MICROPARA

• Mode of transmission for German measles

  Droplet infection

  
• Stages of German measles

  1. Pre-eruptive/Prodromal stage (Forchheimer's spots, with or without slight fever, headache, mild sore throat, loss of appetite, runny nose, leukopenia)

  2. Eruptive stage (rash - oval, rose-red papules, begins on face and covers entire body in 24 hours, enlargement of lymph nodes)

  3. Post-eruptive stage (rashes disappear on 3rd day, lymph nodes subside)

  
• Forchheimer's spots


  • Pathognomonic enanthem consisting of fine red spots on the soft palate or uvula, seen on the 1st day
• Prevention and management of German measles

  1. Passive immunization (gamma globulin if exposed)

  2. Active immunization (MMR vaccine at 15 months and booster at 3-4 years)

  
• Control measures for German measles

  • Proper disposal of nasopharyngeal secretions, cover nose and mouth, isolate, medical asepsis will not prevent spread as it is airborne

  
• Nursing care for German measles

  • CBR, adequate nutrition, increase fluids, vitamin C, prevent eye and ear infections, avoid exposure to draft, never sponge with cold water
• Chickenpox (Varicella)


  • Most highly contagious childhood disease, affects adults more severely, one attack confers lifelong immunity, virus may become dormant and lead to Herpes Zoster
• Varicella Zoster virus


  Causative agent of chickenpox
• Incubation period of chickenpox

  14-16 days or 21 days
• Period of communicability for chickenpox


  A day before eruptions begin up to when last vesicle has dried up
• Mode of transmission for chickenpox

  Droplet (nasopharyngeal secretions), discharges from vesicles
• Stages of chickenpox


  1. Pre-eruptive/Prodromal stage (with or without low-grade fever, malaise, muscle pains)

  2. Eruptive stage (exanthem appears one at a time and disappears in same manner, starts as macules, papules, successive crops of vesicles, occasionally pustules, spread throughout body in 6 hours, ends as granular crusts/scabs)

  3. Post-eruptive stage (falling off of exanthem)
• Prevention and management of chickenpox

  1. Active immunization (Varivax vaccine)

  2. Pharmacotherapeutics (Zovirax may lessen severity but not provide immunity)
• Control measures for chickenpox

  • Isolation in a room
• Nursing care for chickenpox

  • Warm bath with baking soda to relieve itchiness, prevent scarring (mittens, clove-hitch restraints)
• Herpes Zoster (Shingles)


  • Caused by same virus as chickenpox, a dormant type of chickenpox, more often attacks adults than children
• Varicella Zoster virus


  Causative agent of Herpes Zoster

  
• Incubation period of Herpes Zoster

  10-21 days
• Mode of transmission for Herpes Zoster

  Droplet infection
• Stages of Herpes Zoster

  1. Pre-eruptive/Prodromal stage (fever, malaise 1-2 days before rash onset)

  2. Eruptive stage (maculo-vesicular rash, unilateral following peripheral nerves, very painful, appear in clusters)

  3. Post-eruptive stage
• Prevention and management of Herpes Zoster


  1. Active immunization (recombinant zoster vaccine)

  2. Pharmacotherapeutics (Zovirax, potassium permanganate compress)
• Control measures for Herpes Zoster

  • Isolation in a room
• Nursing care for Herpes Zoster

  • Warm bath with baking soda to relieve itchiness, prevent scarring (mittens, clove-hitch restraints)
• Diseases


  • 7-DAY MEASLES
  • 9-DAY MEASLES
  • RUBELLA
  • 3-DAY MEASLES

  
• Important Information


  • An extremely contagious exanthematous childhood disease
  • Acute onset
  • Breastfed babies of mothers who have a measles possess a relative immunity for the first 3 months of life
  • An acute contagious disease
  • Essentially a mild childhood disease, the danger actually being congenital defects in the newborn
  • If a pregnant woman suffers for it or is exposed to someone with the disease: Microcephaly, Congenital heart defect, Cataract, Deafness and mutism

  
• Causative Agent


  • PARAMYXO VIRUS
  • RUBEOLA/MEASLES VIRUS
  • PSEUDOPARAMYXO VIRUS (RUBELLA/TOGA VIRUS)

  
• Incubation Period


  10 days -15 days, usually 10 days
• Infections


  • MEASLES
  • GERMAN MEASLES
• Period of Communicability


  • 9 days (4 days before - 5 days after appearance of rash)
  • Most communicable at height of the rash
  • 4-7 days after the onset of catarrhal symptoms
• Mode of Transmission


  • Droplet / airborne
  • Nasopharyngeal secretions
  • Droplet infection
• Signs & Symptoms


  1. Pre-eruptive / Prodromal Stage: Fever for 3-4 days, headache, sore throat/colds, body malaise, Excessive mucopurulent lacrimal discharge, Stimson sign, Koplik's spots, Forcheimer's spots, With or without slight fever, headache, mild sore throat, loss of appetite, runny nose, Leukopenia during febrile stage

  2. Eruptive Stage: Maculopapular rashes, Reddish in color and blotchy in appearance, First appearing around the 3rd day, Cephalocaudal appearance, Photosensitivity, Rash - cardinal sign: Oval, rose-red papules about the size of a pinhead, Begins on the face, covers the entire body in 24 hours (cephalocaudal), Enlargement of the lymph nodes - suboccipital, postauricular and postcervical

  3. Post Eruptive Stage: Cephalocaudal disappearance of the rashes, Fine, branny desquamation of the skin, Rashes disappear on the 3rd day, Lymph nodes subside

  
• Sequela


  • Tuberculosis
  • Conjunctivitis
• Management


  Prevention: Passive immunization - gamma globulin if the child has been exposed; immunity lasts for 2-3 weeks, Active immunization - Measles-Mumps-Rubella (MMR) or measles vaccine at 9 months of age or as early as 6 months, 0.5 ml subcutaneous; may experience fever for 2-3 days and rashes
• Control


  1. Proper disposal of nasopharyngeal secretions

  2. Cover nose and mouth

  3. Isolate

  4. Medical asepsis will not prevent the spread of measles because it is an airborne disease

  
• Nursing Care


  1. CBR

  2. Adequate nutrition

  3. Increase fluids

  4. Vitamin C

  5. Prevent eye and ear infections

  6. Avoid exposure to draft

  7. Never sponge with cold water
• Diseases


  • CHICKEN POX
  • HERPES ZOSTER
• Medical Term


  • VARICELLA
  • SHINGLES
  • ZORA
  • ACUTE POSTERIOR GANGLIONITIS
• Important Information


  • Most highly contagious childhood disease
  • Affects adults more severely than children
  • One attack confers lifelong immunity
  • Not all viruses may leave the body; they just become dormant and live in the nerves which, when weakened by low resistance, may lead to Herpes Zoster
  • Caused by the same virus that causes chickenpox
  • A dormant type of chickenpox
  • More often attacks adults rather than children

  
• Causative Agent


  • VARICELLA ZOSTER VIRUS
  • HERPES VIRUS VARICELLA

  
• Incubation Period


  14 -16 days or 21 days