CHICKEN POX

CHICKEN POX:

CHICKEN POX DR. PRIYA ARORA ASST. PROF. DEPTT.OF COMM. MEDICINE

Chicken pox:

Chicken pox ACUTE, HIGHLY INFECTIOUS DISEASE CAUSED BY VARICELLA ZOSTER VIRUS CHICKEN POX & HERPES ZOSTER DIFFERENT MANIFESTATIONS OF SAME VIRAL INFECTION USUALLY A MILD ILLNESS OF CHILDHOOD, HOWEVER OCCURS IN SEVERE FORM IN ADULTS OCCURS IN BOTH EPIDEMIC & ENDEMIC FORMS

Mode of Transmission Chicken Pox (Varicella-zoster Virus):

Mode of Transmission Chicken Pox (Varicella-zoster Virus) Cases of chicken pox . Cases of Herpes Zoster are infectious and can transmit chicken pox to others. Early childhood Both sexes are equally affected Reservoir Susceptible host Rare in infants below 1 year, More in winter and spring (Seasonal trend) More severe in immuno-suppressed and pregnant women 3.Indirect by: Contaminated fomites with discharge 1.Direct Droplet infection 2. Indirect through droplet nuclei (Air-borne) Period of communicability 1day Rash 6days

Clinical Picture :

Clinical Picture Incubation period : 2-3 weeks (17 days). Clinical manifestations : 1. Prodromal stage : fever and malaise. for 1-2 days or may pass unnoticed . 2. Eruptive stage : vesicles on the mucous membrane of the mouth, soon rupture leaving small ulcers. macule, papule, vesicle and pustule Exanthema: Enanthema : Complete evolution of rash takes about 5 days .

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Other special severe clinical forms of Chicken pox. Varicella haemorrhagica Rare, but a potentially fatal form of chickenpox. Varicella bullosa . Varicella gangerenosa .

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Complications of Chicken Pox Secondary infection Encephalitis Fetal malformation pneumonia, furunculosis, abscess formation if varicella infection occurs during pregnancy.? more susceptible in Adult with steroid therapy 2nd week of illness

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SMALL POX CHICKEN POX INCUBATION 12 DAYS RANGE : 7-17 DAYS 15 DAYS RANGE: 7-21 DAYS PRODROME SEVERE MILD RASH PALMS& SOLES INVOLVED AXILLA FREE MORE ON EXTENSOR SURFACES SPARED INVOLVED MORE ON FLEXOR SURFACES CHARACTER OF RASH DEEP SEATED MULTILOCULAR, UMBILICATED ONE STAGE AT A TIME NO INFLAMMATION SUPERFICIAL UNILOCULAR PLEOMORPHIC INFLAMMATION AROUND RASH+ EVOLUTION OF RASH SLOW RAPID

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Small Pox Chicken Pox

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Notification: to local health authorities. Disinfection of different articles of cases. Health promotion . Active Immunization: live attenuated virus vaccine (not obligatory) 1 dose :< 13years >: 2 doses. Passive Immunization: IG - as early as possible or within 72hours after exposure to high risk close contacts . Prevention Control Isolation at home for 6 days after the rash . Symptomatic treatment Surveillance of contacts for 3 weeks .

Chicken Pox Vaccine:

Chicken Pox Vaccine - Live attenuated vaccine - Dose : 0.5 ml s.c. - Below 13 years : 1 dose ≥ 13 years : 2 doses 4-8 weeks apart - Given to : school teachers, day care centers, international travelers and health care workers…… - Side effect of the vaccine : may cause mild infection. transmission of the virus is high among immuno-compromised contacts.

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Zoster immune globulin (ZIG) is prepared from patients recovering from herpes zoster. VZIG prevents clinical varicella in susceptible, healthy children if administered within 72 hours of exposure. provides maximum benefit when administered as soon as possible after the presumed exposure. The duration of protection provided after administration of VZIG is unknown, but protection should last at least approximately 3 weeks). Varicella Zoster Immunoglobulin www.cdc.gov

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Indications for the Use of VZIG The decision to administer VZIG to a person exposed to varicella should be based on: a) whether the patient is susceptible (lacking documentation of vaccination), b) whether the exposure is likely to result in infection, c) whether the patient is at greater risk for complications than the general population.

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MODE OF TRANSMISSION SUSCEPTIBLE HOST Reactivation of the dormant virus under certain unfavorable conditions ( DEPRESSED IMMUNITY). One gets herpes zoster from his own chicken pox virus. 1- Old Age . 2- Depressed immunity. - RADIATION THERAPY - TUMORS - CHRONIC DISEASES - STRESS A case of Herpes Zoster. Herpes Zoster

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Case identification Localized vesicular eruption on Skin areas supplied by the affected sensory nerves. The lesion is unilateral. Pain. Parathesia.

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Control A-Isolation - Herpes Zoster patients are isolated at home away from susceptible children. - Cases of chicken pox have frequently been observed 11-21 days after contact with herpes zoster cases. B-Treatment : 1- Topical antibiotic. 2- Systemic Antiviral ( Acyclovir). in case of severe cases or high risk patients. C- Disinfection

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