Tamil Nadu health authorities have ramped up surveillance efforts and implemented preventive and control measures to curb rising chickenpox cases in the state. The Directorate of Public Health (DPH) and Preventive Medicine has instructed all health officers to intensify active and passive surveillance in all government and private health facilities, schools, colleges and hostels.They were also directed to ensure that all suspected and confirmed cases are entered into the Integrated Disease Surveillance Programme (IDSP) line list with complete demographic and clinical details. All medical officers across the state have further been asked to be alert to differentiate chickenpox from other rash illnesses such as measles, rubella, and hand, foot and mouth disease.This comes weeks after doctors across Pune also warned against the exponential rise in chickenpox cases this winter.Dr Shirish Kankariya, head of paediatrics at Apollo Hospital Swargate, said he had seen around 15 chickenpox patients in Jan alone, and the current season has brought a visible uptick in cases."Chickenpox cases have risen. We are also seeing infections in older children and adult family members, who never had the disease earlier," he told Times of India.Dr Prateek Kataria, consultant pediatrician and neonatologist at Sahyadri Hospital also noted that out-patient departments (OPDs) have recently seen a large increase confirmed chickenpox cases this year.He also told the publication: "We are seeing many children with chickenpox in the OPD even among those who have taken both doses of the vaccine. This is expected because the vaccine does not guarantee 100% protection, but vaccinated children usually develop milder illness and do not need hospitalization."What Is Chickenpox And How Does It Spread?Chickenpox, caused by the varicella-zoster virus, is extremely contagious and spreads through respiratory droplets or direct contact with someone who is infected. In children, it often starts as a mild rash accompanied by fever, but it can spread quickly in crowded areas.The virus can also be transmitted through coughing or sneezing, and it is most infectious a day or two before the rash appears and in the early days of the rash. In individuals with weak immunity, the dormant virus may reactivate later in life, causing shingles (herpes zoster).How To Detect Chickenpox Symptoms Early?Spotting chickenpox early means looking for general warning signs like fever, fatigue, headache, and loss of appetite, which usually appear one to two days before the rash. The rash itself starts as tiny red spots that later form fluid-filled blisters and eventually scab over. Paying attention to these early symptoms, especially after known exposure, can help identify the infection sooner.How To Spot A Chickenpox RashThe first rash usually shows up as small red bumps on the face, chest, or back. These bumps quickly turn into blisters filled with fluid, which are contagious. Over a few days, the blisters break and crust over, forming scabs. It’s common to see spots, blisters, and scabs all at the same time, according to the CDC.Stages Of ChickenpoxThe Mayo Clinic explains that chickenpox progresses in three main stages:Incubation Stage (10–21 days): After exposure, the virus remains inactive. Infected individuals typically show no symptoms during this period.Prodromal Stage (1–2 days): Early signs include fever, tiredness, headache, loss of appetite, and body aches. This is also when the virus can start spreading to others.Rash Stage (5–10 days): Red, itchy spots appear first on the face and chest, spreading across the body. These spots develop into fluid-filled blisters that scab over within a few days. Mild fever, itching, and discomfort are common during this stage.According to the Cleveland Clinic, complications are uncommon but can include pneumonia, brain inflammation (encephalitis), and bacterial skin infections. Vulnerable groups, such as infants, pregnant women, older adults, and people with weakened immunity are at higher risk of severe illness.