Herpes Viruses: Chickenpox
Herpes viruses have the ability to establish lifelong persistent infections in their hosts and to undergo periodic reactivation. Their frequent reactivation in immunosupressed patients causes serious health complications.
Chickenpox is more commonly known as Varicella. It is a highly infectious disease that is characterized by fever and a maculopapular rash that develops into vesicular eruptions of the skin and the mucus membrane then after 3-4 days, granular crusts develops. This is usually present in children but can be severe in adults and those immunocompromised. The incubation of this infection usually lasts for two to three weeks or 14-21 days. This infection is transmitted through direct contact, through droplet infection and by contact with formites or contaminated with the vesicular secretions. The course of infection starts in the mucosa of the upper respiratory tract or the conjnuctiva. The replication follows in the lymphnodes, primary viremia starts in the liver and then spreads into the spleen. Secondary viremia then follows in the skin, where the rash starts to develop.
Malaise, fever, headache and loss of appetite are the earliest symptoms, soon followed by rashes which initially appear on the trunk, then on the face, limbs and the buccal and pharyngeal mucosa of the mouth. Mucus membrane lesions in the mouth, rectum and vagina in women, rupture easily because of their location and eventually develop into ulcerations. Fever persists as long as new lesions appear and is proportionate to the severity of the rash.
Chickenpox is highly contagious during its recovery period when the vesicles begin to rupture shedding millions of virus. The infection is also contagious when the rash appears as long as 6 days after the appearance of the new skin and the vesicles have crusted all over.
Chickenpox is a mild viral disease which needs no treatment. However, there are available antiviral compounds in the market that provide effective therapy to the infection and help prevent the development of systemic infection in immunosuppressed patients.
Nursing role in taking care of patients with chickenpox includes health teaching in regards with the course of the disease and how it is transmitted. The nurse should stress the importance of isolation of the patient during periods when he is highly contagious. Since there is no specific cure to this infection, supportive care for the symptoms experienced is observed. These care are as follow: the use of calamine lotion and oatmeal bath to relieve itching, cutting of fingernails to minimize the effects of scratching and stress the importance of not using Aspirin for fever ( to prevent Reye’s Syndrome).
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