Chicken Pox: Epidemiologic Triangle, Role Of The Community Health
EPIDEMIOLOGY PAPER 1
EPIDEMIOLOGY PAPER 2
CHICKEN POX
Welcome to the chicken pox party! In 1970’s, 1980’s, and early 1990’s, chicken pox parties were an actual gathering. Parents understanding that their child would inevitably “get” the chicken pox wanted this process to be done quickly and a party of contagious kids was one way of getting this done. Now, chicken pox is something children do not have to “get”. The purpose of this paper is to discuss chicken pox in detail, explain the epidemiologic triangle, role of the community health nurse, and resources pertaining to chicken pox.
CAUSES
Chicken pox is extremely contagious virus that can affect anyone who has not had chicken pox before or has …show more content…
not had the vaccine. The virus known as the varicella-zoster virus causes chicken pox. It is a DNA virus, which has DNA as its genetic material and replicates using a DNA polymerase(). This just means the virus has its own profile and uses a person to replicate its own DNA. SYMPTOMS
There are few symptoms that the chicken pox virus presents. The main symptom is a blister type rash that can cover the whole body. Each blister is filled with fluid, which will eventually crust or scab over. Scarring can unfortunately occur as well. Other symptoms associated with the chicken pox are high fevers, tiredness, headache and loss of appetite().
EPIDEMIOLOGY PAPER 3
TRANSMISSION
A person with chicken pox is contagious one to two days before the rash appears and can continue to spread the virus until the blisters turn into scabs. It takes from 10 to 21 days after exposure for a person with chickenpox or shingles to present symptoms(). A person who is suffering from chicken pox can spread it to anyone that has not had the virus before. The virus is spread through the air from either sneezing or coughing, or from touching an open lesion. Lastly, a person can get the chicken pox virus from someone who has shingles. Shingles is seen in older adults and is caused by the same virus as chicken pox. Chicken pox can lay dormant and come out as shingles in later years. Because shingles is the same virus, shingles can also be spread to others who have not had chicken pox or been vaccinated.
COMPLICATIONS AND TREATMENT
Chicken pox is usually a common, mild disease, but with limited treatment serious complications can occur to those at high risk.
Those considered high risk is infants, immunosuppressed elderly, and pregnant women. Infants, elderly, and people who are immunosuppressed are more susceptible to develop pneumonia, dehydration, and other infections, as their immune systems are weaker. Mother and unborn baby can have serious complications if exposed to chickenpox if mother is not immune. 10-20% of pregnant women who get chickenpox develop pneumonia, with the chance of death as high as 40%(). If a pregnant woman gets chickenpox while in the first or early second trimester of pregnancy, there is a small chance (0.4 – 2.0%) that the baby could be born with birth defects known as "congenital varicella syndrome." These babies may suffer from low birth weight and have scarring of the skin and problems with arms, legs, brain, and eyes. Treatments focus on treating the symptoms rather than the chicken pox virus. Those at higher risk for complications can take antiviral medication including Acyclovir. It can only be administered with 24 hours of the emergence of the rash. Acyclovir reduces the severity of symptoms, but does not cure the disease(). Immunoglobin treatment can also be administered as well. This treatment is a solution containing VZIG (Varicella-zoster immunoglobulin), which is taken from healthy individuals that have had chicken pox in the past who contain the …show more content…
viral antibodies(). This may be administered to patients at high risk of complications or very severe symptoms, including those with weakened immune systems, pregnant mothers and newborns. The varicella vaccine is the biggest importance to preventing chicken pox. Before the varicella vaccine was developed, 4 million people would get chicken pox each year, highest rate of chicken pox affecting pre-school children. Out of these millions infected, 100-150 would die from complications of the chicken pox. Since 1995, when the vaccine was introduced, there has been an 85% decline of cases in the United States(). The recommended children vaccine dose is one between the ages of 12-15 months and second dose between 4-6 years of age. In 2010, 90% of children
19 to 35 months old in the United States had received one dose of varicella vaccine, while 58% had received 2 doses of the vaccine().
HEALTH DETERMINATES Social determinates centered around chicken pox include insurance coverage, lack of resources, and lack of education.
In recent years, people considered at poverty level or below the poverty level, have received lower insurance rates or free vaccine coverage for their children. It was found that children in poor income families had lower rates of vaccines than families above the poverty level. This had helped increase the rate of vaccinations across the country. For instance, The Vaccines for Children (VFC) Program offers vaccines at no cost for eligible children through VFC-enrolled(). Lack of resources in communities or in rural areas can also have impact. Travel expense and travel time to see a physician can become a hardship on families, especially families who live in rural areas. Other social determinates is the lack of knowledge about vaccines. Recently, many well-educated families have chosen to not vaccinate their children due to the fear of the impact of the vaccine. In false news reports, autism was supposedly linked to vaccines. Many families have chosen to not vaccinate children due to such media reports, although there is no factual statistics to support claims. Other families may not vaccinate due to lack of knowledge of importance and what vaccine can help
prevent.
EPIDEIMEOLGY TRIANGLE
The chicken pox epidemiology triangle consists of the agent, hosts, and environmental factors that continue the chain of infection. The agent being the varicella zoster virus. It is an extremely contagious virus recognized since ancient times. The virus enters through the respiratory tract and conjunctiva and starts to disseminate throughout the host’s body. Replication of the virus continues to occur as it passes to the sensory nerves. Here, the virus remains latent(). Chicken pox can only be transmitted to humans. No animal, vector, or insect has ever been known to carry or spread the disease. Immunity appears to be long lasting. Once the virus has invaded, the chances of having chickenpox again are extremely rare. This is true as well with vaccinations. Among healthy adolescents and adults, an average of 78% develop antibodies after one dose of the varicella vaccine. Environmental factors include temporal patterns and living or gathering in close vicinities. In the United States the highest incidences of chicken pox are between the months of March and May, while lowest rates are between the months September through November(). People who are around others in close proximity are also more likely to get chicken pox as well as spread chicken pox to others if not immune and actively have chicken pox. Places like churches, schools, and persons living in the same household are at greater risk. The epidemiological triangle is the overall path of infection. Until there is a break in this chain, the infection will continue to spread.
COMMUNITY HEALTH NURSE AND RESOURCES The community health nurse is vital in reporting, collecting data, administering care and conducting follow-up treatments, as well as providing resources to those in need. There is limited data concerning chicken pox, but with the new varicella vaccine, outbreaks and cases have declined dramatically. In 2002, Council of State and Territorial Epidemiologists (CSTE) recommended that varicella be included in National Notifiable Diseases Surveillance System (NNDSS). All states are encouraged to conduct ongoing varicella surveillance to monitor vaccine impact on morbidity. NNDS is a nationwide collaboration that enables all levels of public health to share health information to monitor, control, and prevent the occurrence and spread of communicable diseases and infections(). The community nurse can go out to the community and rural areas to assess who needs vaccines and administer the vaccine. This helps break the chain of infection and identify the communities in need of vaccinations. The nurse also should make sure there is follow-op with these patients. Patients that have only received one varicella vaccine should be followed to administer booster when needed. It’s important for community nurses to investigate, identify and help control chickenpox outbreaks. Every state has a department of health, which is a great resource for anyone needing more information on chickenpox. For instance the state of Arizona Department of Health has information for both children and adults concerning chickenpox and the varicella vaccine and booster. A person can find information about chickenpox and also gives the latest news and data concerning this disease. The Center for Disease Control is also a great reliable resource for anyone looking for detailed information concerning the chickenpox virus.
CONCLUSION
Chickenpox was a disease that infected millions of people each year. With tremendous gains in medical research and the development of the varicella vaccine many will not have to endure the affects of chicken pox. Knowledge of the virus, community nurses, vaccines, and resources will help continue to decrease these incidences and promote healthier living.
HERITAGE ASSESSMENT 7
References
References
Center for Disease Control and Prevention, (2014). Chickenpox. Retrieved from
http://www.cdc.gov/chickenpox/about/index.html Center for Disease Control and Prevention, (2014). Monitoring the Impact of
Varicella Vaccination. Retrieved from Doughtery, M., (2002). From Chickenpox to Shingles. InVivo, 1(7).
Medical News Today, (2011). What Is Chickenpox (Varicella)? What Causes
Chickenpox? Retrieved from
http://www.medicalnewstoday.com/articles/239450.php
Papadopoulo, A., (2014). Chickenpox Treatment and Management. Medscape.
Retrieved from http://emedicine.medscape.com/article/1131785-treatment#aw2aab6b6b4
EPIDEMIOLOGY PAPER 2
CHICKEN POX
Welcome to the chicken pox party! In 1970’s, 1980’s, and early 1990’s, chicken pox parties were an actual gathering. Parents understanding that their child would inevitably “get” the chicken pox wanted this process to be done quickly and a party of contagious kids was one way of getting this done. Now, chicken pox is something children do not have to “get”. The purpose of this paper is to discuss chicken pox in detail, explain the epidemiologic triangle, role of the community health nurse, and resources pertaining to chicken pox.
CAUSES
Chicken pox is extremely contagious virus that can affect anyone who has not had chicken pox before or has …show more content…
not had the vaccine. The virus known as the varicella-zoster virus causes chicken pox. It is a DNA virus, which has DNA as its genetic material and replicates using a DNA polymerase(). This just means the virus has its own profile and uses a person to replicate its own DNA. SYMPTOMS
There are few symptoms that the chicken pox virus presents. The main symptom is a blister type rash that can cover the whole body. Each blister is filled with fluid, which will eventually crust or scab over. Scarring can unfortunately occur as well. Other symptoms associated with the chicken pox are high fevers, tiredness, headache and loss of appetite().
EPIDEMIOLOGY PAPER 3
TRANSMISSION
A person with chicken pox is contagious one to two days before the rash appears and can continue to spread the virus until the blisters turn into scabs. It takes from 10 to 21 days after exposure for a person with chickenpox or shingles to present symptoms(). A person who is suffering from chicken pox can spread it to anyone that has not had the virus before. The virus is spread through the air from either sneezing or coughing, or from touching an open lesion. Lastly, a person can get the chicken pox virus from someone who has shingles. Shingles is seen in older adults and is caused by the same virus as chicken pox. Chicken pox can lay dormant and come out as shingles in later years. Because shingles is the same virus, shingles can also be spread to others who have not had chicken pox or been vaccinated.
COMPLICATIONS AND TREATMENT
Chicken pox is usually a common, mild disease, but with limited treatment serious complications can occur to those at high risk.
Those considered high risk is infants, immunosuppressed elderly, and pregnant women. Infants, elderly, and people who are immunosuppressed are more susceptible to develop pneumonia, dehydration, and other infections, as their immune systems are weaker. Mother and unborn baby can have serious complications if exposed to chickenpox if mother is not immune. 10-20% of pregnant women who get chickenpox develop pneumonia, with the chance of death as high as 40%(). If a pregnant woman gets chickenpox while in the first or early second trimester of pregnancy, there is a small chance (0.4 – 2.0%) that the baby could be born with birth defects known as "congenital varicella syndrome." These babies may suffer from low birth weight and have scarring of the skin and problems with arms, legs, brain, and eyes. Treatments focus on treating the symptoms rather than the chicken pox virus. Those at higher risk for complications can take antiviral medication including Acyclovir. It can only be administered with 24 hours of the emergence of the rash. Acyclovir reduces the severity of symptoms, but does not cure the disease(). Immunoglobin treatment can also be administered as well. This treatment is a solution containing VZIG (Varicella-zoster immunoglobulin), which is taken from healthy individuals that have had chicken pox in the past who contain the …show more content…
viral antibodies(). This may be administered to patients at high risk of complications or very severe symptoms, including those with weakened immune systems, pregnant mothers and newborns. The varicella vaccine is the biggest importance to preventing chicken pox. Before the varicella vaccine was developed, 4 million people would get chicken pox each year, highest rate of chicken pox affecting pre-school children. Out of these millions infected, 100-150 would die from complications of the chicken pox. Since 1995, when the vaccine was introduced, there has been an 85% decline of cases in the United States(). The recommended children vaccine dose is one between the ages of 12-15 months and second dose between 4-6 years of age. In 2010, 90% of children
19 to 35 months old in the United States had received one dose of varicella vaccine, while 58% had received 2 doses of the vaccine().
HEALTH DETERMINATES Social determinates centered around chicken pox include insurance coverage, lack of resources, and lack of education.
In recent years, people considered at poverty level or below the poverty level, have received lower insurance rates or free vaccine coverage for their children. It was found that children in poor income families had lower rates of vaccines than families above the poverty level. This had helped increase the rate of vaccinations across the country. For instance, The Vaccines for Children (VFC) Program offers vaccines at no cost for eligible children through VFC-enrolled(). Lack of resources in communities or in rural areas can also have impact. Travel expense and travel time to see a physician can become a hardship on families, especially families who live in rural areas. Other social determinates is the lack of knowledge about vaccines. Recently, many well-educated families have chosen to not vaccinate their children due to the fear of the impact of the vaccine. In false news reports, autism was supposedly linked to vaccines. Many families have chosen to not vaccinate children due to such media reports, although there is no factual statistics to support claims. Other families may not vaccinate due to lack of knowledge of importance and what vaccine can help
prevent.
EPIDEIMEOLGY TRIANGLE
The chicken pox epidemiology triangle consists of the agent, hosts, and environmental factors that continue the chain of infection. The agent being the varicella zoster virus. It is an extremely contagious virus recognized since ancient times. The virus enters through the respiratory tract and conjunctiva and starts to disseminate throughout the host’s body. Replication of the virus continues to occur as it passes to the sensory nerves. Here, the virus remains latent(). Chicken pox can only be transmitted to humans. No animal, vector, or insect has ever been known to carry or spread the disease. Immunity appears to be long lasting. Once the virus has invaded, the chances of having chickenpox again are extremely rare. This is true as well with vaccinations. Among healthy adolescents and adults, an average of 78% develop antibodies after one dose of the varicella vaccine. Environmental factors include temporal patterns and living or gathering in close vicinities. In the United States the highest incidences of chicken pox are between the months of March and May, while lowest rates are between the months September through November(). People who are around others in close proximity are also more likely to get chicken pox as well as spread chicken pox to others if not immune and actively have chicken pox. Places like churches, schools, and persons living in the same household are at greater risk. The epidemiological triangle is the overall path of infection. Until there is a break in this chain, the infection will continue to spread.
COMMUNITY HEALTH NURSE AND RESOURCES The community health nurse is vital in reporting, collecting data, administering care and conducting follow-up treatments, as well as providing resources to those in need. There is limited data concerning chicken pox, but with the new varicella vaccine, outbreaks and cases have declined dramatically. In 2002, Council of State and Territorial Epidemiologists (CSTE) recommended that varicella be included in National Notifiable Diseases Surveillance System (NNDSS). All states are encouraged to conduct ongoing varicella surveillance to monitor vaccine impact on morbidity. NNDS is a nationwide collaboration that enables all levels of public health to share health information to monitor, control, and prevent the occurrence and spread of communicable diseases and infections(). The community nurse can go out to the community and rural areas to assess who needs vaccines and administer the vaccine. This helps break the chain of infection and identify the communities in need of vaccinations. The nurse also should make sure there is follow-op with these patients. Patients that have only received one varicella vaccine should be followed to administer booster when needed. It’s important for community nurses to investigate, identify and help control chickenpox outbreaks. Every state has a department of health, which is a great resource for anyone needing more information on chickenpox. For instance the state of Arizona Department of Health has information for both children and adults concerning chickenpox and the varicella vaccine and booster. A person can find information about chickenpox and also gives the latest news and data concerning this disease. The Center for Disease Control is also a great reliable resource for anyone looking for detailed information concerning the chickenpox virus.
CONCLUSION
Chickenpox was a disease that infected millions of people each year. With tremendous gains in medical research and the development of the varicella vaccine many will not have to endure the affects of chicken pox. Knowledge of the virus, community nurses, vaccines, and resources will help continue to decrease these incidences and promote healthier living.
HERITAGE ASSESSMENT 7
References
References
Center for Disease Control and Prevention, (2014). Chickenpox. Retrieved from
http://www.cdc.gov/chickenpox/about/index.html Center for Disease Control and Prevention, (2014). Monitoring the Impact of
Varicella Vaccination. Retrieved from Doughtery, M., (2002). From Chickenpox to Shingles. InVivo, 1(7).
Medical News Today, (2011). What Is Chickenpox (Varicella)? What Causes
Chickenpox? Retrieved from
http://www.medicalnewstoday.com/articles/239450.php
Papadopoulo, A., (2014). Chickenpox Treatment and Management. Medscape.
Retrieved from http://emedicine.medscape.com/article/1131785-treatment#aw2aab6b6b4