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    Varicella (Chickenpox) Disease: Chananart Yuakyen: Icn

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    Kana Fajar
    Varicella, also known as chickenpox, is caused by the varicella zoster virus and causes a itchy rash. It is highly contagious and spreads through direct contact or respiratory droplets. The rash appears 10-21 days after exposure. While most children experience only mild symptoms, it can be more serious for adults and immunocompromised individuals. Vaccination and antiviral drugs can help prevent or reduce the severity of the disease.

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    Varicella (Chickenpox) Disease: Chananart Yuakyen: Icn

    Uploaded by

    Kana Fajar
    29 views28 pages
    Varicella, also known as chickenpox, is caused by the varicella zoster virus and causes a itchy rash. It is highly contagious and spreads through direct contact or respiratory droplets. The rash appears 10-21 days after exposure. While most children experience only mild symptoms, it can be more serious for adults and immunocompromised individuals. Vaccination and antiviral drugs can help prevent or reduce the severity of the disease.

    Original Description:

    LUKA KULIT BRUNTUS

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    Varicella, also known as chickenpox, is caused by the varicella zoster virus and causes a itchy rash. It is highly contagious and spreads through direct contact or respiratory droplets. The rash appears 10-21 days after exposure. While most children experience only mild symptoms, it can be more serious for adults and immunocompromised individuals. Vaccination and antiviral drugs can help prevent or reduce the severity of the disease.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    29 views28 pages

    Varicella (Chickenpox) Disease: Chananart Yuakyen: Icn

    Uploaded by

    Kana Fajar
    Varicella, also known as chickenpox, is caused by the varicella zoster virus and causes a itchy rash. It is highly contagious and spreads through direct contact or respiratory droplets. The rash appears 10-21 days after exposure. While most children experience only mild symptoms, it can be more serious for adults and immunocompromised individuals. Vaccination and antiviral drugs can help prevent or reduce the severity of the disease.

    Copyright:

    © All Rights Reserved
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    Varicella

    (Chickenpox)
    Disease
    CHANANART YUAKYEN : ICN
    Definition

    • Varicella (Chicken pox) is a disease caused by the


    varicella zoster virus; it causes fever and an itchy
    rash
    Infectious agent

    • Varicella-zoster virus (VZV) is a DNA virus


    of the herpes virus family.
    •It causes two diseases:
    • varicella (chickenpox), the primary infection,
    • and herpes zoster (shingles), a secondary
    infection due to a reactivation of latent varicella
    infection in the dorsal root ganglia
    Signs and Symptoms

    • Symptoms include a skin rash of blister-like lesions,


    covering the body but mostly concentrated in the face,
    scalp and trunk. Most infected individuals experience
    fever developing either just before or when the rash
    appears. If a vaccinated individual is exposed they may
    experience a milder illness with less severe rash and mild
    or no fever.

    dewdrops on a rose petal


    Occurrence
    • Worldwide.
    • At lease 90% of the population has had chickenpox by age 15
    • At lease 95% by young adulthood

    • In temperate zones, chickenpox occurs most frequently in winter


    and early spring.

    • The epidemiology of varicella in tropical countries differs from


    temperate climates, with a higher proportion of cases occurring
    among adults.

    • Herpes zoster occurrence has been described most commonly in


    developed countries where Zoster occurs more commonly in
    older people 50 years of age.
    Occurrence

    • Chickenpox typically infects children under the age of 10;


    5-10 % of the population remains susceptible to the
    disease in adulthood.
    • Lifetime risk of reactivation as zoster/shingles is about 15-
    20 % and can occur at any time, most often in the elderly
    population.
    Reservoir
    •Humans
    Mode of transmission

    • Person-to-person by direct contact,


    • Droplet or airborne spread of vesicle fluid,
    • Secretion of the respiratory tract of chickenpox cases
    • Vesicle fluid of patients with herpes zoster
    • Indirectly through articles freshly soiled by discharges
    from vesicle and mucous membranes of infected
    people
    Mode of transmission (cont.)

    • Varicella in unvaccinated persons is one of the


    most readily communicable of diseases,
    especially in the early stages of the eruption,

    • Secondary attack rates in susceptible household


    contacts range from 61% to 100%

    • Scabs from varicella lesion are not infective.


    Mode of transmission (cont.)

    • Herpes zoster has a lower rate of transmission:

    • Data from a household study showed that 20%


    of those who are varicella seronegative develop
    varicella when they are in contact with persons
    who have herpes zoster
    Incubation period

    • 10-21 days
    • Commonly 14-16 days
    • May be prolonged as long as 28 days after passive
    immunization against varicella
    • And may be shortened in the immunodeficient.
    (8-21 days)
    Period of communicability

    • As long as 5 days,
    • But usually 1-2 days before onset of rash,
    • And continuing until all lesions are crusted
    (usually about 5 days).
    Period of communicability (cont.)

    • Contagiousness may be prolonged in patients


    with altered immunity.
    • The secondary attack rate among susceptible
    siblings is 60-100%.
    • Patients with herpes zoster may be infectious for
    a week after the appearance of vesiculopustula
    lesion.
    • Susceptible individuals should be considered
    infectious for 10-21 days following exposure.
    Contagiousness
    all lesions
    are crusted

    1-2 days 5 days


    Susceptibility
    • Susceptibility to varicella is universal among
    those not previously infected or vaccinated;
    • Ordinarily a more severe disease of adults than of
    children.

    • Infection usually confers long immunity;


    • Second attack are rate in immunocompetient persons
    but have been documented ;
    • Subclinical reinfection is common.
    Susceptibility

    • Viral infection remains latent;


    • Disease may recur years later as herpes zoster.

    • Herpes zoster occurs in about 15% of older adults,


    and rearly in children.
    Susceptibility
    • Neanates whose mothers are not immune and
    patients with leukemia may suffer severe,
    • Prolonged or fetal chickenpox.

    • Adults with cancer-especially of lymphoid tissue,


    with or without steroid therapy-immunodeficint
    patients and those on immunosuppressive
    therapy may have an increased frequency of
    severe herpes zoster, both localized and
    dissaminated.
    Methods of control

    • Preventive measures.

    • Control of patient, contacts and the immediate


    environment.

    • Epidemic measures.
    Methods of control ; Preventive measures

    • Protect high-risk individuals who cannot be


    immunized
    • e.g. non-immune neonates and the immunodeficient-
    from exposure, by immunizing household or other
    close contacts.
    Methods of control ; Preventive measures

    • A herpes zoster vaccine


    • for older adults has been approved and recommended for
    use in the USA for healthy persons aged 60 years or older.

    • Varicella-zoster immune globulin (VZIG or VariZIG),


    • prepared from the plasma of noemal blood donors with
    high VZV antibody titer,
    • effectively modifies or prevents disease if given within
    96 hours after exposure.
    Methods of control ;Control of patient, contacts
    and the immediate environment.

    • Isolation
    • Exclude children from school, medical offices, emergency
    rooms or public places until vesicles become dry and
    crusted, usually after 5 days in non-immunized children
    and 1-4 days with breakthrough varicella in immunized
    children;
    • Exclude infected adults from workplace and avoid contact
    with susceptibles.

    • In hospital, observe strict isolation, because


    of the risk of varicella in susceptible
    immunocompromised patients.
    Methods of control ;Control of patient, contacts
    and the immediate environment. (cont.)

    • Quarantine.
    • in places where susceptible children with known
    recent exposure must remain for medicle reasons, the
    risk of spread to steroid-treated or immunodeficient
    patients may justify quarantine of known contacts for
    at lease 10-21 days after exposure (up to 28 days if
    VZIG was given).
    Methods of control ;Control of patient, contacts
    and the immediate environment. (cont.)

    • Protection of contacts:
    • Varicella vaccine is effective in preventing illness or
    modifying severity if used within 3 days, and possibly
    up to 5 days, of exposure; it is recommended for
    susceptible persons following exposure to
    varicella.
    Methods of control ; Control of patient, contacts
    and the immediate environment. (cont.)
    • Protection of contacts: (cont.)
    • VZIG
    • Within 96 hours of exposure may prevent or modify
    disease in susceptible close contacts of cases.
    • It is available in several countries for high-risk persons
    exposed to chickenpox, and indicated for newborns of
    mothers who develop chickenpox within 5 days prior to
    or 2 days after delivery.
    • There is no assurance that administering VZIG to a
    pregnant woman will prevent congenital malformations
    in the fetus, but it may modifify varicella severity in the
    pregnant woman.
    Methods of control ; Control of patient, contacts
    and the immediate environment. (cont.)

    • Protection of contacts: (cont.)


    • Antiviral drugs such as acyclovir
    • appear useful in preventing or modifying varicella in
    exposed in individuals if given within a week of
    exposure. Most studied have been carried out in
    immunocompromised children, with few data available
    for healthy children.
    • A dose of 8o mg/kg/day in 4 divided doses has been
    used,
    • But no regimen is as yet generally recommended for this
    purpose.
    Methods of control ; Control of patient, contacts
    and the immediate environment. (cont.)

    • Specific treatment:

    • Antiviral therapy is moderately effective in treating


    varicella and herpes zoster infections: acyclovir,
    valacyclovir or famcyclovir are considered the agents
    of choice for treatment or varicella…

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