JAKARTA - Many people consider chickenpox or varicella as a mild disease in children. Moreover, it is known that the Varicella zoster virus, which causes chickenpox, can settle latently in the nervous system and potentially cause herpes zoster or chickenpox.
In recent months, the Indonesian Association of Pediatricians (IDAI) has seen an increase in cases of chickenpox and shingles, especially among schoolchildren. One of the areas that has found smallpox, although the number of cases is relatively small and does not fall into the category of an outbreak, is Bali.
Head of the Denpasar City Health Office, dr. A.A. Ayu Agung Candrawati said that the emergence of smallpox cases is a condition that can still be found every year. However, the number is not worrying.
This was also confirmed by Member of the Tropical Disease Infection Coordination Working Unit (UKK) at IDAI Ratni Indrawanti, who said there were no specific figures related to the recent increase in chickenpox and herpes zoster cases. However, many areas have reported cases.
"Recently, there have been several cases, especially among schoolchildren. There are several reports, fairly evenly, I think in Indonesia," said Ratni in a seminar held by IDAI online, Tuesday (13/1/2026).
Very High Transmission LevelChickenpox is a disease known to the public. In 2024, a number of schools reported a large number of cases of chickenpox in students. One of them is SMPN 8 South Tangerang, which found as many as 53 students were infected with chickenpox. As a result, the school imposed distance learning (PJJ) for two weeks to stop the spread of chickenpox.
Chickenpox (chickenpox) used to be a common disease in children. The cause of chickenpox or also known as varicella is the Varicella zoster virus. This disease is characterized by the appearance of blisters or blisters containing fluid that feels very itchy all over the body.
The Varicella zoster virus is easily transmitted through a splash of saliva, or direct contact with fluids from the rash and blisters of chickenpox sufferers. Clinically, varicella is preceded by fever and followed by a typical rash that appears gradually. Skin lesions develop from macules, papules, vesicles containing clear fluid, pustules, and finally dry into crusts.
The problem is, varicella is already contagious one to two days before the rash appears.
Children can also spread the virus until all skin lesions dry up and turn into scabs. With an incubation period of about two weeks, controlling the smallpox outbreak is difficult without good prevention.
Ritni Indrawati said the transmission rate of chickenpox was very high. The basic reproduction number (reproduction number/R0) of this disease is in the range of 8 to 12.
This means that one child infected with chickenpox can transmit the disease to eight to 12 other children, especially in environments with close contact such as schools, homes, or treatment rooms.
Herpes ZosterFor most people, the assumption that chickenpox can only be experienced once in a lifetime is still valid. In fact, medically it is not.
Many people do not know that the varicella zoster virus that causes chickenpox does not actually disappear from the sufferer's body. In other words, even though it has healed, Varicella zoster is still hiding and still lives in a person's body. This virus can reactivate into herpes zoster when immunity is declining.
Simply put, Ratni explained, if a person is first exposed to the Varicella zoster virus, he will experience chickenpox. And when it is cured, the virus does not die or disappear from the human body, but will be dormant or latent, especially in neuronal cells.
That way, one day the virus can experience reactivation and manifest itself as herpes zoster disease or better known as chickenpox.
"Varicella zoster is the two clinical manifestations of the Varicella zoster virus in a spectrum of diseases throughout life," said Ratni.
Herpes zoster is more common in adults and the elderly, but Ratni said this condition can also occur in children. Meanwhile, quoted from the Ministry of Health's website, the incidence of herpes zoster varies by age. At least, there are 2-9 cases of chickenpox per 1,000 people every year.
He added that the presence of herpes zoster in children is also a reminder that varicella infection is not without long-term consequences. The same virus can return to cause the disease years after the first infection.
"Therefore, prevention of varicella at an early age is very important, not only to prevent chickenpox, but also to reduce the risk of herpes zoster later in life," concluded Ratni.
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