Varicella - chickenpox in children and Zooster (shingles) in adult.

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Varicella is an acute disease that results after primary contact with varicella- Zooster virus, the causative agent of varicella (chickenpox) in children and Zooster in adults. Varicella-Zooster virus is an enveloped virus with icosahedral nucleocapsid and linear double-stranded DNA.

Varicella-Zooster virus

PATHOGENESIS

Transmission of varicella is primarily by respiratory droplets. Varicella is a highly contagious disease, though mild in children is characterized by generalized vesicular eruptions of the skin and mucus membrane.

Varicella- chickenpox on adult

Varicella- chickenpox on child
In adults, Zooster is not transmitted, but caused by a reactivate of latent virus. The disease, Zooster (shingles) is the response of the partially immune adult host to reactivation of dormant (latent) form of varicella virus present in sensory ganglia neurons. Zooster (shingles) is severe, more especially in immunocompromised persons. It is characterized by a rash limited in distribution to the skin which corresponds to the areas of innervations from a person's dorsal root sensory ganglion. In addition, there is an acute inflammation of the sensory nerves and ganglia. Zooster most often begins with severe pain in locations of the skin or mucosa supplied by corresponding sensory nerves and ganglia. Then after few days rashes appear over the area of skin. The most affected parts of the body are the head, neck or trunk.
The disease is experienced by individuals that are immunocompromised due to aging, disease or chemotherapy, although young healthy persons occasionally suffer from the disease.

LABORATORY DIAGNOSIS.

Specific antibody rise in titre can be detected in patients serum using immunoflorescent antibody and enzyme immunoassay. In addition, virus specific antigens or viral DNA can be detected in skin scrapings, vesicle fluid or in biopsy materials.

TREATMENT

Varicella requires no treatment in normal children but neonates and immunecompromised patients should be treated. In adult, no antiviral therapy is required in immune competent patients but in immunecompromised patient, Acyclovir can prevent dissemination.

PREVENTION

Both disease conditions have combine vaccine that contain either live, or attenuated varicella- Zooster virus vaccine. Immune comprised patients exposed to the virus should receive passive immunization with varicella-Zooster immunoglobulin (VZIG) and Acyclovir to prevent disseminated disease.
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REFERENCE

Varicella- Zooster virus
Diagnosis, treatment and prevention
Overview of varicella-Zooster