Chickenpox Epidemiology and Community Health Nurse

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Chickenpox Epidemiology and Community Health Nurse

Introduction

Chickenpox, which is also referred to as Varicella, is a viral disease with considerably high rates of transmissibility and is caused by varicella zoster virus (VZV) (Bloch & Johnson, 2012; Lopez & Marin, 2016). It is worth noting that, in the recent past, chickenpox was almost considered global childhood diseases, having high morbidity and relatively high incidences of mortalities throughout the world. However, the incidences have greatly reduced after considerable use of the varicella vaccine, especially in the US (Bloch & Johnson, 2012).

Description of Chickenpox

Causes

As mentioned in the introduction, the causative agent of chickenpox is VZV, which is a double-stranded deoxyribonucleic acid classified under the family of Alphaherpesvirinae, genus and species Varicellovirus human herpesvirus 3 (HHV-3) (Goldman & King, 2013; Bayani, et al., 2013).

Symptoms of chickenpox

After the activation of the VZV virus, chickenpox may manifest in different ways in different patients. The initial symptoms manifest at the onset of the second week after contact with a host. Usually, chickenpox is manifested by abdominal pain, fever, reduced appetite, headache, and cough (Bloch & Johnson, 2012; Metanat, Alenabi, Mirshekari, & Khosravi, 2014). The initial symptoms are mostly preceded by evidence of the itchy rashes on the patients skin (Bayani, et al., 2013).

Modes of transmission

The rudimentary modes of transmission of the VZV virus include inhalation of infected air and contact with blistered soared skin (Bayani, et al., 2013). In addition, it is of paramount importance to note that exposure to body fluid, including saliva and blood, constitute a considerable percentage of total transmissions (Bakaaun & Pahor, 2014; Bakaaun & Pahor, 2014). However, pundits assert that environmental reservoirs play trivial roles in transmission (Metanat, Alenabi, Mirshekari, & Khosravi, 2014).

Complications

Notably, complications associated with chickenpox are more common in adult patients relative to child patients (Metanat, Alenabi, Mirshekari, & Khosravi, 2014; Bloch & Johnson, 2012). Nevertheless, they occur, especially when the virus is not treated on time and appropriately.

Common complications include skin and soft-tissue infections, pneumonia, fulminant liver failure with disseminated intravascular coagulation and intestinal bleeding, encephalitis, and thrombocytopenia (Papadopoulos, 2016; Metanat, Alenabi, Mirshekari, & Khosravi, 2014).

Treatment

To ease pain and severity associated with chickenpox, patients are oftentimes treated with antiviral medicines, which are generally administered within the first and the second day after rashes are evident (Metanat, Alenabi, Mirshekari, & Khosravi, 2014).

Demographics of interest (mortality, morbidity, incidence, and prevalence)

According to Goldman and King (2013), proper administration of the chickenpox vaccine could reduce 5000 fatalities and 186 million cases (over 50 years) in the US alone.

As such, it is evident that infection of VZV is considerably high, especially among children and young adults. In fact, more than 90% of all infections occur to people under 20 years, with a considerable percentage occurring in schools and children socials groupings (Papadopoulos, 2016).

It is vital noting that global chickenpox prevalence and new infections have significantly reduced, especially with the widespread use of vaccines (Bloch & Johnson, 2012).

Determinants of Health in Chickenpox

The US government and healthcare providers work in collaboration to ensure that infections, morbidity, mortality, and prevalence of chickenpox are reduced. For instance, policies that promote and foster vaccination have been enacted (Lopez & Marin, 2016). Nevertheless, cases of virus infections have not been eradicated due to various factors.

First, there are social determinants that still stimulate the spread and occurrence of chickenpox, especially among children. For instance, reports are made where parents deliberately expose their children to infected patients so that they acquire the virus and consequently acquire natural lifelong immunity, which is considered stronger and more effective than the immunity from vaccination (HealthPost, 2013).

Second, environmental factors such as seasonal climatic changes, where more incidences have been liked to late winter and the beginning of springs (Bakaaun & Pahor, 2014). In addition, exposure to the chickenpox virus is more in some environments than other physical surroundings. For instance, schools and children in social environments have higher rates of infections. Moreover, nursing homes and hospital environments have been linked to considerable rates of exposure, acquisition, and transmission, especially to health workers and other susceptible hosts (Bayani, et al., 2013; Bakaaun & Pahor, 2014).

Third, economic determinants have also been linked to the development and spread of the chickenpox virus. For instance, urban planning and the financial ability to carry out seclusion and isolation of affected cases have been associated with the aptitude of policymakers and implementers in preventing transmissions (Bakaaun & Pahor, 2014).

The Epidemiologic Triangle as it relates to Chickenpox

The transmission and development of chickenpox depend on three rudimentary elements, which together make the chickenpox epidemiological triangle. The components include the host, environment, and the agent.

Host

Human beings are the host of the chickenpox virus. The virus enters the host through inhalation of contaminated air and exposure to body fluids, especially on skin rashes of the initial host. VZV virus stays in the host in an inactive state in the sensory dorsal root ganglia. VZV virus is then reactivated, mostly by infection of herpes zoster (Bloch & Johnson, 2012).

It is worth noting that although all human beings of all ages are equally susceptible, children under 10 are at the highest risks of initial infections (Goldman & King, 2013).

Environment

The chickenpox virus is transmitted through the air and through body fluids. It is worth noting that although the environment does not play significant roles in the transmission, most infections happen in moderate temperatures, especially at the beginning of winter. In addition, it is imperative to note that environments with young children are a common transmission grounds (Bakaaun & Pahor, 2014).

Agent

As seen earlier in this paper, chickenpox is caused by Varicella-zoster virus (VZV), which moves from the host to the environment or to a susceptible host and stays relatively inactive (Bakaaun & Pahor, 2014; Bloch & Johnson, 2012). Varicella-zoster virus (VZV) is later deactivated through the exposure and infection of herpes zoster (Ogunjimi, Damme, & Beutels, 2013; Sood, 2013).

Roles of the Community Health Nurse in Managing Chickenpox

The vital roles of community health nurses in the management of chickenpox are evident (Papadopoulos, 2016; Bayani, et al., 2013).

According to Lopez and Marin (2016), case finding is critical and, therefore, nurses have a role in carrying out of surveys in populations where outbreaks are confirmed. As such, nurses should be significantly involved in the diagnosis exercises.

Moreover, nurses should be involved in the collection of key and appropriate data, including age, vaccination status, disease history, and underlying medical conditions from all the infected cases in different populations.

In addition, nurses are responsible for analyzing data collected from chickenpox cases, especially on the progress, response to treatment, chances of further transmissions, and the need for the seclusion of patients among other pertinent data. Nurses should adopt appropriate and pertinent techniques in the data analysis process to facilitate proper decision and policymaking.

Treatment and follow-up of every chickenpox case are critical since it may alleviate complications (Metanat, Alenabi, Mirshekari, & Khosravi, 2014; Bayani, et al., 2013). Therefore, community health nurses should work with other healthcare professionals to ensure that patients get accurate and appropriate treatment and medication. Further, nurses should be involved in ensuring that transmissions are minimized (Lopez & Marin, 2016).

The National Foundation for Infectious Diseases and its role in addressing Chickenpox

In the US, the National Foundation for Infectious Diseases (NFID) is one of the agencies that play significant roles in addressing chickenpox and other infectious diseases. NFID provides information to the public concerning the cause, transmission, and vaccination of Varicella.

The information is availed to the public through various means, including their website, publications, and the media. Moreover, NFID works together with other agencies like CDC to campaign for vaccination and awareness (Lopez & Marin, 2016).

Lastly, NFID works with medical practitioners and healthcare providers in the provision of treatment to reduce the severity of chickenpox (Lopez & Marin, 2016).

Conclusion

This paper has comprehensively discussed the chickenpox epidemiology where chickenpox has been described as a highly infectious viral disease caused by VZV. In addition, the symptoms, treatment, mortality, morbidity, incidence, and prevalence of chickenpox has been deliberated.

Moreover, the determinants of health and the epidemiological triangle have been discussed. Apparently, transmission of chickenpox is predominantly determined by exposure and vaccination. Moreover, chickenpox has three rudimentary elements, including the host, environment, and the VZV virus.

Finally, roles of nurses and government agencies in dealing with chickenpox have been significantly highlighted and recommended.

References

Bakaaun, V., & Pahor, . (2014). Epidemiological patterns of varicella in the period of 1977 to 2012 in the Rijeka District, Croatia. Epidemiology Research International, 2014(2014), 1-4. Web.

Bayani, M., Hasanjani-Roushan, M. R., Siadati, S., Javanian, M., Sadeghi-Haddad-Zavareh, M., Shokri, M.,& Asghari, S. (2013). Seroepidemiology of varicella zoster virus in healthcare workers in Babol, Northern Iran. Caspian Journal Internal of Medicine, 4(3), 686691.

Bloch, K. C., & Johnson, J. G. (2012). Varicella zoster virus transmission in the vaccine era: Unmasking the role of herpes Zoster. Journal of Infectious Diseases, 205(9), 1331-1333. Web.

Goldman, G., & King, P. (2013). Review of the United States universal varicella vaccination program: Herpes zoster incidence rates, cost-effectiveness, and vaccine efficacy based primarily on the Antelope Valley Varicella Active Surveillance Project data. Vaccine, 31(13), 16801694. Web.

HealthPost. (2013). HealthPost. Web.

Lopez, A. S., & Marin, M. (2016). Strategies for the Control and Investigation of Varicella Outbreaks Manual, 2008. Web.

Metanat, M., Alenabi, A., Mirshekari, H., & Khosravi, H. (2014). Acute abdomen: A rare presentation of chickenpox. International Journal of Infection, 1(2), e20622. Web.

Ogunjimi, B., Damme, P. V., & Beutels, P. (2013). Herpes zoster risk reduction through exposure to chickenpox patients: A systematic multidisciplinary review. PloS One, 8(6), e66485. Web.

Papadopoulos, A. J. (2016). Chickenpox. Web.

Sood, S. (2013). Occupationally related outbreak of chickenpox in hospital staff: A learning experience. Journal Clinical Diagnosis Reseach, 7(10), 22942295. Web.

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