HERPES ZOSTER - SHINGLESCHICKENPOX - VARICELLA

Disediakan Oleh : Nassruto

DEFINISI HERPES ZOSTER - SHINGLES

• Infeksi kulit melibatkan & saraf dengan ledakan inflamatori di dalam kulit bermula dari T3 – L3

Agen Penyebab

• Human (alpha) herpesvirus 3 (Virus Varicella Zoster – V-Z Virus), a member of the Herpesvirus group

• Reactivation infection with the virus that causes CHICKENPOX

• Attack to skin area supplied by sensory nerves

Insiden

• Semua golongan seluruh dunia• Pesakit leukaemia, Hodgkin & limpoma• Pesakit menerima rawatan kanser, kosteroid• Belaku banyak pada orang dewasa - tua• 10% pada kanak-kanak• Pesakit HIV berisiko tinggi mendapat zoster

Reservoir

• Man

Mode of transmission

• Direct contact• Droplet / airborne • Respiratory tract• Vesicle fluid

Incubation period

• 2-3 weeks• Commonly 13- 17 days.

Period of communicability

• 1 week• 10-21 days – susceptible persons

Susceptibility and resistance

• Universal among those not previously infected

• More severe in adults than of children• Second attacks are rare• Leukemia patient – suffer more severe,

prolong or fatal chickenpox.

Susceptibility and resistance

• Cancer patients• Steroid therapy• Immuno-deficient patients• Immunisuppressive therapy

Menifestasi Klinikal

• Kesakitan tulang belakang• Bintik merah pada dada, leher, muka dan

selaput mukosa• Sakit yang kuat atau rasa kebas

Komplikasi

• Parut• Neuralgia• Motor palsi• Keratitis

Penyelidikan

• Calitan lesi • Serologi

Rawatan

• Simptomatik• Antiviral• Steroid• Vitamin E

Method of control

• Preventive measures• control of patients, contact and the

immediate environment

Preventive measures

• Health education• personal hygiene

• Avoid contaminating skin • with infectious material

• Health personnel• wear glove

Preventive measures

• Protect high risk individu • Neonates• Immuno-deficient patients

Control of patients, contact and the immediate environment

• Report - notification• Isolation from;• neonatal• severe primary lesion• drainage/ secretion• newborn baby• School children at least 5 days• immunosuppressed patients

Control of patients, contact and the immediate environment

• Concurrent disinfection; • Discharges from nose, throat, lesions

• Quarantine ; none• Immunization of contacts:• VZIG given within 96 hours

• Investigation of contacts and source of infection; of no practical importance

Control of patients, contact and the immediate environment

• Specific treatment:• zovirax

• Epidemic measures: none• Disaster implications: outbreaks• International measure: none

THANK YOU