Every thing you want to know about Chickenpox (Varicella)

Chickenpox (Varicella)

-an acute and highly contagious disease of viral etiology, characterized by vesicular eruptions on the skin and mucous membrane with mild constitutional symptoms.

Infectious Agent: Herpesvirus varicellae – a DNA containing virus

Incubation Period – 10-21 days or maybe prolonged after passive immunization.

Mode of Transmission  Mode of Transmission

·         Direct contact – shedding of the virus from the vesicles

·         Indirect contact – through linens or fomites

·         Airborne (droplet infection)

Period of Communicability

The patient is capable of transmitting the disease about a day before the eruption of the first lesion up to about five days after the appearance of the last crop.

Diagnostic Tests:

·         Complement Fixation Test – to determine the V-Z virus

·         Electron Microscopic Exam of the vesicular fluid

Clinical Manifestations

Ø  pre-eruptive manifestations are mild fever & malaise

Ø  Eruptive Stage

a.       Rash starts from the trunk, then spread to other parts of the body.

b.      Initial lesions are distinctively red papules where contents become milky and a pus-like within 4 days.

c.       In adult and bigger children, the lesions are more widespread and more severe.

d.      Vesicular lesions are very pruritic.

e.      “Celestial map” – scabs

f.        Stages of lesions:

v  Macule – lesion that is not elevated above the skin surface.

v  Papule – lesion that is elevated above the skin surface with a diameter of about 3 mm.

v  Vesicle – pop-like eruption filled with fluid.

v  Pustule – vesicle that is infected or filled with pus.

v  Crust – scab or eschar. Secondary lesion caused by the secretion of vesicle drying on the skin. The scars are superficial, depigmented and take time to fade out.

 

Complications

·         Secondary infection of the lesions – furuncles, cellulitis, skin abscess, erysipelas

·         Meningoencephalitis

·         Pneumonia

·         Sepsis

Treatment Modalities

Ø  Zoverax

Ø  Oral acyclovir

Ø  Oral antihistamine

Ø  Calamine lotion

Ø  Antipyretic

Nursing Management

·         Respiratory Isolation is a must until all vesicles have crusted.

·         Prevent secondary infection of the skin lesion through hygienic care of the patient.

·         Linens must be disinfected under the sunlight or through boiling.

·         Cut fingers nails short and wash hands more often.

·         Provide activities to keep child occupied to lessen pruritus.