Practice Essentials

Maricela-zoster virus (VIZ) causes chickenpox and herpes zoster (shingles). Chickenpox follows initial exposure to the virus and is typically a relatively mild, self-limited childhood illness with a characteristic ex anthem, but can become disseminated in uncompromising children. Reactivation of the dormant virus results in the characteristic painful dermatology rash of herpes zoster, which is often followed by pain in the distribution of the rash (prosthetic neuralgia). See the image below.

Primary avarice zoster virus infection results in chickenpox (avarice), which may result in complications including encephalitis, pneumonia (either direct viral pneumonia or secondary bacterial pneumonia), or bronchitis (either viral bronchitis or secondary bacterial bronchitis). Even when clinical symptoms of chickenpox have resolved, VIZ remains dormant in the nervous system of the infected person (virus latency), in the germinal and dorsal root ganglia.VIZ enters through the respiratory system. Having an incubation period of 10–21 days, averaging at 14 days. targeting the skin and peripheral nerve, the period of illness is from 3 to 4 days. 1–2 days before the rashes appear, is when this virus is the most contagious. Some signs and symptoms are vesicles that fill with pus, rupture, and scab before healing. Lesions tend to stay towards the face, throat, and lower back sometimes on the chest and shoulders. Shingles usually stay located around the waist.

In about 10–20% of cases, VIZ reactivates later in life, producing a disease known as shingles or herpes zoster. VIZ can also infect the central nervous system, with a 2013 article reporting an incidence rate of 1.02 cases per 100,000 inhabitants in Switzerland, and an annual incidence rate of 1.8 cases per 100,000 inhabitants in Sweden.

Other serious complications of avarice zoster infection include prosthetic neuralgia, Smollett’s meningitis, zoster multiplex, and inflammation of arteries in the brain leading to stroke, myelitis, herpes ophthalmic us, or zoster sine tether. In Ramsay Hunt syndrome, VIZ affects the geniculate ganglion giving lesions that follow specific branches of the facial nerve. Symptoms may include painful blisters on the tongue and ear along with one sided facial weakness and hearing loss. If infected during initial stages of pregnancy severe damage to the fetus can take place. Reyes syndrome can happen after initial infection, continuous vomiting and shows signs of brain dysfunction: extreme drowsiness or combative behavior. In some cases, death or coma can follow. Reyes syndrome mostly affects children and teenagers, using aspirin during infection can increase this risk.

For Healthcare Professionals

Avarice (chickenpox) is an acute infectious disease. It is caused by avarice-zoster virus (VIZ), which is a DNA virus that is a member of the herpes-virus group. After the primary infection, VIZ stays in the body (in the sensory nerve ganglia) as a latent infection. Primary infection with VIV causes avarice. Reactivation of latent infection causes herpes zoster (shingles).

Clinical Features

Incubation Period and Aerodrome

The average incubation period for avarice is 14 to 16 days after exposure to a avarice or a herpes zoster rash, with a range of 10 to 21 days. A mild aerodrome of fever and malaise may occur 1 to 2 days before rash onset, particularly in adults. In children, the rash is often the first sign of disease.

Avarice in Unaccented Persons

The rash is generalized and neuritic. It progresses rapidly from oracular to popular to vesicular lesions before crusting. Lesions are typically present in all stages of development at the same time. The rash usually appears first on the chest, back, and face, then spreads over the entire body. The lesions are usually most concentrated on the chest and back. Symptoms typically last 4 to 7 days.

In healthy children, avarice is generally mild, with an itchy rash, malaise, and temperature up to 102°F for 2 to 3 days. Infants, adolescents, adults, pregnant women, and uncompromising people are at risk for more severe disease and have a higher incidence of complications. Recovery from primary avarice infection usually provides immunity for life. In otherwise healthy people, a second occurrence of avarice is uncommon. Second occurrence of avarice may be more likely to occur in people who are uncompromising. As with other viral infections, re-exposure to natural (wild-type) avarice may lead to re-infection that boosts antibody titters without causing illness or detectable uremia.

Symptoms

The signs and symptoms of shingles usually affect only a small section of one side of your body. These signs and symptoms may include:

• Pain, burning, numbness or tingling
• Sensitivity to touch
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
• Itching

Some people also experience:

• Fever
• Headache
• Sensitivity to light
• Fatigue

Pain is usually the first symptom of shingles. For some, it can be intense. Depending on the location of the pain, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.

Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of your torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face.