Natural Chickenpox Treatment Systems
Zoster is usually heralded by dermatomal pain, sometimes accompanied by fever. Within a few days, the skin overlying the dermatome reddens and blisters. A few vesicles are usually grouped on one erythematous base, in contrasttothe scattered, single vesicles of chickenpox. Several days later the vesicles become pustular and develop crusts, followed by scabs.
A vaccine is a solution that contains a harmless version of a virus, bacterium, or a toxin that causes an immune response when introduced to the body. Vaccination is a highly effective way to prevent viral infection. Viral vaccines can be made from inactivated viruses, attenuated viruses, or parts of the viral coat. An inactivated virus is not able to replicate in a host. An attenuated virus is a weakened form of the virus that cannot cause disease. In general, attenuated viruses provide greater protection from disease. Vaccines against measles, mumps, rubella, polio, hepatitis A and B, and chickenpox have greatly reduced the incidence of these diseases. The genetic diversity of HIV makes the development of an AIDS vaccine a difficult task. Educating people about HIV transmission is currently the best approach to slowing the spread of AIDS. Several kinds of antiviral drugs interfere with viral nucleic acid synthesis. Unfortunately, the number of antiviral drugs is small compared to...
Varicella infection is not uncommon in children with malignancy (e.g. acute lymphocytic leukemia) who are receiving chemotherapy. As a preventive measure, immunocompromised children with no immunity against varicella should receive varicella zoster immune globulin (VZIG) as soon as possible if exposed to either chickenpox or varicella zoster. Those with active infection should be treated with intravenous acyclovir. Foscarnet is usually effective in patients with acyclovir resistance.
Facial rash caused by the varicella-zoster virus. Etiology The disorder is caused by the varicella-zoster virus, which initially manifests itself as chickenpox. If activation or reinfection occurs, the latent neurotropic viruses present in the body can lead to the clinical syndrome of herpes zoster ophthalmicus (Fig. 2.14). Fig. 2.14 The facial rash of herpes zoster is caused by the neurotropic varicella-zoster virus. After the clear watery vesicles burst, brownish scabs form, which are later shed.
A correct diagnosis of swimmers' itch is not always very easy. Similar external symptoms may occur after insect bites and in some communicable diseases, such as chickenpox, measles, and some venereal diseases. Similar symptoms may also sometimes be induced by plants in sensitive persons. The localization of the affected skin areas is important to consider for the differential diagnosis. A history of bathing or immersion of affected skin areas in water is of course most important for a presumptive diagnosis. However, allergic reactions after exposure to blue-green algae (cyanobacteria) have also been recorded (Solomon and Stoughton 1978).
Generally less of a problem, unless the attendant is susceptible to the infection (e.g. chickenpox or measles). Vaccination of staff against readily transmissible organisms is essential, and a record of vaccinations and previously acquired immunity should be kept and updated.
The following drugs are used primarily in the treatment of herpesviruses. Among these are herpes simplex virus-1 (HSV-1), which typically causes herpes labialis (cold sores) or herpes esophagitis herpes simplex virus-2 (HSV-2), which is responsible for most cases of genital herpes varicella zoster virus (VZV), which produces chickenpox and shingles Epstein-Barr virus (EBV), which is the major cause of infectious mononucleosis and cytomegalovirus (CMV), which can produce pneumonia, gastroenteritis, retinitis, encephalitis, and mononucleosis in immunocompromised individuals.
An endemic disease is the average or normal number of cases of a disease in a certain population.The number of people contracting the disease and the severity of the disease is so low that it raises little concern and does not constitute a health problem. An example is the varicella-zoster virus (the virus that causes chickenpox). Chickenpox is an endemic disease that usually affects children and is seasonal. An endemic disease can give rise to epidemics.
The varicella-zoster virus, which causes varicella (chickenpox), has an incubation period of two weeks. The human immunodeficiency virus, the virus that causes AIDS, has an incubation period of 7 to 11 years. During this phase, the disease can be spread from the infected individual to a non-infected individual.
In one series, 15 of 34 children with rheg-matogenous retinal detachment had a history of inflammatory or infectious disease in the eye with the detachment 44 . Acute retinal necrosis, characterized by anterior uveitis, occlusive retinal vasculitis and progressive peripheral retinal necrosis, occurs primarily in nonim-munocompromised adults as a result of reactivated herpes simplex or varicella zoster virus infection. The risk of retinal detachment is high, reported to be between 25 and 75 and due to retinal breaks, usually following posterior vitreous detachment after the acute phase is over. Although less common, it has been reported to occur in children 6 .
Varicella (chickenpox) and herpes zoster (shingles) are different clinical manifestations of infection by the same virus - Varicella-Zoster, a DNA human herpes virus, conditions caused - an acute encephalitis - postinfectious encephalomyelitis This occurs after virus reactivation, dormant after the primary infection (chickenpox).
According to Hart, these sickness behaviours are adaptive because they enhance illness-induced fever, which may aid the animal to combat pathogens. In fact, Kluger and colleagues have shown that animals not allowed to express the typical febrile response associated with illness have a greater risk of dying. Higher mortality rates were observed in lizards forced to remain in a cold environment after exposure to a bacterial infection than those placed in a warm environment 43 . Moreover, lizards in the warm environment that were treated with an antipyretic (salicylate), experienced higher mortality rates than untreated animals 44 . Likewise in humans, the use of antipyretics (aspirin and acetaminophen) has been shown to extend the duration and symptoms of chicken pox 45 and common colds L46 , although we cannot be certain these effects of the drugs are attributable to the absence of a fever. The work of others has shown that a behavioural fever (moving to a warmer environment) increases...
Varicella Zoster (VZV or human herpes virus 3 (HHV-3)) causes chickenpox. In adults, complications can develop leading to 20-25 deaths per year in England and Wales (Rawson et al. 2001). VZV is currently controlled by a live attenuated vaccine. Animal studies with recombinant VZV glyco-proteins B, C, E and I (gB, gC, gE and gI), have confirmed the role of antibody in protection, while the intermediate early protein IE62 appears to be implicated in the generation of VSV-specific CTL responses. A recombinant HSV-1 vector expressing either gE or IE62 induced antibody and CTL responses in mice, supporting the feasibility of a combined HSV VZV vaccine (Lowry et al. 1997).
A broad range of casually defined terms has evolved to describe the processes used to diagnose the presence of bacterial or viral agents. Microbiologists have used culture-based diagnostics for decades to grow and characterize bacteria that are capable of being grown in vitro. Prior to the need to be concerned with bioterror attacks, the public health system was concerned with clinical diagnostics that could distinguish between the wide variety of naturally occurring pathogens that present similar symptoms. For a number of years these have included both classical culture-based diagnostics as well as modern genomics-based diagnostics, which includes the more specific category of poly-merase chain reaction (PCR)-based diagnostics. An important concept regardless of technique is rule-out diagnostics, which eliminate the pathogen in question and may even confirm the presence of a microbe of less concern (e.g., chickenpox instead of smallpox). The same can be said for microbial diagnostics...
Virus-caused diseases are numerous and all too familiar chicken pox, influenza, some types of pneumonia, polio, measles, rabies, hepatitis, the common cold, and many others. Smallpox, once a worldwide scourge, was eradicated by a decade-long global immunization effort beginning in the mid-1960s. Viral infections in plants (e.g., dwarf mosaic virus in corn) have a major economic impact on crop production. Planting of virus-resistant varieties, developed by traditional breeding methods and more recently by genetic engineering techniques, can reduce crop losses significantly. Most viruses have a rather limited host range, infecting certain bacteria, plants, or animals (Figure 1-6).
Some viral diseases involve the upper alimentary system but produce more dramatic symptoms elsewhere in the body. For example, measles produces Koplik's spots in the mouth, a dramatic skin rash, and respiratory symptoms chickenpox causes oral blisters and ulcers, but a striking skin rash infectious mononucleo-sis can cause multiple oral ulcers and bleeding gums, but impressively enlarged lymph nodes and spleen. In this section, we focus on herpes simplex, with its characteristically painful oral ulcers, and mumps, with its enlarged, painful parotid glands. measles, p. 549 chickenpox, p. 546 infectious mononucleosis, p. 726
Examples of DNA viruses and the diseases that they produce include adenoviruses (colds, conjunctivitis) hepadnaviruses (hepatitis B) herpesviruses (cytomega-lovirus, chickenpox, shingles) papillomaviruses (warts) and poxviruses (smallpox). Pathogenic RNA viruses include arborviruses (tick-borne encephalitis, yellow fever) arenaviruses (Lassa fever, meningitis) or-thomyxoviruses (influenza) paramyxoviruses (measles, mumps) picornaviruses (polio, meningitis, colds) rhab-doviruses (rabies) rubella virus (German measles) and retroviruses (AIDS).
The three main causes of encephalopathy and encephalitis in patients with advanced HIV disease and CD4 counts below 100 * 10 6 l are HIV encephalopathy, progressive multifocal leukoencephalopathy, and cytomegalovirus-related encephalitis. Less commonly, herpes simplex virus and varicella zoster virus infection may be implicated. Encephalopathy may also be metabolically induced by drugs or by liver or renal failure. Magnetic resonance imaging (MRI) of the brain will show cerebral atrophy and variable degrees of white matter change in HIV encephalopathy. Similar changes may be seen with cytomegalovirus. Progressive multifocal leukoencephalopathy produces asymmetrical white matter changes without a mass effect on MRI. Herpes simplex virus and varicella zoster virus lesions are usually more localized and may produce a mass effect in patients with encephalitis. A lumbar puncture should be performed to identify cytomegalovirus, herpes simplex virus (I and II), varicella zoster virus, and...
Many common childhood diseases such as measles, mumps and chickenpox are caused by viruses, as are the common cold and flu. More dangerous viral diseases include polio, smallpox, herpes, Lassa fever, Ebola and AIDS. Do viruses ever do anything useful Yes infection by a mild virus can provide resistance against a related but more dangerous virus (see Ch. 17). Viruses may carry genes from one host organism to another, in a process known as transduction (see Ch. 18), and have thereby played a major role in molecular evolution (see Ch. 20). The ability of viruses to carry genes between organisms may be put to good use by genetic engineers. All the same, about the best that can be said for the natural role of viruses is that most of them do relatively little damage and only a few cause highly virulent diseases.
A major goal in questioning the patient and reviewing the medical records is to develop a firm impression of the types of infections that the patient has suffered so that subsequent laboratory tests can be targeted to analyze specifically those components of the immune system whose defects would most likely explain the patient's symptoms. This will be best served by keeping in mind general patterns of infection that might be caused by defects in specific immunologic defense mechanisms. Thus, infections with encapsulated extracellular bacterial pathogens, particularly of the respiratory tract, are suggestive of defects in antibody production ( 19,20), which constitute the majority of all immune deficiencies (1). Superficial mucosal infections may particularly suggest isolated IgA deficiency ( 21). Infections with opportunistic pathogens, including protozoans and fungi, and recurrent episodes of chickenpox or chronic herpetic lesions, may suggest problems in cell-mediated immunity (20)....
This disorder may follow upper respiratory and gastrointestinal infections (viral), viral exanthems (measles, chickenpox, rubella, etc.) or immunisation with live or killed virus vaccines (influenza, rabies). Measles is the commonest cause occurring in 1 per 1000 primary infections next Varicella zoster (chickenpox), 1 per 2000 primary infections.
Three basic approaches are used to control viral diseases vaccination, antiviral chemotherapy, and stimulation of host resistance mechanisms. Vaccination has been used successfully to prevent measles, rubella, mumps, poliomyelitis, yellow fever, smallpox, chickenpox, and hepatitis B. Unfortunately, the usefulness of vaccines appears to be limited when many stereotypes are involved (e.g., rhinoviruses, HIV). Furthermore, vaccines have little or no use once the infection has been established because they cannot prevent the spread of active infections within the host. Passive immunization with human immune globulin, equine antiserum, or antiserum from vaccinated humans can be used to assist the body's own defense mechanisms. Intramuscular preparations of immune globulin may be used to prevent infection following viral exposure and as replacement therapy in individuals with antibody deficiencies. Peak plasma concentrations of intramuscular immune globulins occur in about 2 days. In...
Most DNA viruses of animals contain double stranded DNA. For example, Simian Virus 40 (SV40) is a smallish, spherical virus that causes cancer in monkeys by inserting its DNA into the host chromosome. Another double stranded DNA virus, Herpes virus, is spherical with an extra outer envelope of material stolen from the nuclear membrane of the host cell (Fig. 17.14). The internal nucleic acid with its protein shell is referred to as the nucleocapsid. This family includes viruses that cause cold sores and genital herpes as well as chickenpox and infectious mononucleosis. The herpes viruses are difficult to cure completely as they are capable of remaining in a latent state where they cause no damage but merely replicate in step with the host cell. Active infections may then break out again after a long period of quiescence, due to stress or other factors.
Viruses cause most pneumonia in infants and children, but viral pneumonia is uncommon in adults. Essentially, any virus can produce any syndrome, but severe pneumonia leading to ICU admission in adults is mainly due to influenza and herpes viruses, particularly varicella zoster virus. Hantavirus, which is known to cause hemorrhagic fever with renal syndrome, has been also responsible for multiple organ failure with non-cardiogenic pulmonary edema.
One of the great fears when pediatric transplantation began was that because of immunosuppression, the child would be at risk for severe complications from common childhood diseases. In actual experience, with careful triple therapy immunosuppression, most common childhood illnesses are well-tolerated. Routine immunizations (except for live virus vaccines) should resume at 12 weeks posttransplant. Transplant recipients have a normal response to routine immunization with diptheria, pertussis, typhoid, and Hepatitis B. Pediatric transplant recipients and their siblings should receive only inactivated polio. Measles, mumps and rubella vaccines are not given to these patients. Varicella-Zoster immune globulin should be given to pediatric heart transplant recipients within 72 hours after exposure to chicken pox. Currently, varicella vaccine is given to siblings, but not to the transplant recipient.
Airborne pathogens have the greatest chance of infecting new individuals when these individuals are crowded together indoors or in a climate-controlled building where heating and air conditioning units regulate temperature and very little fresh air enters the building. Airborne pathogens can fall to the floor and combine with dust particles. This dust can then be stirred up with walking, dry mopping, or changing bedding and clothing. Examples of diseases that are transmitted by airborne transmissions and dust particles are measles, chickenpox, histoplasmosis, and tuberculosis.
It is active against herpes simplex viruses 1 and 2 and varicella-zoster virus, but poorly active against cytomegalovirus. The intravenous route is most reliable and it is distributed to all tissues including the meninges. Acyclovir is excreted by the kidneys and dose reduction is necessary in renal failure, although it is removed by hemodialysis. For the immune-suppressed patient with herpes zoster or varicella, acyclovir prevents dissemination and reduces shedding. It is effective in the treatment of herpes simplex encephalitis. Chickenpox in adults should be treated with acyclovir to reduce the morbidity associated with pneumonia. Phlebitis, reversible renal impairment, and elevation of transaminases are minor side-effects.
Shingles or herpes zoster, which is the same virus that causes chicken pox, is characterized by a painful rash usually on one side of the body. Nerve pain, called postherpetic neuralgia, may persist after the rash has disappeared and can be helped by 1200 to 1600 IU vitamin E orally and 30 IU applied topically and by intramuscular injections of Vitamin B12. Intramuscular injections of 100 mg three times weekly of adenosine monophosphate, a naturally occurring compound in the body, can accelerate healing of shingles, reduce pain, and may prevent postherpetic neuralgia. Capsaicin containing cream from red pepper applied topically can help relieve pain.
Intravenous acyclovir (aciclovir) has been used early in the onset of severe varicella zoster virus pneumonia and seems to reduce the respiratory rate and the duration of fever, and to improve oxygenation. It probably favors the healing of bronchial lesions. The same treatment might be recommended for the rare cases of severe necrotizing herpes simplex virus pneumonia, although there are no published data, as acyclovir is highly active in vitro and is non-toxic. The dose for severe pneumonia due to varicella zoster virus is 500 mg m2 intravenously every 8 h for 5 to 10 days.
Viruses cause many diseases in humans, such as flu, chickenpox, measles, polio, and viral hepatitis. Viral infections can affect various human organs, including the brain, liver, heart, lungs, and skin. Chickenpox and Shingles Chickenpox and shingles are caused by the same varicella-zoster herpesvirus. The virus multiplies in the lungs and travels to blood vessels in the skin. The symptoms of chickenpox include fever and skin rash. The virus is spread through direct contact with the skin rash and through the air. After recovery, a person has lifelong resistance to reinfection. The virus, however, can sometimes stay in nerve cells as a provirus. The virus can later cause a disease called shingles. The shingles rash, shown in Figure 24-5, can shed new chickenpox viruses and infect susceptible children and adults.
There are very few effective antiviral drugs because it is difficult to formulate a drug that eradicates the virus from the cells without also killing the cells themselves. The currently available antiviral therapeutics are mostly effective in treating the herpes virus, of which there are 4 main types. The first is the herpes simplex virus (the cause of cold sores), genital herpes, and herpes simplex keratitis. The second is the varicella zoster virus, the virus causing chicken pox and shingles. The third variety is the Epstein-Barr virus, which causes mononucleosis. Last, is the cytomegalovirus, a common infectious agent in AIDS patients.
Varicella zoster virus Varicella zoster virus certainly several multiples higher because of underreporting. The recent introduction of polymerase chain reaction (PCR) tests for the detection of enteroviral ribonucleic acid (RNA) in CSF has greatly increased the detection of enteroviral CNS infections and it has become apparent that 85-90 of acute viral meningitis is caused by enteroviruses (coxsackie B or echo).4 Much less commonly meningitis is caused by herpes simplex virus (HSV) type 2, varicella zoster virus (VZV), mumps, lymphocytic choriomeningitis, and HIV (Box 9.1).
Chickenpox is a highly contagious infection caused by the herpes virus Varicella zoster. It is typically seen in children where it causes crops of pruritic cutaneous vesicles. It is usually transmitted by direct contact and has an incubation period of 2-3 weeks. The exanthem is frequently preceded by a slight fever, malaise and mild headache. The cutaneous lesions start as an itchy macular rash, which progressively becomes vesicular and pustular before breaking down to form focal crusting lesions. They tend to erupt in crops, but lesions at all stages of evolution are frequently present. The back and chest are often the first sites of involvement, but later lesions appear on the face, neck and limbs. They can involve the nose, ears, conjunctiva and genital areas. In the mouth they form small, non-specific, scattered ulcers. The symptoms last from a few days to 2 weeks. In many cases the virus remains latent in dorsal root ganglia. Herpes zoster (shingles) is due to reactivation of the...
Adults suffering a primary infection with varicella can develop chickenpox pneumonia, which in its most severe form requires ventilatory support. Acyclovir (aciclovir) can be beneficial if given early in the disease, but prevention of spread, particularly among non-immune staff, is of prime importance. Viral encephalitis is treated with acyclovir and prolonged supportive therapy. Cytomegalovirus infection usually occurs in AIDS, transplant, or other immunosuppressed patients, and may present as retinitis or pneumonitis. Ganciclovir is the usual treatment but must be started early in the disease.
Chickenpox (Varicella) Chickenpox is the common name for varicella, the most common of the viral rashes of childhood. The causative virus is a member of the herpesvirus family and, like others in that group, produces a latent infection that can reactivate long after recovery from the initial illness. latent infections, p. 463
Following activation of a latent infection with varicella zoster virus lying dormant in the dorsal root or gasserian ganglion, the patient develops a burning, constant pain with severe, sharp paroxysmal twinges over the area supplied by the affected sensory neurons. Touch exacerbates the pain. Thick myelinated fibres are preferentially damaged, possibly opening the 'gate'.
Viruses are some of the smallest particles that are able to cause disease. But they vary in size and shape, as shown in Figure 24-2. The shape of a virus is the result of its genome and the protein coat that covers the genome. A protein coat, or capsid (KAP-sid), is the only layer surrounding some viruses. The capsid of some viruses, such as TMV, forms a helix, shown in Figure 24-2a. The rabies and measles viruses are also helical viruses. As shown in Figure 24-2b, the adenovirus capsid has the shape of an icosahedron (lE-koh-suh-HEE-druhn), a shape with 20 triangular faces and 12 corners. Other viruses with this shape include those that cause herpes simplex, chickenpox, and polio. The influenza virus, shown in Figure 24-2c, is spherical in shape. Some viruses have a bilipid membrane called an envelope that surrounds the capsid. The envelope is formed from either the nuclear membrane or the cell membrane of the host cell as the viral capsid buds from the host cell. Proteins in the...