1. Herpes Viruses Herpes zoster
Chickenpox
Shingles
Filename Herpes2.ppt

2. Herpes Zoster Outline Structure Classification Multiplication
Clinical manifestations
Epidemiology
Diagnosis
Control
Baron’s Web Site

3. Varicellovirus genus in herpesvirus family human herpesvirus 3 (HHV3)
varicella-zoster virus

4. Herpes Zoster virus

5. Chickenpox
varicella

6. Varicella (chickenpox)

7. Varicella eruption

8. Varicella eruption

9. Chickenpox vesicle

10. Tzanck cell Chickenpox vesicle

11. 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.

12. Chickenpox Incubation 10-20 days
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.

13. Chickenpox
pox appears 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.

14. varicella in adults can be life threatening
varicella in adults can be life threatening. In pregnancy it can cause fetal infection and congenital varicella syndrome.

15. Chickenpox: Diagnosis
clinical appearance
antibody titres

16. Chickenpox Treatment usually is not treated.
Acyclovir is used to treat disseminated infection in immunocompromised patients.
ointments are used to relieve itching and bacterial infection of the lesions.

17. prevention and control
living attenuated vaccine is available for immunocompetent children at high risk.

18. Shingles

19. Shingles disease of adults. greater than 65% are >45 yrs.
reactivation can occur at any age and immunocompromised persons are high risk.

20. Herpes zoster

21. Herpes zoster

22. Shingles Herpes zoster

23. ZIG - Zoster Immune Globulin
The antibodies are obtained from persons who have recently recovered from shingles.

24. 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.

25. 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.