Description

Varicella-Zoster Virus (VZV) -- Chickenpox Though just a lifeless particle, Varicella seems to have programmed itself (the magic life and the tragedy of disease) to return as SHINGLES and thus infect susceptible hosts in order to perpetuate its existence. One Chickenpox blister contains billions of infectious particles. Amazing! Maternal Chickenpox, during neonatal period, can cause severe disease to the newborn (if delivered within a week after mother becomes afflicted with Chickenpox). A mother with established immunity against Chickenpox passes transplacental antibodies to her newborn (passive immunization, i.e., IgG) which wanes by 6 months of age. If infants are exposed to Chickenpox before the age of 6 months, they develop an atypical form, papules, and it is usually mild. I once followed two infants that were exposed to Chickenpox at 3 and 4 months and had mild disease. Later, however, they developed Chickenpox when exposed in early childhood. Thus, passive immunity may protect infants, but later, they become susceptible hosts. Today, we have a vaccine against Varicella, which is given at 12 months of age. Susceptible adults may get Chickenpox pneumonia (up to 18%), and I have successfully treated two cases. One of my videos shows you encephalitis due to Chickenpox and medical students should study the video and the associated cerebellar ataxia. The skin breaks may cause a secondary bacterial infection and can be serious. Two deaths were once reported in southern California. TREATMENT: WE HAVE ACYCLOVIR, NUCLEOSIDE ANALOGUE, (ZOVIRAX®/GENERIC) AND IS MOST EFFECTIVE IF THERAPY IS STARTED WITHIN 24 HOURS OR AT THE EARLIEST SIGN/SYMPTOM. I RECOMMEND THAT YOU LOOK UP SPECIFIC ARTICLES REGARDING TREATMENT IN THE NEW ENGLAND JOURNAL OF MEDICINE AND/OR THE MEDICAL LETTER®. Patients with SHINGLES can transmit Chickenpox to susceptible hosts, and clinicians must inform patients about this possibility. SHINGLES (HERPES-ZOSTER) CAN BE SEVERE, AS CAN PRIMARY CHICKENPOX IN IMMUNOCOMPROMISED PATIENTS. Reye's Syndrome, fatty liver with encephalopathy, is seen almost exclusively in children younger than 16 years. Aspirin is contraindicated in such patients since it has been associated with an increased risk of developing Reye's syndrome. I usually do not recommend Ibuprofen (Motrin®/Advil®), an NSAID. Luis Lomeli MD

Video URL:
http://www.thedoctorsvideos.com/video/964/A-painful-rash-Varicella-Zoster-Viruz-VZV--Chickenpox


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