GROUP PRESENTATION

Case Given
 Vaccination coverage of an area was very low .
 3 yrs old child presented with
1. Maculopapular rashes all over the body
2. Fever and malaise
3.Dew drops like rashes
4.Fever and rashes appear simultaneously
5. All stages of rashes ( papules , vesicles, crusts ) at
same time
6.Skin and mucosa are also involved
 EPIDEMIOLOGY
 THE STUDY OF DISTRIBUTION AND DETERMINANTS
OF HEALTH RELATED STATES OR EVENTS IN A
SPECIFIED POPPULATION AND APPLY THIS STUDY TO
CONTROL HEALTH PROBLEMS .

1. DISEASE FREQUENCY ( IN 2013- 28090 CASES OF

CHICKENPOX WERE REPORTED WITH 61 DEATHS)
2. DETERMINANTS OF DISEASE ( CAUSE )
3. DISTRIBUTION OF DISEASE ( TIME, PLACE, AND
PERSON)
EPIDEMIOLOGICAL TRIAD
 AGENT FACTORS :
[A] Causative agents-
-- Varicella zoster virus “human (alpha) herpes virus 3”.
-- Virus when reactivated can cause Herpes Zoster
Disease.(common in 10-30% people and more common after 50 years)
--Characterized by painful, vesicular, postural eruption in distribution of
one or more sensory nerve roots.
[B] Source of Infection-
-- Usually the case of chicken pox.
[C] Infectivity-
--Period of communicability ranges from 1-2 days before appearance of
rash and 4-5 days thereafter., Incubation period 15 days.
[D] Secondary attack rate- 90%
--Second attack rate i.e. person getting second time infection=0-10%
 HOST FACTORS:
1. Age: <10 Years of age
2. Immunity: One attack gives life long immunity.
Second attack rate is 0-10%.
Maternal antibody protect the child in first few months of life (nearly 6 to 9
months).
Cell mediated immunity is important in preventing reactivation of virus.
3. Pregnancy: Infection during early trimester. Leads to “congenital varicella
syndrome”.
Infection during 5 days after delivery lead to “neonatal varicella”.
4. Equally infectious to both boys and girls.
 ENVIRONMENTAL FACTORS:
1. VZV is heat labile
2. Show seasonal trend in temperate and most of
tropical area.
3. Peak incidence during winter and spring or in
coolest months in tropics.
4. Outside the host cell virus survive only for a small
period of time, nearly 1-2 days because virus is
inactivated by lipid solvents, detergents and
proteases.
 TRANSMISSION:
Direct infection–
Droplet nuclei
Can cross placental barrier and lead to a disease called “Congenital
Varicella”.