my name is pox...chicken pox

8/6/2019 My Name is Pox...Chicken Pox

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CHICKEN POX ( VARICELLA)


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Name origin

T he skin appeared to be picked by chickens

Resembles the seeds of Chick Peas

Most common explanation is that its not thatdangerous so it s a chicken version of Pox.

Pox is another word for a curse, which is what itwas believed to be in medieval times.


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Transmission

Persons to person contact or sneezing/coughing

Contact with fluid from a chicken pox blister

Incubation period: 7-21 days ; can be prolonged

in immunocompromised individuals and thosewho have taken post exposure trt with a varicellaantibody containing product.


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Clinical FeaturesMild prodrome precedes the onset of rash inadults; 1-2 days of fever and malaise

In children rash usually the first sign of disease

Healthy children ; mild course of diseasemalaise, pruritus and temp upto 102^F

Adults more severe disease and more chance of complications


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RashG eneralised and pruriticEvolves from macules

Centripetal distribution: lesionsconcentrated on trunkLesions can also occur on mucoudmembranes of the oropharynx, respiratorytract, vagina conjunctiva and cornea.

Multiple crops : pleomorphism

papules vesicles

Noninfectiousdried crusts

Over 5-6 days


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ManagementMinimize fever and discomfort: Antipyretic medicines, Coolbaths and soothing lotionsChickenpox is not usually treated with a specific antiviralcompound . Antiviral medication may be appropriate forolder patients, in whom the disease tends to be moresevere.

IsolationAcyclovir Therapy

Healthy nonpregnant persons >13 years of ageChildren >12 months with chronic cutaneous or pulmonarydisorders or on salicylate therapyChildren receiving short intermittent or aerosolizedsteroidsIV in Immunocompromised children and adults with viral-mediated complicationsNot recommended for post-exposure prophylaxis


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complicationsCertain groups are more likely to havecomplications.: adults, infants, adolescents andpeople with weak immune systems from eitherillnesses or from medications such a long-term

steroids.Bacterial infections of the skin and soft tissues

in children : streptococcal and staphylococcalBacterial pneumoniaCNS: Cerebellar ataxia, Encephalitis, AsepticmeningitisReyes Syndrome:Asprin taken in acute illness


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Communicability

Less contagious than measles but more thanmumps or rubella

Period of communicability extends from 1-2

days before the rash through the first 4-5days or until lesions have formed crust.


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Congenital VZV infection

Maternal varicella infection in the first 20weeks of gestation

Constellation of abnormalities : low birthweight, hypoplasia of extremities, skinscarring, localised muscular atrophy,encephalitis, cortical atrophy, chorioretinitsand microcephaly


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Recurrent disease(Herpes zoster)

Reactivation of latent VZVTrigerred due to aging, immunosuppression,

intrauterine exposure.Also varicella infection at a young age( lessthan 18 mnths)

Dermatomal distribution ( trunk or the fifthcranial nerve most common)2-4 days prior to eruption there may be painand paresthesias.


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preventionVaccination : effectiveness of 70- 86%1 dose >13 yrs of age ; 2 doses in adults andadolescents 4-8 wks apart, subcutaneous

Schedule : 12-24 mnths for early childhoodimmunizationContraindications : Pregnancy; reaction toprevious dose, advance immune disorder orcellular immune deficiency; symptomatic HIVinfection; severe illnessAdverse reaction : mild illness with rash


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P ost Exposure P rophylaxisVaricella vaccine :Susceptible persons followingexposure to varicella and for out break control ;administered within 72 hrs-120hrsprevents/modifies disease

Varicella Zoster ImmuneG

lobulin : mosteffective within 96 hrs of exposureNewborns whose mothers have chickenpox 5 days priorto 2 days after deliveryChildren with leukemia or lymphoma who have not been

vaccinatedPersons with cellular immunodeficiencies or otherimmune problemsPersons receiving drugs, including steroids, that suppress

the immune systemPregnant women


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Thank you

my name is pox...chicken pox

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