicella (chickenpox) basics
Reporting for school and child care
Testing information and promotion
Prevention and control in school and child care
Chickenpox outbreaks
Immunization resources

Varicella (chickenpox) basics

Varicella (Chickenpox) Basics
General information about chickenpox, including symptoms, complications, treatment and vaccination available on Arabic, Hmong, Russian, Somali, Spanish, and Ukranian.

Reporting for school and child care

Schools and child cares are to report all suspected and confirmed cases of chickenpox at their facility, even if they have not been diagnosed by a healthcare provider. Suspect and confirmed cases of shingles in children under 18 must also be reported. If the beginning of an outbreak of chickenpox is suspected, call MDH at 651-201-5414 or 1-877-676-5414.

• Online with REDCap using the Vaccine Preventable Disease (VPD) Reporting Form.
• For other ways to report visit Reporting Varicella (Chickenpox).

Testing information and promotion

Chickenpox can sometimes be difficult to distinguish from other rash illnesses, such as hand, foot, and mouth disease. For this reason, we recommend laboratory testing for all suspected cases of varicella. Because many cases are not seen by a health care provider, we provide home test kits for varicella. Test kits can be sent directly to household or to schools and child cares to distribute to families. Testing at MDH is provided at no charge and documentation of positive results can be used as evidence of immunity to chickenpox in the future. For more information visit Varicella Testing Fact Sheet (PDF).

Prevention and control in school and child care

• Exclude children or staff with chickenpox from school or child care until all blisters have crusted. This is usually four to seven days after the rash began.
• Chickenpox occurring in vaccinated persons (called "breakthrough infection") is usually mild but is still considered infectious. Blisters may not be present, and the rash may not crust. Such cases should be excluded until all lesions have faded or no new lesions have occurred within a 24-hour period, whichever is later. Lesions do not need to be completely gone. Review CDC: Do You Know What Breakthrough Varicella (Chickenpox) Looks Like? (PDF) for more information.
• Parents should be notified if their child is exposed to a case of chickenpox. Call MDH for guidance on the extent of notification and a template letter.
• Pregnant people and people with a weakened immune system are at high risk of severe disease and should be advised to contact their health care provider.

Chickenpox outbreaks

An outbreak of chickenpox is defined as:

• Five or more cases within a two-month period in persons in a child care or elementary school.
• Three or more cases within a two-month period in persons in a middle or high school.

Steps to take when a school outbreak of chickenpox occurs:

1. Call MDH to report the beginning of an outbreak at 651-201-5414 or 1-877-676-5414.
2. Monitor for additional cases and report each case to MDH.
3. Notify and inform parents and staff that a chickenpox outbreak is occurring and provide them information about chickenpox.
   • Template letters are available by calling MDH.
   • We also have fact sheets available on Chickenpox (Varicella).
4. Recommend the following:
   • Two doses of chickenpox vaccine for individuals who have no history of chickenpox disease and are unvaccinated.
   • A second dose of chickenpox vaccine for individuals who have received only one dose of vaccine, provided the appropriate interval has passed since the first dose (i.e., three months for children aged 4-12 years and four weeks for persons 13 years and older).
   • We generally recommend symptom watch of susceptible individuals during chickenpox outbreaks but, in certain situations, exclusion may be necessary.
5. Identify and notify immunocompromised and pregnant people because they are at high risk for complications. High-risk people should contact their health care provider to determine if vaccination, immune-status testing, post-exposure prophylaxis, or school exclusion is indicated. MDH can assist with notifying the local medical community of a varicella outbreak, allowing them to prepare for increased calls from patients.

Chickenpox and Shingles: School Reporting and Disease Control Recommendations (PDF)
Information for school health personnel about school reporting requirements for chickenpox and shingles, as well as disease control recommendations.

Immunization resources

• Immunizations: Schools and Child Care
  Information and resources on the Minnesota immunization law for schools and child cares.
• Subscribe to School Immunization and Vaccine-Preventable Disease Information
  Get an email alert when there are major additions or updates for school health personnel on immunizations and vaccine-preventable diseases.