ASHEVILLE, N.C. (828newsNOW) — Buncombe County health officials are warning families about an increase in chickenpox cases, with infections reported in children from infancy through their teen years.

Health officials said Tuesday the highly contagious virus is spreading more easily in areas with lower vaccination rates. At this time, there are 49 confirmed cases of chickenpox in Buncombe County, officials said.

“We know that there are many more cases we are unaware of as they are not being seen by a provider and instead being self-diagnosed,” Public Information Officer Stacey Wood said.

Chickenpox typically causes an itchy rash that develops into fluid-filled blisters, and people can be contagious one to two days before the rash appears.

Although often mild, chickenpox can lead to serious complications — including bacterial infections, pneumonia, encephalitis and, in rare cases, death. Infants, adolescents, adults, pregnant people and those with weakened immune systems face the highest risk, but severe illness can occur in otherwise healthy children and adults.

County officials emphasized that vaccination remains the best defense. The American Academy of Pediatrics recommends children receive their first dose at age 1 and a second dose between ages 4 and 6. Anyone older than 1 who has never had chickenpox or the vaccine should seek vaccination as soon as possible after exposure, ideally within three days. Vaccination can prevent illness or reduce its severity.

Symptoms typically appear 10 to 21 days after exposure. A person with chickenpox can have as many as 500 blisters, which often begin on the chest, back or face before spreading across the body. People are considered contagious until all blisters have scabbed, usually within a week.

Most healthy children recover with rest, fluids and fever control. Those at higher risk of severe complications should consult their health care provider promptly.

Health officials urge parents and patients to call ahead before visiting any medical facility if they or their children have a rash and fever to avoid exposing others. The reminder comes as measles cases continue to rise nationally, including in nearby Upstate South Carolina.

The Buncombe County Immunization Clinic, at 40 Coxe Ave. in Asheville, offers chickenpox vaccines and can be reached at 828-250-5096 for appointments or questions.