Viral Infection 1

• 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

  
• Measles - Pre-eruptive/Prodromal stage

  1. Fever for 3-4 days

  2. Headache

  3. Sore throat/colds

  4. Body malaise

  5. Excessive mucopurulent lacrimal discharge

  6. Stimson sign

  7. Koplik's spots

  
• Measles - Eruptive stage

  1. Maculopapular rashes, reddish in color and blotchy in appearance, first appearing around 3rd day, cephalocaudal appearance

  2. Photosensitivity

  
• Measles - Post-eruptive stage

  1. Cephalocaudal disappearance of rashes

  2. Fine, branny desquamation of skin

  
• Sequelae of measles

  • Tuberculosis
  • Conjunctivitis
• Prevention of measles

  1. Passive immunization with gamma globulin if exposed

  2. Active immunization with MMR vaccine at 9 months or as early as 6 months

  
• Control measures for measles

  • Proper disposal of nasopharyngeal secretions
  • Cover nose and mouth
  • Isolate
  • Medical asepsis will not prevent spread as it is airborne

  
• Nursing care for measles

  • CBR
  • Adequate nutrition
  • Increase fluids
  • Vitamin C
  • Prevent eye and ear infections
  • Avoid exposure to draft
  • Never sponge with cold water
• German measles/Rubella

  An acute contagious disease, essentially a mild childhood disease, danger being congenital defects in newborns if pregnant woman is infected or exposed
• 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
• German measles - Pre-eruptive/Prodromal stage

  Forcheimer's spots, with or without slight fever, headache, mild sore throat, loss of appetite, runny nose, leukopenia during febrile stage

  
• German measles - Eruptive stage

  1. Rash - oval, rose-red papules about the size of a pinhead, begins on face and covers entire body in 24 hours (cephalocaudal)

  2. Enlargement of lymph nodes - suboccipital, postauricular and postcervical

  
• German measles - Post-eruptive stage

  1. Rashes disappear on 3rd day

  2. Lymph nodes subside
• Prevention of German measles

  1. Passive immunization with gamma globulin if exposed

  2. Active immunization with 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
• Chickenpox - Pre-eruptive/Prodromal stage

  With or without low-grade fever, malaise, muscle pains
• Chickenpox - Eruptive stage

  Exanthem appears one at a time and disappears in same manner (unifocular appearance), starts in covered areas as macules, papules, successive crops of vesicles, occasionally by pustules, spread throughout body in 6 hours, ends as granular crusts/scabs
• Chickenpox - Post-eruptive stage

  Falling off of exanthem
• Sequelae of chickenpox

  None mentioned
• Prevention of chickenpox


  Active immunization with Varivax vaccine
• Pharmacotherapeutics for chickenpox

  Zovirax may lessen severity of symptoms but will not give immunity
• Control measures for chickenpox

  Isolation in a room