The document provides a comprehensive overview of chickenpox, a highly contagious disease caused by the varicella-zoster virus (VZV), which primarily affects children and can lead to severe complications in vulnerable populations. It discusses epidemiology, transmission, clinical manifestations, complications, and prevention methods, including vaccination and good hygiene practices. The role of nurses in educating parents and managing symptoms is also highlighted.

1. CHICKEN POX
BY
SUDHA SANJIBANEE
BSN 2ND YEAR
ROLL NO:17
GOPABANDHU INSTITUTE OF MEDICAL SCIENCE AND
RESEARCH SCHOOL AND COLLEGE OF NURSING,
MADHAPUR, ATHAGARH, CUTTACK

2. INTRODUCTION
CHICKENPOX IS VERY CONTAGIOUS. IF ONE PERSON HAS IT, UP TO 90% OF THE
PEOPLE CLOSE TO THAT PERSON WHO ARE NOT IMMUNE WILL ALSO BECOME
INFECTED. CHICKENPOX CAN ALSO BE SERIOUS, EVEN LIFE-THREATENING,
ESPECIALLY IN BABIES, ADOLESCENTS, ADULTS, PREGNANT WOMEN AND PEOPLE
WITH WEAKENED IMMUNE SYSTEMS. BEFORE THE VACCINE WAS AVAILABLE,
ABOUT 4 MILLION PEOPLE GOT CHICKENPOX EACH YEAR IN THE UNITED STATES,
OVER 10,500 OF THOSE PEOPLE WERE HOSPITALIZED, AND ABOUT 100-150 PEOPLE
DIED.

3. DEFINITION
CHICKENPOX IS A HIGHLY CONTAGIOUS DISEASE CAUSED
BY THE VARICELLA-ZOSTER VIRUS (VZV). IT CAN CAUSE
FEVER & ITCHY RASH COMMONLY AFFECT 12-15 YEAR
CHILDREN.

4. EPIDEMIOLOGICAL FACTORS
•CAUSATIVE AGENT:VARICELLA ZOSTER VIRUS:
•DNA VIRUS,
•A MEMBER OF THE HERPESVIRUS GROUP,
•HAS SHORT SURVIVAL TIME IN THE ENVIRONMENT
•MODE OF TRANSMISSION:
•THE VARICELLA-ZOSTER VIRUS SPREADS IN THE AIR WHEN A PERSON
WITH CHICKENPOX COUGHS OR SNEEZES.
•THE VIRUS ALSO IS SPREAD BY DIRECT CONTACT WITH EITHER THE
CHICKENPOX OR SHINGLES RASH BEFORE A SCAB FORMS.
•ANOTHER WAY TO GET CHICKENPOX IS BY HANDLING ITEMS THAT ARE
SOILED BY THE INFECTED PERSON’S CHICKENPOX LESIONS, SUCH AS
BED LINENS.

5. • RESORVIOR:HUMANS ARE THE ONLY RESERVOIR OF VZV
• AGE:CHILDREN UNDER AGE 10 ARE AT RISK FOR CHICKENPOX; 90% OF ALL CASES OCCUR IN
YOUNG CHILDREN
• OLDER KIDS AND ADULTS CAN ALSO GET IT.
• SEX:BOTH SEX ARE EQUALLY AFFECTED BUT GREATER RISK FOR FEMALE THAN MALE TO GET
CHIKENPOX
• RACE:BLACKS AND HISPANICS
• INCUBATION PERIOD:14-16DAYS
• IMMUNITY:LIFE-LONG IMMUNITY. BUT IN RARE CASES, A PERSON MIGHT GET IT AGAIN,
ESPECIALLY IF THEY WERE VERY YOUNG WHEN THEY HAD IT THE FIRST TIME.

6. •ENVIRONMENTAL FACTORS:
••CHICKENPOX SHOW A SEASONAL TREND IN INDIA, MOSTLY
OCCUR DURING FIRST SIX MONTHS OF THE YEAR.
• IN TEMPERATE CLIMATES THERE IS LITTLE EVIDENCE OF
SEASONAL TRENDS.
•OVERCROWDING FAVOURS TRANSMISSION.

7. PATHOPHYSIOLOGY
ENTERS THROUGH RESPIRATORY TRACT AND CONJUNCTIVA
REPLICATION IN NASOPHARYNX AND REGIONAL LYMPH NODES
PRIMARY VIREMIA 4 TO 6 DAYS AFTER INFECTION
MULTIPLE ORGANS INFECTED DURING VIREMIA(LIVER, SPLEEN, AND
SENSORY GANGLIA)
SECONDARY VIREMIA WITH VIRAL SKIN INFECTION AFTER REPLICATION

8. CLINICAL MANIFESTATIONS
CLINICAL FEATURES OF CHICKENPOX – THE CLINICAL
COURSE OF CHICKENPOX MAY BE DIVIDED INTO TWO
STAGES:
1. PRE-ERUPTIVE STAGE.
2.ERUPTIVE STAGE.

9. PRE ERUPTIVE STAGE
•SUDDEN ONSET WITH MILD OR MODERATE FEVER
•PAIN IN THE BACK
•SHIVERING
•MALAISE.
•LASTS ABOUT 24 HOURS BUT IN ADULTS IT MAY BE SEVERE
LASTING FOR 2-3DAYS

10. ERUPTIVE STAGE
•RASH IS OFTEN THE FIRST SIGN.
•IT COMES ON THE DAY THE FEVER STARTS.THE FEVER DOES NOT
RUN HIGH(102°F)

11. ONCE THE CHICKENPOX RASH APPEARS, IT GOES THROUGH THREE
PHASES:
1. RAISED PINK OR RED BUMPS (PAPULES), WHICH BREAK OUT OVER
SEVERAL DAYS
2. SMALL FLUID-FILLED BLISTERS (VESICLES), WHICH FORM IN ABOUT
ONE DAY AND THEN BREAK AND LEAK
3. CRUSTS AND SCABS, WHICH COVER THE BROKEN BLISTERS AND
TAKE SEVERAL MORE DAYS TO HEAL

12. • TRANSMISSION DURATION: 48 HOURS BEFORE THE RASH APPEARS,
AND THE VIRUS REMAINS CONTAGIOUS UNTIL ALL BROKEN
HAVE CRUSTED OVER.
• IN SEVERE CASE THE RASH CAN COVER THE ENTIRE BODY, AND
MAY FORM IN THE THROAT, EYES, AND MUCOUS MEMBRANES OF
URETHRA, ANUS AND VAGINA.
• AFTER A PERSON RECOVERS FROM CHICKENPOX, THE VIRUS STAYS
DORMANT (INACTIVE) IN THEIR BODY. THE VIRUS CAN REACTIVATE
LATER, CAUSING SHINGLES. MOST PEOPLE WHO DEVELOP
ONLY ONE EPISODE DURING THEIR LIFETIME.

13. Fig:Shingles

14. INVESTIGATION
•HISTORY COLLECTION: HISTORY OF EXPOSURE TO CHICKENPOX
•PHYSICAL EXAMINATION:DOCTORS GENERALLY DIAGNOSE CHICKENPOX BASED
ON THE RASH.
•POLYMERASE CHAIN REACTION (PCR) TO DETECT VZV IN SKIN LESIONS (VESICLES,
SCABS, MACULOPAPULAR LESIONS)(MOST SENSITIVE)
•DIRECT FLUORESCENT ANTIBODY ASSAY (DFA) AND VIRAL CULTURE.
•IGM SEROLOGIC TESTING

15. COMPLICATIONS
ACUTE VARICELLA IS GENERALLY MILD AND SELF-LIMITED, BUT IT MAY BE
ASSOCIATED WITH COMPLICATIONS.
• SECONDARY BACTERIAL INFECTIONS OF SKIN LESIONS WITH
STAPHYLOCOCCUS OR STREPTOCOCCUS (PRIMARILY INVASIVE GROUP A)
• PNEUMONIA (LUNG INFECTIONS)
• ENCEPHALITIS (INFLAMMATION OF THE BRAIN)
• CEREBELLAR ATAXIA (DEFECTIVE MUSCULAR COORDINATION)

16. •TRANSVERSE MYELITIS (INFLAMMATION ALONG THE SPINAL CORD)
•REYE SYNDROME. THIS IS A SERIOUS CONDITION MARKED BY A
GROUP OF SYMPTOMS THAT MAY AFFECT ALL MAJOR SYSTEMS OR
ORGANS. DO NOT GIVE ASPIRIN TO CHILDREN WITH CHICKENPOX.
IT INCREASES THE RISK FOR REYE SYNDROME.
•SHINGLES:A REACTIVATION OF THE CHICKENPOX VIRUS IN THE
BODY, CAUSING A PAINFUL RASH.
•DEATH

17. PREVENTION
•VACCINATION:RECEIVING TWO DOSES OF THE CHICKENPOX
VACCINE IS ABOUT 94 PERCENT EFFECTIVE AT PREVENTING THE
DISEASE.
•BY PRACTICING GOOD HYGIENE AND WASHING YOUR HANDS
FREQUENTLY. REDUCE YOUR EXPOSURE TO PEOPLE WHO HAVE
CHICKENPOX.

18. TREATMENT
•ACETAMINOPHEN (TYLENOL): FOR PAIN AND FEVER
•AVOID SCRATCHING THE ITCH
•AVOID ANTI INFLAMMATORY PAIN KILLER LIKE IBUPROFEN DON’T
USE ASPIRIN.
•IF THE PERSON BELONG TO A RISK GROUP THEMANTIVIRAL
MEDICATION CALLED ACYCLOVIR (SITAVIG, ZOVIRAX) CAN BE
PRESCRIBED.

19. ROLE OF NURSE
• EDUCATE PARENTS ABOUT THE IMPORTANCE AND SAFETY OF THE VARICELLA
ZOSTER VACCINE.
• MANAGE PRURITUS IN PATIENTS WITH VARICELLA WITH COOL COMPRESSES AND
REGULAR BATHING; WARM SOAKS AND OATMEAL OR CORNSTARCH BATHS MAY
REDUCE ITCHING AND PROVIDE COMFORT.
• TRIMMING THE PATIENT’S FINGERNAILS AND HAVING THE WEAR MITTENS WHILE
SLEEPING MAY REDUCE SCRATCHING.
• ADVISE PARENTS TO PROVIDE A FULL AND UNRESTRICTED DIET TO THE CHILD;
SOME CHILDREN WITH VARICELLA HAVE REDUCED APPETITE AND SHOULD BE
ENCOURAGED TO TAKE SUFFICIENT FLUIDS TO MAINTAIN HYDRATION.

20. THANK
YOU