Chicken Pox/ Shingles

Varicella (chicken pox) and Herpes zoster (shingles)

Varicella-zoster virus (VCV) or Human herpevirus 3 (HHV-3)

Enveloped, 150-200 nm, genome double stranded DNA, produces latent infection, targets sensory neuron

Humans

Respiratory System

Aerosol, mother to fetus

10-21 days

Replicates in respiratory tract and spreads to lymph nodes, blood stream, and skin. Viral replication in skin results in vesicular lesions and spread to sensory neurons. Viral genome enters the nucleus in dorsal root ganglion where it remains dormant. Replication of latent virus and resumes in adulthood and produces a skin rash in regions of nerve fiber innervation

Fever, fatigue, Vesivular rash (3-4 days), shingles

Primarly face, throat, and lower back. less frequent chest and shoulders. Vesicles fill with pus, rupture and form scabs

localized to skin innervated by infected sensory neurons- generally unilateral thorax; hypersenstivity, pain, vesicular rash

Secondary infections, Pneumonia, Reye’s Syndrome (<37cases/yr), Encephalitis, mortality rate for varicella 1-1.5/40k cases; Shingles (incidence of 1 in 3)

Swelling of brain and liver, diarrhea, rapid breathing, vomiting, and severe fatigue. Brain dysfunction; drowiness, confusion, seizures, loss of consciousness. Permant brain damage. Mortality- 30%. Additional rish factor- children and adolescents that take aspirin

Necrosis, persitent hypersensitivity (lasts months), Postherpetic neuralgia (buring or stinging- chronic pain), Ramsay Hunt

Varicella- MMRV, First dose 12-15 months, Booster 4-6 yrs; Zoster (50-90% effective) Shingrix (2017), after age 50, 2 doses 2-6 months apart

Acyclovir, Antihistamine, Analgesics