Chicken pox is caused by the varicella-zoster virus and causes a rash that may include fever and malaise. It is highly infectious and spreads through respiratory droplets. The rash starts on the trunk and spreads outward, going through stages of macules, papules, vesicles and scabs. Complications can include pneumonia, encephalitis and Reye's syndrome in rare cases. There is no specific treatment, but isolation and disinfection can help control spread. Vaccination is effective for prevention.

1. Chicken Pox
Dr Ashok Jaisingani
LUMHS

2. 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

3. Causative Agent
Varicella – Zoster virus
Humane Herpes virus type III or (*Humane alpha virus)

4. Host 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

5. 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

6. 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

7. Clinical Features
Clinical features are characterized by the
Pre-eruptive stage
Eruptive stage

8. 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

9. 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

10. 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

11. 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

12. 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

13. Chicken Pox & Herpes Zoster
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

14. 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

15. Control
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

16. 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

17. Thank You
“By Dr Ashok Jaisingani”
Physician Residant
Cardiologist