Chicken Pox

Dr Ashok Jaisingani LUMHS

Chicken Pox Chicken Pox

Also known as Vericelia

Chicken pox is an acute highly infectious disease

Caused by the varicella – Zoster virus

Characterized by the vascular rash, that may be accompanied by the fever and malaise

Causative Agent Causative Agent

Varicella – Zoster virus

Humane Herpes virus type III or (*Humane alpha virus)

Host FactorHost Factor

Man is the host of the virus

Age:

Children under the 10 – years of the age

Immunity:

One attack of the disease give life long immunity, second attacks are rare

Environment:

Over-crowding increase the chance of the disease

Reservoir Reservoir

Infected persons are the reservoir

Source of the infection:

Ooropharyngeal secretion

Lesion of the skin and mucosa

Infectivity Period:

It range from the one to two days before the appearance of the rash and 4 – 5 days thereafter

Mode Of The Transmission Mode Of The Transmission

Direct:

Person to person through the droplets or air borne spread

The virus can cross the placental barrier

Indirect:

Through the articles freshly soiled by the discharge from the mucus membrane of the patient

Clothing

Incubation Period: It is 14 – 16 days

Susceptibility & Resistance: It is universal among those not previously attacked

Clinical Features Clinical Features

Clinical features are characterized by the

Pre-eruptive stage

Eruptive stage

Pre – Eruptive Stage Pre – Eruptive Stage

a) Onset is sudden

b) Mild or moderate fever

c) Back ache

d) Malaise

This stage is lasts for about the 24 hours in the children and 2 – 3 days in adult

Eruptive Stage Eruptive Stage

In children the rash is often first sign coming on the day the fever starts

This stage is characterized by the

Centripetal Distribution

Rapid Evaluation

Pleomorphisms

Fever

Centripetal Distribution Centripetal Distribution

Rashes are symmetrical

First appears on the trunk, where it is abundant and then come on the face, arms and legs where it is less abundant

Mucosal surface (Buccal & Pharyngeal) are generally involved

Axilla may be affected palms and soles are not usually affected

Density of the eruption diminish the centrifugally

Rapid Evaluation Rapid Evaluation

Rash advances quickly through the stage of the macule, papule, vesicles and scab

Vesicles are dew – drops like in appearance, present on the skin, containing the clean fluid superficial in site, with the easily ruptured wall and surrounded by the area of the inflammation and are not umblicated

The vesicles may form the crusts without going through the pustula stage

Scabing begin 4 – 7 days after the rash appearance

Pleomorphisms Pleomorphisms

All stages of the rash (Papule, vesicles & crusts) may be seen simultaneously at one time in same area

This due to the rash appearing in the successive crops for the 4 – 5 days in same area

Fever:

The fever does not run high

It show exacerbation with the each fresh crop of the eruption

Chicken Pox & Herpes Zoster Chicken Pox & Herpes Zoster Virus Virus

The two diseases are regarded as different host responses to the same infectious agent

It is believed that herpes Zoster is the result of the proliferation of the varicella virus in cranial and spinal nerves producing the pain and vascular eruption in innervated areas in persons partially immune as a result of the having varicella in the past

Herpes Zoster could be either a reinfection with the virus or reactivation of the latent virus, which had persisted since the chicken pox virus

Complication Complication

Hemorrhage

Pneumonia

Encephalitis

Acute cerebellar Ataxia

Reye’s Syndrome (Acute encephalopathy associated with the fatty degeneration of the liver)

Fetal death and birth defects in case of the maternal vericela during the pregnancy

ControlControl

There is no special treatment for the chicken pox

Control Of The Patient:

Notification to the health authorities

Isolation from the school for only one week

Contact with the susceptible patient is avoided

Concurrent disinfections of the articles soiled by the discharge

Quarantine is not necessary, child contact should be kept under the observation for the 21 – days

Preventive Measure Preventive Measure

Varicella Zoster immunoglobulin given within the 72 – hours of the exposure has been recommended for the prevention

A live attenuated vaccine has proved safe and effective in preventing the disease

Thank You “By Dr Ashok Jaisingani” Physician Residant Cardiologist