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Chicken pox and shingles

Learning objectives
At the end of the lecture the student should be able to: Know the details of chicken pox, its prevention and treatment. Identify the causes of shingles, its prevention and complications.

Chicken Pox
Chickenpox is caused by the varicella-zoster virus (VZV), also known as human herpes virus 3 (HHV-3), one of the eight herpes viruses known to affect humans. Characterized by:
Fever Raw, open, itchy sores

History
Giovanni Filipo an Italian scientist first described the symptoms of Chicken Pox An English physician described a mild case of Small Pox as Chicken Pox in the 1600s William Heberden was the fist physician to demonstrate that Chicken Pox was different than Small Pox

Name Origin
The skin appeared to be picked by chickens Resembles the seeds of Chick Peas Most common explanation is that its not that dangerous so its a chicken version of Pox. Pox is another word for a curse, which is what it was believed to be in medieval times.

Prevention
Vaccination (Varicella)

Transmission
Persons to person contact or sneezing/coughing Kids around 6 or 7 will usually spread it between each other.

Treatment
Acyclovir Tylenol In medieval times and still today, oatmeal baths are used to relieve itching.

Worst Victims
Adults Infants Teenagers People with weak immune systems

Preventive Treatment after Exposure


Varicella Zoster Immune Globulin (VZIG) Only offers temporary protection Recommended for: Newborns whose mothers have chickenpox 5 days prior to 2 days after delivery Children with leukemia or lymphoma who have not been vaccinated Persons with cellular immunodeficiencies or other immune problems Persons receiving drugs, including steroids, that suppress the immune system Pregnant women

Complications

Bacterial Infections Viral Pneumonia Bleeding Problems Infection of the brain

Deaths from Chicken Pox


Before there was a vaccine, about 100 people died of Chicken Pox every year in America Most of those deaths occurred in people that didnt have an illness that put them at higher risk Deaths still occur in healthy children and adults

To vaccine or not to vaccine? Pro side


Saves lives Kids dont miss school 85% percent affective in preventing disease Less likely to develop Shingles If someone does get Chicken Pox after vaccination, it usually is a lot less worse than a typical case resulting in a few skin lesions, little to no fever and lasting fewer days

To vaccine or not to vaccine? Con Side


Vaccine is new. Dont know about long term side affects yet Chicken Pox is usually pretty harmless. No use in vaccinating The vaccine is only expected to be effective for 20 years. Those who were vaccinated will need a booster shot. Between the time the original shot wears off and the booster shot, those who were vaccinated can now develop Chicken Pox later in life when its more dangerous

People who should not be vaccinated

If you had a serious allergic reaction to Chicken Pox vaccine You have a moderate to serious illness Youre pregnant Unable to fight off serious infection People that have been vaccinated for Chicken Pox can still get Shingles, but they are less likely than someone that hasnt been vaccinated to get it

Shingles
Shingles is a skin rash caused by the same virus that causes chickenpox. The virus is called the Varicella zoster virus. Aka Herpes zoster It occurs most commonly in people over the age of 60.

Shingles (Herpes Zoster)


Is caused by the chickenpoxvirus that remains in the nerve roots of all persons who had chickenpox and can come out in your body again years later to cause illness. More common after age 50 and the increases risk with age Shingles is contagious.

Prevention
If you come in contact with someone with Shingles and you havent had Chicken Pox yet, you will get Chicken Pox and not Shingles There is no vaccine for Shingles. There is work being done to create one. It is expected to take about 5 years

Causes
After an individual has chickenpox, this virus lives in the nervous system It is never fully cleared from the body. Outbreaks occur with: Emotional stress Immune deficiency Cancer Anyone who has had chickenpox is at risk

Symptoms
Before a rash is visible, you may notice several days of burning pain and sensitive skin. Shingles start as small blisters With new blisters continuing to form for three to five days The blisters follow the path of individual nerves that comes out of the spinal cord

Symptoms
Eventually, the blisters pop, and the area starts to ooze. The affected areas will then crust over and heal. It may take three to four weeks from start to finish.

Treatment
The severity of an attack of shingles can be reduced by immediate treatment with antiviral drugs Such as acyclovir or valcyclovir Antiviral drugs may help the painful effects of shingles Other treatments include steroids, antidepressants, anticonvulsants, and topical agents.

Prevention
A vaccine exists known as Zostavax. Adults also receive an immune boost from contact with children infected with varicella a boosting method that prevents about a quarter of herpes zoster cases

Cure
There is no cure for shingles