communicable diseases

1. CHICKENPOX

2. CHICKENPOX
• Chickenpox is a viral infection and highly
contagious, caused by Varicella-Zoster Virus
(VZV). It is worldwide in distribution and
occurs in both epidemic and endemic form.

3. Etiology
• 1. Age: Chickenpox occurs mainly in children
below the age of 10 years.
• 2. Source or reservoir of infection: The source
or reservoir of infection is a case of
chickenpox. The virus is present in the nose
and throat secretions and lesions of the skin,
mucous membranes and blood.

4. • 3. Period of infectivity: The case is infectious for a
period of about one week, commencing 1-2 days
before the appearance of rash and 4 to 5 days
thereafter.
• 4. Environmental factors: It shows seasonal trend in
temperature settings and in most tropical settings
with peak incidence during winter and spring
• 5. Incubation period: Usually 14 to 16 days, extremes
as wide as 10 to 21 days.

5. Risk Factors
• 1. A person who haven't already had chickenpox or
haven't had the chickenpox vaccination
• 2. People who smoke.
• 3. Pregnant women who haven't had chickenpox or
the vaccine.
• 4. People whose immune system is weaknened by
medications such as chemotherapy or by a
disease,such as cancer or HIV.
• 5. Newborns and infants whose mother never had
chickenpox or the vaccine.

6. Pathophysiology

7. • Syndrome of Herpes Zoster
• Reactivation of VZV

8. Clinical Manifestations
• Fever
• Headache
• Tiredness or fatigue
• Red spots first appear on the chest, face and back
• Decreased. appetite

9. • Pre-eruptive Stage
• 1. Mild or moderate fever.
• 2. Pain in the back.
• 3. Shivering and malaise.

10. • Eruptive Stage
• Rashes start to appear and it comes on the day the
fever start.
• 1. Distribution: Rashes on trunk, arm, face and legs.
• 2. Rapid evolution: Trunk, face, arm, legs, mucosa and
axilla.
• 3. Pleomorphism: Rashes seen in papules and vesicles
of crusts.
• 4. Fever: It does not run high but show exacerbation.

11. Diagnostic Evaluation
• 1. Chickenpox symptoms can be diagnosed
with classical symptoms
• 2. Microscopic examination of the skin lesion
can be done for laboratory confirmation of the
disease.

12. MANAGEMENT
• 1. Analgesics, such as paracetamol and ibuprofen are
prescribed to relieve the pain.
• 2. Calamine lotion is used in relieving the itching during
chickenpox.
• 3. Vaccine: A live attenuated varicella virus vaccine is
safe and recommended for children between 12-18
months of age.
• 4. Antihistamines such as benadryl, to ease symptoms

13. • 5. Acyclovir.
• a. In children, 2-16 years of age, the oral dosage is 20
mg/kg 4 times a day for 5 days, (maximum of 800 mg 4
times a day).
• b. Adults can receive upto 800 mg 5 times a day
• 6. Varicella zoster immunoglobulin: Given within 72
hours of exposure has been recommended for
prevention 1.25-5 ml given IM.

14. Nursing Management
• 1. Educate patient and family members about the
importance and safety of varicella zoster vaccine.
• 2. Perform complete physical assessment.
• 3. Monitor vital signs of patient.
• 4. Isolate patient for at least 6 days after onset of
rash.

15. • 5. Instruct family members to frequently change
the cloths of patient which is soiled by the
secretion from the lesion.
• 6. Instruct patient to cover his/her mouth while
coughing or sneezing.
• 7. Provide a full and unrestricted diet to the
patient.

16. • 8. Wear a mask or have the patient wear a mask
to prevent respiratory spread.
• 9. Instruct patient to trim his/her nails to prevent
• injury while scratching lesion.
• 10. Manage itching with calamine lotion or cool
compresses or tepid baths with cornstarch

17. • 11. Disinfect material contaminated by the
nasal and throat secretion and wound.
• 12. Patient is adviced to consume a plenty of
fluids.
• 13. Administer medicines as ordered by
physician.

18. Complication
• 1. Pneumonia
• 2. Hemorrhages
• 3. Encephalitis
• 4. Reye's syndrome (a rare but serious condition
that causes swelling in the liver and brain).

19. Teaching guidelines for patient with
chickenpox
• Use calamine lotion which helps to relieve itching
during chickenpox.
• Trim fingernails, so as to prevent skin infections caused
by scratching blisters.
• Take pain relievers (analgesics), such as paracetamol
and ibuprofen which helps to relieve the pain.
• Consume a plenty of fluids.

20. • Try not to break the blisters or disturb the scabs. This could
leave scars.
• Contact health care provider, if any of the following occurs:
• - Fever above 102° F
• -Chickenpox blister is very close to eyes - Intense itching
• -New chickenpox develops after the 6th day.