This document summarizes chickenpox and mumps. Chickenpox is caused by the varicella-zoster virus and spreads through direct or respiratory contact. It causes a rash that starts on the face and trunk as vesicles that eventually crust over. Complications can include bacterial infections, neurological issues, or pneumonia. Mumps is caused by a paramyxovirus and spreads through droplets. It causes swelling of the parotid glands, usually bilaterally. Complications can include meningitis, orchitis, or pancreatitis. Both are vaccine preventable.

1. Chicken pox

2. Etiopathogenesis
• Highly infectious disease
• By varicella-zoster virus
• Enveloped DNA virus
• Transmission by direct contact, droplet ,
airborne or fomites.

3. • Only 1 serotype known
• Man is the only reservoir
• Virus  upper respiratory tract and tonsillar
tissue replicates there for initial 8-10 days
primary viremia into reticuloendothelial
systemsecondary viremia
• Skin lesions seen during the secondary viremia
that lasts for 3-7 days.

4. • Virus is carried to vescicular fluid and respiratory
tract  shedding  transmits infection to
susceptible contacts
• Virus may be transported to the dorsal nerve
root of spinal cord where latent infection is
established which can be reactivated later to
cause disease.

5. Clinical features
• Incubation period is 14-16 days
• Diseases starts with fever, malaise, sore throat,
headache.
• Maculopapular rash on 1st day of fever.
• Period of Infectivity from 2 days prior to
appearance of rash upto 3-7 days after the rash.

6. • Rash begins as crops of macules which evolve into
papules then vesicles with centripetal distribution.
• Vesicles are initially filled with clear fluid then it
becomes cloudy.
• Vesicles persists for 3-4 days  pustules  crusts
 scab  falls in 10-20 days  usually no
permanent scar
• Infectivity is maximum in prodormal phase and
wanes once the lesions are crusted as crusts donot
contain live virus.

7. • Vesicles may be round, oval or irregular with
surrouned red area.
• Rash 1st on face & scalp  trunk  whole body
• Palms and soles are spared.
• Size of rash 5-10 mm
• Lesions of different stages are seen
simultaneously.

8. Complications
• Bacterial infections  cellulitis, skin abscess
Pneumonia , Septic arthritis, Osteomyelitis
• Neurological  seen at end of 1st week
- Commonest pure cerebellar ataxia
excellent prognosis
- Encephalitis
- ADEM
- Transverse myelitis, GBS , Seizures

9. • Varicella pneumonitis  appears 3-5 days after
rash
others
• Myocarditis, Pericarditis , endocarditis
• Hepatitis
• AGN
• Appendicitis
• Keratoconjuctivitis
• Thrombocytopenia

10. Congenital varicella
• Mother has chickenpox in 1st trimester there is 2%
risk of the baby to develop congenital varicella
embryopathy.
• Malformations includes limb hypoplasia, scarring
of limbs , digital defect , cortical atrophy ,retinitis,
cataract

11. Varicella neonatorum
• If maternal rash appers 5 days before to 2 days
after the delivery there is 20-30 % chance the
baby will be infected and have chickenpox.
• Very high risk of disseminated disease with death
• Fatality rate is around 30 %
• Baby should receive VZIG & IV acyclovir

12. Treatment
• Supportive
• Antipyretic  paracetamol no aspirin
• For pruritus  calamine lotion , antihistaminic
• No antiviral for uncomplicated cases
• Acyclovir for complicated cases
• Antibiotics for secondary bacterial infection

13. Prevention
• Immunization with live vaccine
• 1st dose at 15 months
• 2nd dose at 4-6 years.
• Infection gives life long immunity

14. MUMPS

15. Etiopathogenesis
• Mumps is a acute viral infection of the parotid
and other salivary gland.
• Self limiting and vaccine preventable disease
• Mumps a RNA virus belongs to paramyxovirus
group
• Annual incidence is 100-1000 per 1 lakh
population.

16. • Man is the only host
• Transmission by droplets
• Infective period is 2 days before to 5 days after
the parotitis
• Mumps in adult is severe
• Mumps in pregnancy can lead to abortion

17. Clinical features
• Incubation period is 16-18 days
• Initial symptoms fever, malaise , headache ,
vomiting,
• Classical symptom is parotitis with enlarged
parotid gland.
• Bilateral in 70 % cases , unilateral in 30 % cases
• 10 % cases other salivary glands are involved

18. • Associated with difficultly in swallowing ,
chewing, pain in ear, local edema.
• 1st one side then spreads to other side with in
72 hours.
• Swelling increases in size for 3 – 4 days then
starts receding and disappear by 10-14 days.

19. Complications
• Aseptic meningitis  commonest , in 10 % cases
• Orchitis 25 % in adolescent
• Epididymitis, Oophoritis
• Meningoencephalitis
• Pancreatitis
• Nephritis
• Arthritis
• Thyroditis
• Thromocytopenic purpura

20. DIAGNOSIS
• Mostly clinical
• Virus can be isolated from nasopharangeal swab,
urine, blood , resp secretions .
• Mumps specific IgG Antibodies
• PCR to detect viral antigen

21. Treatment
• No specific treatment
• Supportive management

22. Prevention
• Immunization

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