Concept about Chickenpox – Health of the children has been considered as the vital importance to all societies because children are the basic resource for the future of humankind. Nursing care of children is concerned for both the health of the children and for the illnesses that affect their growth and development. The increasing complexity of medical and nursing science has created a need for special area of child care, i.e. pediatric nursing.
Pediatric nursing is the specialized area of nursing practice concerning the care of children during wellness and illness. It includes preventive, promotive, curative and rehabilitative care of children. It emphasizes on all round development of body, mind and spirit of the growing individual. Thus, pediatric nursing involves in giving assistance, care and support to the growing and developing children to achieve their individual potential for functioning with fullest capacity.
Concept about Chickenpox
Definition of Chickenpox:
Chickenpox or varicella is an acute, highly infectious disease caused by varicella-zoster virus. It is characterized by vesicular rash that may be accompanied by fever and malaise.
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It is highly communicable and infectious disease caused by varicella virus, characterized by mild prodromal symptoms and a typical rash which passes through the stages of macule, papule, vesicle and crustation.
Or
Chickenpox is an acute and highly communicable disease caused by varicella-zoster (V-Z) virus.
(Ref: Paediatric Nursing, Parul Datta/3/224)
Epidemiological Features of Chickenpox:
A. Agent factors:
a) Agent: Varicella zoster virustadt
b) Source of infection:
- Oropharyngeal secretion
- Lesions of skin and mucosa and
- Rarely A patient with herpes zoster
c) Infectivity: 1-2 days before appearance of rash and 4-5 days thereafter
d) Secondary attack rate: The disease is highly contagious, so secondary attack rate in household contacts approximately 90%
B. Host factors:
a) Age: Primarily among children under 10 years. Few may escape until adulthood
b) Immunity: One attack gives life ling immunity
c) Pregnancy: Presents a risk for the foetus and the neonate
C. Environmental factors: Overcrowding favors its transmission
D. Transmission: Person to person by droplet infection and by droplet nuclei. Vertical transmission is possible and can infect the foetus.
E. Incubation period: Usually 14 to 16 days. The range may vary from 7 to 21 days.
Clinical Features of Chickenрох:
Clinical spectrum of chicken pox may vary from a mild illness and only a few scattered lessons to febrile illness and widespread rash.
A. Pre-eruptive stage:
a) Mild to moderate fever
b) Pain in the back
c) Shivering
d) Malaise
B. Eruptive stage: In children the rash is often first sign.
a) Distribution:
- Centripetal
- Rashes are symmetrical
- First appears in trunk (abundant)
- They come to face, arms, and where it is less abundant.
- Mucosal surface usually affected
- Axilla may be affected.
- Palms and soles are not usually affected.
b) Rapid Evolution:
- Stages – Macule, Papule, Vesicle, Scab.
- Vesicles are filled and fluid be and looking like dew drops on the skin.
- Vesicles may form crust without going through pustular stage.
c) Pleomorphism:
- All the stages of the rash (papule, vesicle, crust) may be seen
- simultaneously, at one time in the same area.
d) Fever: Fever does not run high but shows exacerbations and each fresh crop of eruption.
Complications of Chicken Pox:
| A. Viral effects: | a) Hemorrhage (Varicella haemorrhagica) b) Pneumonia c) Encephalitis d) Acute cerebral ataxia. e) Myocarditis f) Reye’s syndrome (Acute encephalopathy + fatty degeneration of the liver) g) Oncogencity h) Glomerulonephritis |
| B. Secondary bacterial infection: | a) Skin b) Septicemia c) Osteo-myelitis/septic arthritis |
| C. Intra-uterine infection: | a) Foetal wastage. b) Congenital birth defects:
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Prevention of Chickenpox:
A. Varicella-Zoster Immunoglobulin (VZIG): Varicella-Zoster Immunoglobulin (VZIG) given within 72 hours of exposure for prevention of chickenpox in exposed susceptible individuals particularly in immuno-suppressed persons.
B. Vaccine: Alive attenuated varicella virus vaccine is safe and currently recommended for children between 12-18 months of age who have not had chickenpox
Control:
- Immunization of high risk groups.
- Notification (To exclude small pox)
- Isolation of cases for about 6 days after onset of rash. Antiviral therapy.
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