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Flashcards in VZV Deck (10):

When is a case of VZV most infectious? When are they infectious until?

- most infectious during prodrome
- Infectious from one to two days before the onset of the rash until the lesions have fully crusted over (i.e. fully dried)


What is the natural history of VZV? Progression of rash?

• Prodrome: fever, malaise, anorexia
• Rash day 3-5:
• Pruritic macules - papules - vesicles - umbilication - crusting
• Central (Scalp, face, trunk)
• Fully crusted lesions by day 10


How is VZV spread

- Spread by direct contact/droplet spread


When is vaccination recommended?

- Recommended for >12mo and seronegative adults


When are complications more common with VZV, and what are the possible complications?

More common in infants, >15yo and IC pts:
• bacterial superinfection (particularly group A beta haemolytic streptococcus and Staph aureus)
• Pneumonia
• Encephalitis
• Cerebellitis
• Hepatitis
• Arthritis
• Reye syndrome


What can VZV recur as?

- Herpes zoster (shingles) – can occur > 1 dermatome in kids, post-herpetic neuralgia less common.


What kind of post-exposure Tx is there fore VZV? When is it given? Who is it recommended for?

• Zoster immunoglobulin
• Give within 96 hours of exposure
• For:
○ Pregnant women
○ Neonates whose mother develops varicella from 7 days before to 2 days after delivery.
○ Immune deficiency


What infection precautions should be taken in VZV?

- Must be notified within 5 days of varicella diagnosis in Victoria
- No school until fully recovered (all lesions crusted over) or at least one week after the eruption first appears
- Any admitted child with active chickenpox or zoster should be isolated
- Cut nails short at first sign of disease - scratching increases risk of 2ndary bacterial infection


What is the Mx of VZV in an immunocompetent child?

- hydrate
- Calamine lotion, cool compresses
- Possible oral anti-histamines to improve sleep
- Paracetamol for fever, not aspirin


When does the Mx of VZV differ, and how does it differ?

- Mx in immunocompromised/certain neonates (i.e. <28d)/severe eczema
- IV aciclovir