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    Chicken Pox & Rubella

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    sumairaghulamnabi2323
    COMMUNITY HEALTHCARE

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    Chicken Pox & Rubella

    Uploaded by

    sumairaghulamnabi2323
    1 views39 pages
    COMMUNITY HEALTHCARE

    Original Title

    CHICKEN POX & RUBELLA

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    COMMUNITY HEALTHCARE

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    1 views39 pages

    Chicken Pox & Rubella

    Uploaded by

    sumairaghulamnabi2323
    COMMUNITY HEALTHCARE

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 39

    CHICKEN POX &

    RUBELLA
    Introduction
     Chickenpox or varicella is a highly
    contagious disease caused by the
    varicella-zoster virus (VZV). It can cause
    an itchy, blister-like rash (vesicular rash),
    fever and malaise. The rash first appears
    on the chest, back, and face, and then
    spreads over the entire body.
    Epidemiological
    determinants
     AGENT :
    Varicella-zoster virus/ Human (alpha)
    herpes virus 3
     SOURCE OF INFECTION:
    Oropharyngeal secretions and lesions of
    skin and mucosa.
    HOST FACTORS
     Children under 10 years of age.
    ENVIORNMENTAL FACTORS
     Poor personal hygiene
     Over crowding
    MODE OF TRANSMISSION
     Droplet infection
     Droplet nuclei
     Face to face contact
     Cross the placental barrier (CONGENITAL
    VARICELLA)
    Incubation period
    The average incubation period for
    varicella is 14 to 16 days after
    exposure to a varicella or a herpes
    zoster rash, with a range of 10 to 21
    days.
    Clinical features
     Divided into two stages :
     PRE-ERUPTIVE STAGE
     ERUPTIVE STAGE
    PRE-ERUPTIVE STAGE

     Onset is sudden
     Mild or moderate fever
     Pain in back, shivering and malaise
     Lasts for 24 hours in children and 2-3
    days in adults
    ERUPTIVE STAGE

    (a) DISTRIBUTION:
     Rash (first sign when fever starts), it first appears on the

    trunk where it is abundant and then comes on face, arms


    and legs.
     Density of eruption diminishes centrifugally

     Mucosal surfaces are also involved

    (b) RAPID EVOLUTION:


     Once the chickenpox rash appears, it goes through three

    phases: Raised pink or red bumps (papules), which break


    out over several days. Small fluid-filled blisters (vesicles),
    which form in about one day and then break and leak.
    Crusts and scabs, which cover the broken blisters and take
    several more days to heal. Vesicles are dewdrop like.
    (c) PLEOMORPHISM:
     All stages of rash may be seen

    simultaneously at one time, in same


    area.
    (d) FEVER:
     Fever does not run high

     Exacerbations with each fresh crop of

    eruption
    complications
     Sepsis
     Hemorrhages
     Dehydration
     Pneumonia
     Inflammation of the brain (encephalitis)
     Toxic shock syndrome
     Acute retinal necrosis
     Reye's syndrome ( acute encephalopathy
    associated with fatty degeneration of the viscera)
     Foetal deaths and birth defetcs
    Laboratory diagnosis
     Rarely required as clinical signs are
    usually clear-cut.
     VZV DNA using PCR
     Cell culture from vesicular fluid, crusts,
    saliva
    Control
     No specific treatment
     Tetracycline to prevent secondary
    infection
     Notification to health authorities
     Isolation from school for only on week
     Contact with susceptible is avoided
     Concurrent disinfection of the articles
    soiled by discharges
    Preventive measures
     VZIG:
    I/M within 72 hours
    12.5 units/kg body weight up to a
    maximum of 625 units, with a repeated
    dose in 3 weeks.
     VACCINE:
    A live attenuated vaccine (12-18
    months)
    MMRV
    RUBELLA
     Also called as GERMAN MEASLES
     Acute, childhood infection
     Mild and have short duration (3 days)
     Low grade fever, maculopapular rash
     Infection in early pregnancy may lead to
    serious congenital defects including
    foetal death.
    EPIDEMOLOGICAL DETERMINANTS

    AGENT:
     RNA virus of Toga virus family

     Recovered from the nasopharynx, throat,

    blood, CSF and urine


    HOST FCTORS:
     Age: 3-10 years

     Immunity: one attack results in life-long

    immunity
    ENVIORNMENTAL FACTORS:
     Temperate zones during the late winter

    and spring
    TRANSMISSION
     Person to person by droplets from nose
    and throat and droplet nuclei
     Portal of entry is respiratory route
     Can cross the placenta (vertical)
    Incubation period
     2-3 weeks, average 18 days
    Clinical features
     5o-65% are asymptomatic
     The signs and symptoms of rubella are often
    difficult to notice, especially in children.
     PRODROMAL:
     Mild fever of 102 F
     Headache
     Stuffy or runny nose
     Red, itchy eyes
     LYMPHADENOPATHY:
    Enlarged, tender lymph nodes at the base of the
    skull, the back of the neck and behind the ears
     RASH:
    A fine, pink,macular rash that begins on
    the face (24 hours) and quickly spreads
    to the trunk and then the arms and legs,
    before disappearing in the same order
     Aching joints, especially in young women
    Complications
     Arthralgia
     Encephalitis
     Thrombocytopenia purpura
     Congenital malformations
    CONGENITAL RUBELLA
    Congenital rubella syndrome (CRS) is an
    illness in infants that results from
    maternal infection with rubella virus
    during pregnancy. When rubella
    infection occurs during early pregnancy,
    serious consequences occurs such as:
     miscarriages,
     stillbirths, and a constellation of severe
    birth defects in infants–can result.
     CLASSIC TRIAD:
    1. cataracts
    2. congenital heart disease (most commonly patent
    ductus arteriosus or peripheral pulmonary artery
    stenosis)
    3. hearing impairment
     congenital glaucoma
     retinopathy
     hepatosplenomegaly,
     microcephaly
     developmental delay
     meningoencephalitis

    Laboratory diagnosis
     It can go unrecognized unless it is an
    epidemic
     Virus isolation and serology
     Haemagglutination inhibition test
     Detection of IgG ntibody
    Preventive measures

     Active immunization with live attenuated


    vaccine
     RUBELLA VACCINE:
     RA 27/3 vaccine (produced in human diploid
    fibro-blast)
     Single dos, 0.5ml, S/C
     Infants under 1 year should not be
    vaccinated
     Contraindicated in pregnancy
     MMR Vaccine
     Rubella can be prevented with MMR
    vaccine. This protects against three
    diseases: measles, mumps, and rubella.
     CDC recommends children get two
    doses of MMR vaccine, starting with the:
     first dose at 12-15 months
     second dose at 4-6 years

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