Description of the chickenpox as a communicable disease.
Chicken pox is also refers to as varicella, is a communicable disease (CDC – ACIP, 2015). Chicken pox is a viral disease and it is characterized by an itchy red rash in body which mainly begins on face then chest and eventually to the back before spreading allover the body. Herpes varicella-zoster virus causes chickenpox. The oozing blisters or bed linens of an infected person, or contact with the clothing, or droplets as a result of sneeze or cough are all means of spreading the chicken pox. The person infected by the virus will show the symptoms after ten to twenty days of exposure. A day or two days before the rashes are seen is the good period for the disease to spread. The symptoms of chickenpox are characterized with a very itching rash on the face, neck and limbs before spreading allover the body. The rash moved from a red bumps stage to vesicles (fluid-filled blisters) which eventually drain and scab over and it mostly last between seven to ten days. Vesicles are very painful and they may concentrate on the genitals, mouth and around the eyes. Chickenpox affects severely adult men than children or women. Serious complications are highest to the pregnant women who are with suppressed immune system or non-immune (Rossi et al., 2012). The fetus can be infected through placenta if the pregnant women are infected with varicella zoster virus (VZV). When infection occurs in the early stage of gestation especially on the first 28 weeks it will leads to a very fatal varicella syndrome. Complications to the fetus ranges from underdeveloped fingers and toes to malformation of bladder and anal. The other complications include damage to the eye, to brain, to body and skin disorders. Maternal infection late in gestation may lead to premature delivery. The newborns is at risk of developing chickenpox if he/she get expose to VZV and it will be very severe if the mother is not immune. Newborns with symptoms are at risk of developing a serious complications and pneumonia. Chickenpox in most cases does not require further treatment after treating the symptoms. The antiviral drug such as acyclovir when taken will shorten duration of the symptoms and they are very effective to infected pregnant women and people with weakened immune system who are also infected with the VZV. The over-the-counter painkillers and antihistamine may also be recommended by the doctor in order to relieve someone from pain, swelling and itching. Antibiotics will be recommended when secondary skin infections developed and again when a person infected with VZV developed bacterial pneumonia. Young children are more prone to chickenpox but the disease is less severe to them hence morbidity and mortality rate is low (Blackburn et al., 2014). Chickenpox incidence is less prevalence to adults but once adults are infected it is very severe. Therefore the mortality and morbidity is greater in adults than young children.
Determinants of health and how these factors contribute to the development of this disease.
Age
Chickenpox is mild and very common to young children. The treatment is more symptomatic in children and the virus will be attacked by the immune system of the body. Varicella zoster viruses (VZV) mostly infect children because they have not developed immune system against the virus since they had never get exposed to the virus before. The incident of the disease is not prevalence to adults but once infected is very severe. The antiviral drugs are recommended to adults infected with VZV to curb the development of disease.
Society and culture
Some societies and culture prefer their children to be infected with chickenpox than to be vaccinated and hence they deliberately expose them to virus. The development of the disease through this mean can be very fatal. According to doctors a weakened virus is better to be administered than contracting the chickenpox itself.
Sex
Men are rare to be attacked by chicken but after infected they suffer severely. Chickenpox in Children and women are very common but less severe. Chickenpox in adults results in other complication depending on sex of the individual. Infection may lead to bronchitis and pneumonia in both men and women (Ogunjimi et al., 2013). Infected Pregnant women may cause the unborn to have impaired or underdeveloped on some of the body parts.
Geographical location
In temperate regions it mostly affects children than adults and it occurs usually in winter and spring seasons. Countries which located along the tropical regions adults suffer from chickenpox than children.
epidemiologic triangle
Infectious agent
Microbes-viruses only
Pathegenity is the varicella zoster virus
The infective dose against the virus causing disease is varicella zoster immune globulin.
The virus can remain dormant in sensory nerves cells for many years and reactivate when the immune system is compromised.
Reservoirs
The reservoirs of the virus are mainly human beings and to a small extend some animals acts as reservoirs such as chimpanzee.
Portal of exit
Respiratory- virus can be transmitted from an infected person through respiratory system when someone sneezes or cough.
Blood-it can be transmitted when fluid of an infected person come in contact with uninfected person or remain clothes used by infected person (Ogunjimi et al., 2013).
Means of transmission
The means of transmission is both Direct and indirect.
Portal of re-entry
Respiratory-the virus is transmitted from an infected person through respiratory system when someone sneezes or coughs and eventually get inhale by a healthy person.
Blood-the virus can be transmitted when fluid of an infected person come in contact with uninfected person (Ogunjimi et al., 2013).
Susceptible host
The disease affect mainly people who are under age 15 and any other person who has never been infected with the disease. A person once expose to the virus will develop a natural immunity system against the pathogens causing infection. An artificial immunity system can be developed by inducing a weakened form of the virus to the person who has never had the virus.
Role of the community health nurse
A community health nurse plays a key role in the improvement of health of the local community. He/she is involves in giving the basic education and information on the chicken symptoms. He/ she encourages the community members to report varicella cases as fast as possible to any health care institutions and child care centers in order to facilitate quick response. This will enable the nurse and other health practitioners to take control of the chickenpox at its early stages before it become chronic. The nurse is involved in initiatives which are aimed at preventing the spread of chickenpox by working closely with the major stakeholders in the community e.g. church leaders, community leaders, parents and public administration officers. The community nurse is also involved in carrying out survey to establish the prevalence of the chickenpox within the community. This is achieved through collection of data from each and every individual who has shown the symptoms of the illness within the community. The collection of data also takes into consideration the number of households that have been affected by chickenpox. During the survey the nurse is expected to visit every health facility within the community to get reports on the patients who have received treatment on the chicken and where they live within the community. This will help the nurse to know the exact number of the patients who have received treatment and their location within the community. The location of the patient is instrumental since it would help in the follow up on the patients who have received treatment and check how the patients are responding to treatment. After collection of data, the community nurse will code the data to get the major themes of the study. The nurse is will analyze the data by using of various statistical measures to get the average of the people affected in each location of the community. The analyses will also help the nurse to know which age group or gender is vulnerable to the disease and takes appropriate action (Hockenberry et al., 2013). Lastly the nurse can joint hands with other professional bodies in health promotions and immunization programs against chickenpox in the community.
National agency which addresses the chickenpox disease and contributions in resolving or reducing the impact of disease.
The body in the United States which is concern with addressing the communicable disease is known as Advisory Committee on Immunization Practices (ACIP). It gives advice on who to be given the first and the second dose of varicella vaccine, and who is to receive both. For example they have suggested that adults with 60 years and above should be given herpes zoster vaccine (CDC – ACIP, 2015). They have researched and found out that 1 dose is enough for children with1-4 years of age and 2 doses should be administered to people with 4 years and above.
In conclusion, Chickenpox is a dangerous disease if it is left untreated. Chickenpox is treatable and the community should be encouraged to seek medical attention early enough, within the 10 days before the disease becomes chronic. Additionally, community should be educated on how to prevent the disease and where to seek help when they have been diagnosed with Chickenpox or have symptoms of the disease. Furthermore, the disease and drug are bound to change over time and hence a community health nurse and health sector in general must stay up to date on the latest immunization recommendations and the necessary precautions when giving out immunization.
References
Blackburn, F., Sharpe, D., & Ross, J. (2014). G23 (P) Increasing Rates of Complicated Chickenpox presenting to a Paediatric ED–Should Emergency Departments have a wider role in Disease Surveillance?. Archives of Disease in Childhood, 99(Suppl 1), A11-A11.
CDC - ACIP. (2015). CDC - ACIP - Advisory Committee on Immunization Practices (ACIP) Home Page - Vaccines. Retrieved from http://www.cdc.gov/vaccines/acip/
Hockenberry, M. J., & Wilson, D. (2013). Wong's Nursing Care of Infants and Children Multimedia Enhanced Version. Elsevier Health Sciences.
Ogunjimi, B., Van Damme, P., & Beutels, P. (2013). Herpes zoster risk reduction through exposure to chickenpox patients: a systematic multidisciplinary review. PloS one, 8(6), e66485.
Rossi, G., Cavazza, A., Gennari, W., Marchioni, A., Graziano, P., Caminati, A., & Colby, T. V. (2012). Chickenpox-related pulmonary granulomas in immunocompetent adults: clinicopathologic and molecular features of an underrated occurrence. The American journal of surgical pathology, 36(10), 1497-1502.
