Topic for BAMS

1. CHICKENPOX
AND MEASLES
Presented By :
Aparna Pachori

2. INDEX
Chickenpox Measles
Introduction Introduction
Epidemiology Epidemiology
Etiology Etiology
Pathology Pathogenesis
Sign and symptoms Sign andsymptoms
Diagnosis Diagnosis
Management Management

3. CHICKEN POX
Introduction
Chicken pox is a ubiquitous and extremely
contagious infection caused by Vericella
zoster virus(VZV) usually a beningn illness of
childhood charecterised by an exanthemtous
vasicular rash,with reativation of latent VZV.

4. EPIDEMIOGY
 Humans are the only known reservoir for VZV.
 Chickenpox is highly contagious with an attack rate of
atleast 90% among susceptible (sero –ve) individuals.
 The virus is endemic in the population at
large,however, it become epidemisc among susceptible
individuals during saesonal peaks – late winter and
early spring in the temperate.
 5-9 years old children are most commonly
affectedaccount for 50% of all cases.
 Most other case involve children 1-4 and 10-14 years
old.

5. In India highest cases are found in the Kerela.

6. ETIOLOGY
 It is caused by vericella zoster virurs (VZV).
 It is a virus belong to the family herpesviridae.
 Dimentions :
Diameter : ~180-200nm
Double stranded DNA
That is around ~1,25,000bp
in t length.

7. INCUBATION PERIOD :
Ranges from 10-21 days, but usually 10-14
days.
TRANSMISSION
- Nasal droplets,by coughing and sneezing.
-Direct touching the blisters,saliva and mucus
of an infected person.

8. PATHOGENESIS
Primary Infection : Transmission occurs readily by the respiratory route.
 The subsequent localized replication of the virus at an undefined site
(presumably the nasopharynx) leads to seeding of the
lymphatic/reticuloendothelial system and ultimately to the development
of viremia.
 Viremia in patients with chickenpox is reflected in the diffuse and
scattered nature of the skin lesions and can be confirmed in selected cases
by the recovery of VZV from the blood or routinely by the detection of viral
DNA in either blood or lesions by polymerase chain reaction (PCR).
 Vesicles involve the corium and dermis, with degenerative changes
characterized by ballooning, the presence of multinucleated giant cells,
and eosinophilic intranuclear inclusions.
 Infection may involve localized blood vessels of the skin, resulting in
necrosis and epidermal hemorrhage. With the evolution of disease, the
vesicular fluid becomes cloudy because of the recruitment of
polymorphonuclear leukocytes and the presence of degenerated cells and
fibrin. Ultimately, the vesicles either rupture and release their fluid (which
includes infectious virus) or are gradually reabsorbed.

9. SIGN AND SYMPTOMS
Patients are infectious ~48 hr
Before onset of vesicular rash.
SIGN : Rashes ( spread centripitally )
SYMPTOMS :
- Low grade fever
-Malaise

11. CHICKEN POX IN ADULTS :
-More severe than childhood
-No. Of rashes are more than childhood
-Pneumonia
CHICKEN POX IN PREGNANCY ;
Chicken pox within 5 days of delivery leads to severe
neonatal vericella with visceral involvement and
haemorrhage .
-

12. DIAGNOSIS
a. Charecterstic rashes and history
of recent exposure.
b. Laboratory findings : lab
diagnosis is usually not required
but if required there are some tests.
i. Most frequent source of isolation is
vesicular fluid
ii. Stained smears from vesicular
scarpings.
iii.Serology test for vericella IgM
antibody
iv.ELISA test is also useful.

14. MEASLES ( RUBEOLLA)
Introduction :
-It is a contageous disease caused by Rubella
virus.
-It is also called as Rubeolla.

15. EPIDEMOLOGY
1.First described in 7th cenruary
2.Near universal infection of childhood in
prevaccination era.
3.Common and often fatal in developing countries.
4.WHO has set the objective of eradicating measles
globally by 2010,using the live attenuated
vaccine (MMR).
5.India launched a massive plio style maesles
vaccination project in 14 high population states in
a 3 phase campaign

16. ETIOLOGY
Itis caused by Rubella virus.

18. INCUBATION PERIOD : 6 – 19 DAYS
Transmission:
By resperatory droplets

19. SIGN AND SYMPTOMS
-Rashes
-Prodromal illness 1-3 days before the rashes, occurs
with the upper respiratory symptoms
-Conjunctivitis
-Koplick’s spot on the buccal mucosa ( cardinal sign )

20. KOPLICK’S SPOT

21. COMPLICATIONS
Generalised lymph adenopathy
Diarrhoea
Ottitis media
Bacterial pneumonia
Clinical encephalitis (0.1%) children
Measles in adults : More severe and prolonged
with complication such as
pneumonitis,hepatitis and encephalitis.

22. DIAGNOSIS
1.The diagnosis is usually apparent from the
charecterstics clinical picture laboratory
confirmation is rarely needed.
2. ELISA : Testing for measles IgM antibodies
is recommended in some situation.
3. Hemoagglutination inhibition (HAI) :
Most frequently used method of screening
for the presence of rubella.

23. Prevention : Vaccination ( MMR )

24. MEASLES CAN OCCUR IN :

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