Chicken pox in children

1. Chicken Pox
Nidhi Chauhan
M.Sc Nursing Final Year
GCON, Jodhpur

2. HISTORY
• Discovered by Giovanni Filippo
during the 15th century in Italy.
• In 16th century, an English physician
Richard Morton gave the name
“CHICKEN POX”.
• William Heberden proved chicken
pox is different from smallpox.

3. Contd…
•The term chicken pox, has
been said to be derived
from chickpeas based on
resemblance of the vesicles
to chickpeas.

4. DEFINITION
Chickenpox is an infectious
disease caused by the
varicella zoster virus
(VZV), a virus that is part
of the herpes virus family.

5. PREVALENCE OF DISEASE
• Very common in the U.S before the
vaccine became available in 1995.
• In early 1990s, an average of 4
million people got chickenpox.
• 10,500 -13,000 were hospitalized.
• 100 - 150 died each year.

6. Contd…
• Each year, more than 3.5
million cases of varicella,
9,000 hospitalizations, and 100
deaths are prevented by
varicella vaccination in the
United States.

7. Contd…
Studies show that from 1995 to
2005, the occurrence of this
disease has decreased by 90%
among children and adolescents,
and Varicella-related
hospitalizations also declined by
88%.

8. EPIDEMIOLOGICAL
FACTORS
• The source of infection-person
infected by chicken pox.
• Commonly found in winter
season
• Occurs more in children than
in adults.

9. Contd…
• One attack of disease produce
sufficient resistance power for
long period.
• Transmission of disease-
mostly through personal
contact or droplet infection.

10. INCUBATION PERIOD
• 7-21 days
CAUSATIVE ORGANISM:
• Varicella zoster virus also
called human (alpha) herpes
virus.

12. SIGN AND SYMPTOMS
In children:
• Itchy rash appears on the head and spreads
down to the trunk and other body parts.
• The rash becomes raised, and blisters form.
• Blisters may also form on mucous
membranes, such as inside the mouth,
nose, throat, and vagina.

13. Contd…
• The blisters crust over and
disappear within about 10-14
days.
• Children may also have fever
and tiredness along with the
rash.

15. Contd…
In adults:
• Pre-eruptive stage:
At the onset of disease, low or
moderate fever , feeling cold,
restlessness, backache etc. are
complained.

16. Contd…
• Eruptive phase:
After the pre eruptive phase
the rashes are found on the
body which are less on face
and hands and more on the
body.

18. Contd….
• Different stages of rashes are
(macular ,papular ,vesicular
and scabal) found together.
• This is the special
characteristic of the disease.

19. Contd….
•The eruptive stage last for
4-7 days
•After that the scales comes
out and the wound is
healed.

20. SERIOUS SYMPTOMS
1. High fever
2. Vomiting
3. Diarrhea
4. Headache
5. Dehydration
6. Worsening of asthma

21. Chicken Pox & The Immune
System
• The virus 1st infects the
mucous of the upper
respiratory tract
• Viral proliferation occurs in
lymph nodes for 2-4 days after
initial infection

22. = infected area

23. Contd…
• 4-6 days after initial infection,
virus enters blood stream
• This is followed by a second
round of replication in body’s
organs
• ESPECIALLY in Spleen & Liver

24. Contd...

25. 1st Exposure
• Body 1st Exposed creates antibodies
– Immunoglobulin G (IgG)
– Immunoglobulin M (IgM)
– Immunoglobulin A (IgA)

26. 1st Exposure Cont.
•B & T memory cells are
also created
•IF there is a 2nd exposure,
memory cells will stimulate
cells to create antibodies

27. COMPLICATIONS
• Pneumonia
• Bleeding
• Encephalitis
• Serious diseases of fetus in
case of pregnancy.

28. DIAGNOSTIC EVALUATION:
• Sign and symptoms, the typical
spread of rashes and the
appearance of different stages
of rashes together are helpful
in making diagnosis

29. VACCINES FOR CHICKEN
POX
• The chickenpox vaccine is live attenuated
vaccine and not recommended for people
with weak immune system
• The chickenpox vaccine was added to the
childhood immunization schedule in
1995.
• The booster dose was added in 2006.

30. Contd….
• The U.S. Advisory Committee on
Immunization Practices recommends 2
doses of the vaccine for children.
• The 1st dose is given around at 1 yr. and
the 2nd around age 4-6 yrs.
• A single dose of the vaccine reduces risk
upto 70-90%, and 2 doses reduce the risk
even more.

31. Contd…
• It is available as a single
vaccine, also as part of the
MMRV vaccine (measles,
mumps, rubella, and varicella
vaccine).
• Route : Subcutaneously

32. Contd…
• When chickenpox occurs in
vaccinated individuals, these
cases are known as
“breakthrough cases”. These
cases are usually very mild
compared with the disease in
unvaccinated individuals.

33. MEDICAL MANAGEMENT
•Care for chickenpox
usually includes use of pain
medications and topical
treatments for the itchy
rash, blisters, and scabs.

34. Contd….
• In serious cases, anti-viral drugs
can alter the course of the illness.
• These are typically given early to
people at highest risk of
complications, including sick
children and pregnant women.

35. NURSING MANAGEMENT
Prevent infection:
-Prevent the spread of the disease
-Wear gloves to perform dressing
-Change the bed linens frequently
-Wear a mask or have the patient
wear a mask

36. Contd….
• Treat itching:
- Cut the patient’s fingernails short
- Encourage frequent hand washing.
- Use of antihistamines or soothing skin
lotions such as calamine to ease the
itching.
- Use of baking soda in a cool bath may
also decrease itching.

37. Contd…
Other treatment:
• Assess the patient frequently to
manage symptoms such as itching or
to detect symptoms that may indicate
a complication, such as a moist
cough that could signal early
pneumonia.

38. DIETERY MANAGEMENT
• Foods which are easily digestible like
kichri, plain rice and dal, poppy seeds etc
are advised.
• Non vegetarian diet strictly avoided.
• The diet mostly consist of fluids like fruit
juice, coconut water, vegetable soup etc.
Fluid diet helps the nutrients to be
absorbed faster.

39. Contd….
• Include Zinc, magnesium and
calcium supplements in diet to
enhance the immune system.
Enhanced immune system help
in quick cure.

40. Contd….
• Encourage fluids and a healthy diet.
Some patients develop sores inside
the mouth and may need soft foods
that are easy to chew and swallow.
• Chicken Pox diet should include
coriander and carrot soup once every
day

41. SUMMARY
• Chicken pox is an infectious disease caused by
the varicella virus. Most cases develop in
children under age 15 but older children
and adults can get it. It spreads very easily from
one person to another. Symptoms
of chickenpox include an uncomfortable, itchy rash,
fever and headache. The disease is usually mild and
lasts 5 to 10 days, but it sometimes causes serious
problems. Adults and older children tend to get sicker
from chickenpox. Do not give aspirin to anyone sick
with chickenpox since the combination might cause
Reye’s syndrome