Chicken Pox(Main)

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Chicken Pox


Definition

Chickenpox or chicken pox is a highly contagious illness caused by primary infection with varicella zoster virus (VZV). It usually starts with vesicular skin rash mainly on the body and head rather than at the periphery and become itchy, raw pockmarks, which mostly heal without scarring.


Causes

Chickenpox is a highly contagious disease, caused by a virus which belongs to the herpes family. This virus is known as varicella-zoster virus and also as the Herpes Zoster virus. Not only chickenpox is produced by it but shingles is too.Shingles occurs most commonly in older patients, and occurs because of a reactivation of the Varicella virus.


Varicella-Zoster Virus


• If an infected person coughs or sneezes, the virus will be spread in the air and will be caught by other healthy persons while breathing. The virus is known to be present in the body long before the skin rash appears; this is the reason why there are so many cases of contamination.


• After the virus got into your body it generally needs two weeks to develop and only then the rash will appear. But this does not mean that you are not contagious within these two weeks.


• It is transmitted from person to person by droplet infection through the respiratory tract. Rarely the condition may be caused by exposure to a case of Herpes Zoster. Once the virus enters the body it rests and reproduces in the lymph nodes of the body for about 3 to 4 days before it travels to the blood to infect the spleen and liver. It finally rests in the nerve roots near the spinal cord till it is activated. No trigger maybe needed for its activation, but sometimes it waits for events like stress or diminished immunity before it attacks.


Risk Factors

• Usually it is a self limiting disease but complications can occur in those with the following risk factors– Immunocompromised– Older age– Long-term steroid use– Malignancy

• It tends to be milder in younger children than in older children and if contracted in adulthood it is significantly more unpleasant.

• It is dangerous in neonates and to the fetus if contracted in pregnancy.

• The infection tends to be severe in pregnancy - a high risk of pneumonia as well as risks to the fetus as described below

• Complications may occur in as many as 1 in 50 cases


Pathophysiology

•Chickenpox is usually acquired by the inhalation of airborne respiratory droplets from an infected host •It is spread easily through coughs or sneezes of ill individuals or through direct contact with secretions from the rash•After initial inhalation of contaminated respiratory droplets, the virus infects the conjunctivae or the mucosae of the upper respiratory tract•A second round of viral replication occurs in the body’s internal organs •followed by a secondary viremia 14-16 days postinfection•This secondary viremia is characterized by diffuse viral invasion of capillary endothelial cells and the epidermis.


Pathophysiology

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Manifestations

The characteristic chickenpox vesicle, surrounded by an erythematous halo, is described as a dewdrop on a rose petal Chickenpox is clinically characterized by the presence of active and healing lesions, in all stages of development, within affected locations. Lesions characteristically heal without scarring, though excoriation or secondary bacterial superinfection predispose to scar formation.Adults may experience a more widespread rash; prolonged fever; and an increased likelihood of complications, the most common being varicella pneumonia.


In children the first symptom is usually the development of a papular rash

Followed by development of malaise, fever (a body temperature of 38 °C (100 °F), but may be as high as 42 °C (108 °F) in rare cases), and anorexia.

Typically, the disease is more severe in adults.


Chickenpox is usually diagnosed clinically on the basis of the characteristic rash and successive crops of lesions. Lesions may be found in all stages of development and healing in affected sites. A history of exposure to an infected contact within the incubation period of 10-21 days is also an important clue in the diagnosis. Consider the following:

Chickenpox in adults and adolescents may be preceded by a prodrome of nausea, myalgia, anorexia, and headache.

The typical patient is infectious for 1-2 days prior to the development of rash and for 4-5 days afterwards, which is usually the time at which the last crop of vesicles has crusted over.

The triad of rash, malaise, and low-grade fever signals the onset of chickenpox.


• Small, erythematous macules appear on the scalp, the face, the trunk, and the proximal limbs, with rapid sequential progression over 12-14 hours to papules, clear vesicles, and pustules, with subsequent central umbilication and crust formation.

• New crops of lesions form, which subsequently progress to vesicles with crusting.

• Vesicles may appear on the palms and the soles and on the mucous membranes, with painful, shallow, oropharyngeal or urogenital ulcers.

• Intense pruritus commonly accompanies the vesicular stage of the rash.


A single blister, typical during the early stages of the rash


In children the first symptom is usually the development of a papular rash

Followed by development of malaise, fever (a body temperature of 38 °C (100 °F), but may be as high as 42 °C (108 °F) in rare cases), and anorexia.

Typically, the disease is more severe in adults.


Causes



Treatment


Prevention

•Stay at home (To prevent infecting other people.)

•Promote good Hygiene (eg. Cutting of nails.) to minimize risk of secondary infection.

•Avoidance of close proximity or physical contact with affected individual•Vaccine


Nursing Management

Minimize scratchingAvoid sharing of things such as clothes & utensilsPrevent spread of infectionProvide adequate rest periodPromote good hygieneAdvice regarding adequate fluid intakeSymptomatic treatmentAciclovirPractice universal precautionsIsolate the patient


Causes


Chicken Pox(Main)

Documents

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