Summary: Varicella-Zoster Virus

Chickenpox
Talitha Marquez
Grand Canyon University
Concepts in Community and Public Health
NRS-427V
Colleen Darrow
June 7, 2014
Chickenpox
Communicable Diseases are transmitted from one person to the next. The transmission occurs via airborne viruses or bacteria, but may also be transmitted through bodily fluids or blood. Communicable diseases may also be referred to as contagious or infectious diseases. One communicable disease is Chickenpox, also known as Varicella-Zoster Virus. Chickenpox is extremely contagious. In fact, it had a 90 percent rate of transmission in close contact (CDC.gov). Before 1995, almost all persons acquired varicella by adulthood. There was an endemic in the United States. It was reported that 4 million per
year were affected. (CDC.gov). To give a better understanding of Chickenpox, this paper will cover the description of this communicable disease, determinants of health, the epidemiologic triangle, the role of the community health nurse and a national agency.
Causes of this disease were attributed to the virus known as Varicella-Zoster.
Varicella Zoster is one of the herpes viruses. Symptoms are not usually identified for 10 to 21 days after exposure. The symptoms include fever, tired, no appetite, rash then itchy blisters filled with fluid. This rash usually covers the whole body. These symptoms last between 5 to 10 days. A person that is known to have chickenpox is contagious 1 to 2 days before they get the rash. Once their blisters have formed scabs, it is said to not be contagious. This same virus is also responsible for shingles. Mode of transmission of this disease is transferred through sneezing, coughing or
touch.
Complications of Chickenpox are not as common in the “healthy person”. There is a higher rate for complications for infants, pregnant women, adults and immunocompromised people. Some complications include skin infections, dehydration, pneumonia, encephalitis, toxic shock syndrome and even death.
Treatment of chickenpox is to treat symptomatically. Example, if you have a fever use Acetaminophen. Do not use Aspirin. This could cause Reye’s syndrome. Increase fluids to keep hydrated. Loss of appetite is common. Include small amounts of food if tolerable. Last would be treatment of the itchy blisters. Calamine lotion helps with the itchiness. Antihistamines may also be used. Cool bath with oatmeal may also help soothe the itchiness. Most important is to relax and rest. Avoid scratching the blisters. This can cause scarring.
Prevention is important.
As described earlier, before 1985 nearly everyone had Chickenpox. If you had not contracted this disease then you would be considered to have no immunity against it. This would then put one at risk. There was “Chickenpox parties”. This one when one found out that someone had chickenpox, they would then send over their children so they would contract this disease and be done with it. Dr. Michiaki Takahasi developed the vaccine in the mid 1970’s. However it was not approved until 1995 in the United States. Japan and Korea had the availability in 1988. The vaccine is a live virus called Varivax and ProQuad. Both are manufactured by a company named Merck. There is also an antiviral medication that may be prescribed in severe cases. This medication is Acylovir. Once one has been exposed they become immune to this disease. The susceptibility of contracting this disease again is very rare. Second attacks have happened but are said to be very rare. This usually happens if the first case is mild or at infancy age. There is also a recommendation that if you are 60 years or older, you should receive the booster. A onetime dose. This will also help in the prevention of Shingles. National statistics show that the mortality of Chickenpox in adults have decreased from 1996- 2000. (Rawson, Crampin, & Noah,
2001).
Determinants of health would be included in prevention of this communicable disease. Environmental, social and economic factors are associated with the ability to access health care services. Here in California the Affordable Care Act has taken place. This is to prevent the uninsured population. There is medical free of charge or at a discounted rate. There is also public health departments that will provide vaccines at little or no cost. The issue is that some may not get the message. It is mandatory now for all health providers to have the titer done. This is to verify immunity. Again this is for protection from the population that could possible expose you. Currently there is a small population that is not vaccinating their children. This could expose our older patients that could then contract shingles. This has become controversial over the last 5-10years with associating autism with vaccinations.
The epidemiologic triangle is a model that scientists have developed to help study health related issues. It is to help get an understanding of how infectious diseases are spread. (CDC.gov). The Triangle is exactly that, a triangle. Three sides called vertices and each have a representation. To simplify this explanation, there are the host( who), the agent(what) and the environment(where). On the top of the triangle is the host, which in this case of the chickenpox enters the host through the upper respiratory tract or the conjunctiva. The agent is the Varicella-Zoster virus. Last would be the environment, this would correspond to the typical school year. Peak timing would be March and April. There is an incubation period this is not currently a factor due to the vaccination.
The role of the community health nurse is to promote prevention. This would include primary, secondary and tertiary preventions. Public health nursing requires specific educational material to prepare the role as a public health nurse. This would include the following: (1)epidemiology, statistics, and research (2) orientation to heath care systems (3) identification of high-risk population(4) application of public health concepts to the care of groups of culturally diverse person (5) interventions with high-risk population (6) orientation to regulations affecting public health nursing practice. (Maurer & Smith, 2013, Chapter 2).
The United States Centers for Disease Control and Prevention attributes most of the education and research. We often refer to them as the CDC. They gather the statistic and data. They work 24/7 to protect Americans from health, safety and security threats, both foreign and in the United States. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights diseases and supports communities and citizens to do the same.(CDC.gov). This organization opened its doors on July 1, 1946. That was when Malaria was spreading across the nation. Since then the CDC has brought to the public evidenced based information. The funding for this program is 85 percent through grants. Each year the CDC is awarded 7 billion in grants. There is a vaccine as described earlier that currently is in use. Due to all the research the CDC has developed this to decrease and promote health.
Chickenpox is something the current generation may never experience. This is something that is talked about. With the current practice of medicine, this has overall helped the population. This is a disease that is now preventable. Thanks to all the research to the CDC and other national agencies. As a patient advocate is currently our job to get the education out there so everyone could get vaccinated.

References
CDC.Gov
Chickenpox. (2014). Chickenpox. Retrieved from NVIC.org/chickenpox.aspx
Maurer, F. A., & Smith, C. M. (2013). Origins and Future of Community/Public Health Nursing. In Community/Public Health Nursing Practice (5th ed., Ch. 2). [evolve]. Retrieved from
Rawson, H., Crampin, A., & Noah, N. (2001, November 10). Deaths from chickenpox. PubMed, 1091-1093. Retrieved from PubMed.com