Varicella Zoster

Question 1

Define varicella zoster?

Answer 1

Primary infection is called varicella (chickenpox).

Reactivation of the dormant virus in the dorsal root ganglia, causes zoster (shingles).

Question 2

outline the epidemiology of varicella zoster?

Answer 2

Chickenpox peak incidence: 4–10 years

Shingles peak incidence: >50 years.

About 90% of adults are VZV IgG positive.

Question 3

outline the presentation of chicken pox?

Answer 3

Prodromal malaise

Mild pyrexia

Generalised pruritic, vesicular rash - face and trunk predominantly

Contagious from 48 h before the rash and until all the vesicles have crusted over (within 7–10 days).

Question 4

outline the presentation of shingles?

Answer 4

• May occur due to stress
• Tingling in a dermatomaldistribution
• Followedby painful skin lesions.
• Recovery in 10–14 days.

Question 5

how is the diagnosis for chicken pox made?

Answer 5

clinical diagnosis

Question 6

outline the management for chicken pox in children?

Answer 6

Treat symptoms

• Calamine lotion
• Analgesia
• Antihistamines

Question 7

outline the management of chicken pox in adults?

Answer 7

Consider Aciclovir

valaciclovir or famciclovir if within 24 h of rash onset

Question 8

outline the prevention of varicella zoster?

Answer 8

VZIG may be indicated:

• immunosuppressed
• Pregnant women exposed to varicella zoster

Chickenpox vaccine is licensed in the United Kingdom, but no guidelines available for appropriate use.