Herpes Viruses Herpes zoster
Herpes Zoster Outline
Varicellovirus
- genus in herpesvirus family
- human herpesvirus 3 (HHV3)
Herpes Zoster virus
Chickenpox
Varicella (chickenpox)
Varicella eruption
Varicella eruption
Chickenpox vesicle
Tzanck cell Chickenpox vesicle
Chickenpox
- chicken pox is the acute primary disease
- shingles is the delayed recurrent form of the same disease
- begins as a disease of childhood
- aerosol from a child most common source
- virus enters nose or throat - airborne - very communicable.
- early viral multiplication in upper respiratory tract, no symptoms; not infectious.
Chickenpox
- virus begins to disseminate during the latter part of the incubation period.
- virus enters regional lymph nodes. Passes into the blood and internal organs.
- patient becomes infectious 3-4 days before the first pox is seen. Sore throat is common 1-2 days before the first pox.
Chickenpox
- pox appears 14-21 days after the exposure. Usually, a macular i.e. flat rash appears on the skin. within 24 hrs. the vesicles appear and these form into pustules which form scab and fall off in a few days.
- virus is shed from the respiratory tract and the pox.
- virus sequestered in neural ganglia and remains latent.
varicella in adults can be life threatening. In pregnancy it can cause fetal infection and congenital varicella syndrome.
Chickenpox: Diagnosis
Chickenpox Treatment
- Acyclovir is used to treat disseminated infection in immunocompromised patients.
- ointments are used to relieve itching and bacterial infection of the lesions.
prevention and control
- living attenuated vaccine is available for immunocompetent children at high risk.
Shingles
Shingles
- greater than 65% are ᡥ yrs.
- reactivation can occur at any age and immunocompromised persons are high risk.
Herpes zoster
Herpes zoster
Shingles Herpes zoster
ZIG - Zoster Immune Globulin
- The antibodies are obtained from persons who have recently recovered from shingles.
Shingles Diagnosis
- fluorescent antibody for viral gene products.
- tissue cultures are used for rapid diagnosis.
- cells are grown for 24 to 72 hours.
- scrapings of lesions can also be diagnosed with very specific fluorescent antibodies.
- women have dysuria, urinary retention (involvement of urethra).
- 10% of individuals develop aseptic meningitis.
Sacral radiculomyelitis
- results in neuralgias, urinary retention, obstipation (intractable constipation).
- radiculitis is inflammation of the spinal nerve roots.
- radiculomyelitis is inflammation of the nerve roots and spinal cord.
- sacrum; the bones of the lower back.