Chickenpox is a highly contagious viral infection that causes an acute fever and blistered rash, mainly in children.
The name may be derived from the French term for chick pea, chiche pois. Another theory is that the word 'chicken' was derived from a slang term for 'child'. Chickenpox is also known as varicella.
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2. Summary
Definition | introduction
Epidemiology
Aetiology | causes
Risk factors
How do you get chickenpox
Pathophysiology
Signs and symptoms
When to see a doctor
Diagnostic tests
Treatment
Complication
Prevention
Vaccination
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3. Chickenpox is a highly contagious viral
infection that causes an acute fever and
blistered rash, mainly in children.
The name may be derived from the French
term for chick pea, chiche pois. Another
theory is that the word 'chicken' was
derived from a slang term for 'child'.
Chickenpox is also known as varicella.
Introduction
| Definition
4. Epidemiology
Chickenpox is largely a childhood disease, with more
than 90% of cases occurring in children younger than
10 years.
Varicella occurs in all countries and is responsible
annually for about 7000 deaths.
the fatality rates for varicella were approximately 1
per 100,000 cases among children 1-14 years of age,
2.7 per 100,000 cases among persons 15-19 years of
age, and 25.2 per 100,000 cases among adults 30-49
years of age.
5. Chickenpox is caused by #primary infection with the
varicella-zoster #virus, of the #herpesviridae
#family.This virus is sometimes called #herpes virus
type 3.Causes|
aetiology
6. Chickenpox occurs #worldwide, affecting #persons
of all #races, #gender and age. However, most
cases occurring in children before they are 10 years
of age.
Risk
Factor
7. Chickenpox is highly contagious and is easily
#spread from person to person by #breathing in
#airborne #respiratory #droplets from an infected
person's #coughing or #sneezing or through direct
contact with the #fluid from the open #sores.
A person who is not #immune to the virus has a 70–
80% chance of being infected with the virus if
exposed in the early stages of the disease.
How do you
get
chickenpox.
8. Pathophysiol
ogy
After initial inhalation of contaminated respiratory
droplets, the virus infects the conjunctiva or the mucosa
of the upper respiratory tract.
Viral proliferation occurs in regional lymph nodes of the
upper respiratory tract 2-4 days after initial infection;
this is followed by primary viremia on post infection days
4-6.
A second round of viral replication occurs in the body's
internal organs, most notably the liver and the spleen,
followed by a secondary viremia 14-16 days post
infection.This secondary viremia is characterized by
diffuse viral invasion of capillary endothelial cells and the
epidermis.
9. Inhalation of respiratory droplets
Virus infect upper respiratory tract
Viral proliferation in regional lymph node of
the URTs
Stage of primary viremia
Viral replication in other organs ( liver &
spleen )
VZV infection of cells of the malphigian layer
produce intracellular oedema & intercellular
oedema resulting in the characteristic vesicle
Diffuse viral of capillary endothelial cells and
epidermis
Stage of secondary viremia
10. In children, chickenpox usually begins as itchy red
papules progressing to vesicles on the stomach, back and
face, and then spreading to other parts of the body.
Blisters can also arise inside the mouth
The spread pattern can vary from child to child.There
may be only a scattering of vesicles, or the entire body
may be covered with up to 500 vesicles.The vesicles tend
to be very itchy and uncomfortable.
Some children may also experience additional symptoms
such as high fever, headache, cold-like symptoms,
vomiting and diarrhoea.
Sign And
Symptoms
11. The blisters clear up within one to three weeks but
may leave a few scars .These are most often
depressed (anetoderma) but they may be thickened
(hypertrophic scars). Scarring is prominent when the
lesions get infected with bacteria.
Chickenpox is usually more severe in adults and can be
life-threatening in complicated cases. Most adults who
get chickenpox experience prodromal symptoms for up
to 48 hours before breaking out in the rash.These
include fever, malaise, headache, loss of appetite and
abdominal pain. Chickenpox is usually more severe in
adults and can be life-threatening in complicated cases.
Sign And
Symptoms(
cont…)
12. Diagnosis of chickenpox is usually made on the presence
of its characteristic rash and the presence of different
stages of lesions simultaneously. A clue to the diagnosis
is in knowing that the patient has been exposed to an
infected contact within the 10–21 day incubation period.
Patients may also have prodromal signs and symptoms.
See also chickenpox pathology.
Laboratory tests are often undertaken to confirm the
diagnosis.
Diagnosis:
Chicken
Pox
(Varicella)
13. PCR detects varicella virus in skin lesions and is the
most accurate method for diagnosis.
Culture of blister fluid is time consuming and is less
frequently performed.
Serology (IgM and IgG) is most useful in pregnant
women, or prior to prescribing immune suppression
medication to determine need for pre-treatment
immunisation.
Diagnosis:
Chicken
Pox
(Varicella)(
cont..)
14. •Patient exposed to the virus for the first time.
•Childhood disease with generalized self-limiting
vesicular eruption à Brownish crust à Lesions
heal within 10 days à After attack, virus reside in
posterior root ganglia
Summary:
15. For most healthy patients with chickenpox
symptomatic therapy is usually all that is required.
Trim children's fingernails to minimize scratching.
Take a warm bath and apply moisturizing cream.
Paracetamol can reduce fever and pain (do not use
aspirin in children as this is associated with Reye
syndrome).
Calamine lotion and/or oral antihistamines may relieve
itching.
Treatment
16. Consider oral aciclovir (antiviral agent) in people
older than 12 years, which reduces the number of
days with fever.
Immuno compromised patients with chickenpox
need intravenous treatment with the antiviral
aciclovir. In cases of inadvertent exposure to the
virus, varicella-zoster immune globulin if given
within 96 hours of initial contact can reduce the
severity of the disease though not prevent it.
Treatment
(cont..)
17. In healthy children, chickenpox infection is usually
an uncomplicated, self-limiting disease.
Complications may include:
Secondary bacterial infection of skin lesions caused
from scratching
Infection may lead to abscess, cellulitis, necrotising
fasciitis and gangrene
Dehydration from vomiting and diarrhoea
Complication
18. Exacerbation of asthma
Viral pneumonia
Some complications are more commonly seen in
immune compromised and adult patients with
chickenpox.
Disseminated primary varicella infection; this carries
high morbidity
Central nervous system complications such as Reye
syndrome, Guillain-Barré syndrome and encephalitis
Complication
(cont..)
19. Thrombocytopenia and purpura
Varicella in pregnancy
Exposure to varicella virus in pregnancy may cause
viral pneumonia, premature labour and delivery and
rarely maternal death.
Approximately 25% of fetuses become infected.
Offspring may remain asymptomatic, or develop
herpes zoster at a young age without previous
history of primary chickenpox infection.
Complicati
on(cont..)
20. Shingles (herpes zoster)
The varicella zoster virus remains dormant in sensory
ganglia after infection.
It may reactivate after many years as shingles.
Shingles presents with grouped vesicular lesions
usually affecting a single dermatome.
Other infections occurring as a result of reactivation
of virus include post-herpetic neuralgia,
vasculopathy, myelopathy, retinal necrosis,
cerebellitis and zoster sine herpete.
Complicati
on(cont..)
21. A person with chickenpox is contagious 1–2 days
before the rash appears and until all the blisters have
formed scabs.This may take 5–10 days. Children
should stay away from school or childcare facilities
throughout this contagious period. Adults with
chickenpox who work amongst children, should also
remain home.
It can take 10–21 days after contact with an infected
person for someone to develop chickenpox.This is
how long it takes for the virus to replicate and come
out in the characteristic rash in the new host.
Prevention
22. As chickenpox may cause complications in immune
compromised individuals and pregnant women, these
people should avoid visiting friends or family when there
is a known case of chickenpox
Vaccination against chickenpox
Vaccination is available for chickenpox, and is highly
recommended.
Chickenpox is highly preventable by vaccination with live
attenuated varicella vaccine.The vaccine is subsidised
("scheduled") for infants aged 15 months in New Zealand
as well as non-immune individuals that are
immunosuppressed or are in other special groups.
Preventio
n(cont..)
23. Vaccinatio
n
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