VIRAL INFECTIONS

• Exanthema


  A widespread rash occurring on the outside of the body, usually occurring in children, can be caused by toxins, drugs, microorganisms, or autoimmune disease
• Exanthema


  A widespread rash occurring on the outside of the body, usually occurring in children, can be caused by toxins, drugs, microorganisms, or autoimmune disease
• Enanthema


  A rash on the mucous membranes, characteristic of patients with viral infections causing hand foot and mouth disease, measles

  
• Macule


  A flat, distinct discolored area of skin less than 1 cm wide

  
• Papule


  A raised area of skin tissue that is less than 1 cm around, may have distinct or indistinct borders

  
• Vesicle


  A small fluid-filled bladder, sac, cyst or vacuole within the body
• Measles


  • An extremely contagious exanthematous childhood disease
  • Acute onset
  • Breastfed babies of mothers who have measles possess relative immunity for first 3 months of life

  
• Rubeolla/Measles virus


  Causative agent of measles

  
• Incubation period of measles

  10-15 days
• Period of communicability for measles

  9 days (4 days before - 5 days after appearance of rash), most communicable at height of rash
• Mode of transmission for measles

  Droplet/airborne, nasopharyngeal secretions

  
• Stages of measles


  1. Pre-eruptive/Prodromal stage (fever, headache, sore throat, body malaise, excessive mucopurulent lacrimal discharge, Stimson sign, Koplik's spots)

  2. Eruptive stage (maculopapular rashes, cephalocaudal appearance)

  3. Post-eruptive stage (cephalocaudal disappearance of rashes, fine branny desquamation)

  
• Measles


  • Sequelae: Tuberculosis, Conjunctivitis
• Prevention and management of measles

  1. Passive immunization (gamma globulin if exposed)

  2. Active immunization (MMR vaccine at 9 months or 6 months)

  3. Control measures (proper disposal of secretions, cover nose/mouth, isolate)

  
• Nursing care for measles

  CBR, adequate nutrition, increase fluids, Vitamin C, prevent eye/ear infections, avoid drafts, no cold water sponging
• German Measles/Rubella


  • An acute contagious disease, essentially a mild childhood disease but danger is congenital defects in newborns if pregnant woman is infected (microcephaly, congenital heart defect, cataract, deafness, mutism)
• Rubella/Toga virus


  Causative agent of German Measles
• Incubation period of German Measles

  Usually 10 days
• Period of communicability for German Measles

  1. 7 days after onset of catarrhal symptoms
• Mode of transmission for German Measles

  Droplet infection
• Stages of German Measles

  1. Pre-eruptive/Prodromal stage (Forchheimer's spots, slight fever, headache, sore throat, loss of appetite, runny nose, leukopenia)

  2. Eruptive stage (rose-red oval papules, cephalocaudal rash, lymph node enlargement)

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

  
• 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)
• Nursing care for German Measles


  Same as for measles
• Chickenpox


  • Most highly contagious childhood disease, affects adults more severely, one attack confers lifelong immunity, virus may become dormant and reactivate as 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 until last vesicle has dried up
• Mode of transmission for chickenpox

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


  1. Pre-eruptive/Prodromal stage (low-grade fever, malaise, muscle pains)

  2. Eruptive stage (exanthem appears one at a time, macules to papules to vesicles to pustules to crusts/scabs)

  3. Post-eruptive stage (falling off of exanthem)
• Chickenpox


  • Sequelae: Herpes Zoster
• Prevention and management of chickenpox

  1. Active immunization (Varivax vaccine)

  2. Pharmacotherapeutics (Zovirax to lessen severity but not provide immunity)
• Nursing care for chickenpox

  Warm baths with baking soda, prevent scarring (mittens, clove-hitch restraints)
• Herpes Zoster


  • 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)

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

  3. Post-eruptive stage
• Herpes Zoster


  • Sequelae
• Prevention and management of Herpes Zoster


  1. Active immunization (recombinant zoster vaccine)

  2. Pharmacotherapeutics (Zovirax, potassium permanganate compress)
• Nursing care for Herpes Zoster

  Same as for chickenpox