Epidemiology Paper Assignment: Chickenpox Essay

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Epidemiology Paper Assignment: Chickenpox Essay

Epidemiology Paper Assignment: Chickenpox Essay


Chickenpox which is also known as Varicella is a viral disease which is extremely contagious, especially among children and is characterized by an early eruption of vesicles and papules, mild constitutional disturbances and fever. It was until the late 19th century that physicians were able to distinguish chickenpox varicella from smallpox. However, in the 16th century, Giovanni Filippo made the first description of chickenpox. In 1767, William Heberden came up with a demonstration differentiating chickenpox from smallpox. Rudolf Steiner conducted further investigations and in 1875, reported that chickenpox was caused by an infectious agent, as Von Bokay made the first observation that varicella zoster is different from herpes zoster in 1909 (Adams et al., 2017). In 1954, Thomas Weller isolated the causative agent, varicella virus and Michiaki Takahashi went ahead to make the first live attenuated vaccine for the virus in 1972.

Chickenpox Description

Chickenpox is an airborne infection that is caused by the varicella-zoster virus (VZV). The virus can be transmitted from an infected person through sneezing or coughing, and inhalation of the viral particles by a healthy individual. The disease can also be spread through inhaling or touching the virus particles that have been shed from the body. Consequently, the virus can be spread by indirectly being in contact with items which were in direct contact with active blisters. People who have never contracted the disease before and have not been vaccinated are at a high risk of acquiring the infection. The virus is considered contagious within a period of one to two days before the eruption of rashes and formation of scrabs from the blisters. Symptoms might take between 14 to 16 days to appear after exposure to the virus (Lo et al., 2019). The initial symptoms resemble the common colds, such as fever, running nose, malaise, and sore throat. Immediately after the occurrence of these symptoms, the red spot will start appearing on the body. The spots usually start appearing on the scalp and trunk before spreading outward. The mucous membrane can also be affected in addition to the spots being noted along the nasal passages and the mouth. The spots then develop into vesicles as elevated bumps with clear blisters that are teardrop shaped and turn rapidly within six to eight hours to crusty lesions (Lo et al., 2019). New spots will continue to develop as the old ones heal and disappear. It takes up to 5 to 6 days for new lesions to stop developing. However, all the crusts will start disappearing after about twenty days.

Intense itching is a common symptom of chickenpox that increases an individual’s irresistible urge to scratch and may lead to complications such as cellulitis which is a skin bacterial infection. Other complications that might result from chickenpox include pneumonia, invasive group A streptococcal infection, sepsis, necrotizing fasciitis, encephalitis and Reye syndrome (Driesen et al., 2015). Most of these complications are usually developed by individuals with a poor immune system. the diagnosis of chickenpox is based on symptoms such as rash and fever. In case, the physician needs confirmation of the diagnosis, the fluid from the lesion is taken to the lab, and cultured for about 5 to 10 days.

Chickenpox treatment is based on managing the symptoms of infectious diseases, such as itchiness and fever reduction, as most cases are usually uncomplicated and take about two to three weeks to resolve themselves. An antihistamine such as Atarax and Benadryl are mainly recommended for the management of pruritis (Lo et al., 2019). Wet compresses and topical treatment are used to provide immediate relief of the blisters as the fever is managed by non-steroidal anti-inflammatory drugs such as acetaminophen or ibuprofen. The use of aspirin is, however, contraindicated as a result of the complication of Reye’s syndrome. Given that chickenpox is a viral infection, antiviral agents such as valacyclovir, famciclovir, and acyclovir are recommended in managing the infection by reducing the intensity of the itching and speeding up the healing of the skin lesions with an overall outcome of shortening the duration of the infection. For maximum effectiveness of treatment, the patient should start medication therapy within 24 hours of the initial appearance of the first rash (Lo et al., 2019). Non-pharmacological measures include taking an adequate amount of fluids and electrolytes to prevent dehydration as a result of the infection. Frequent bathing and maintaining short fingernails among other hygienic traits are recommended as the most appropriate prophylactic measure of preventing the disease.

Chickenpox vaccine, Varivax was developed in 1955 and approved by the FDA the same year. The vaccine is administered to children above 1 year old. It has proven to be 90% effective in the prevention of infection by the virus. However, for the individuals who might develop the infection even after being vaccinated, the symptoms are usually mild as compared to those who have never received the vaccine. The Varivax vaccine is also effective in protecting people against diseases such as shingles which is an extremely painful rash caused by the same virus, varicella-zoster, and lies dormant in nerve tissues around the brain and spinal cord in people with chickenpox and can easily be reactivated (Gemmill, Quach-Thanh, Dayneka, & Public Health Agency of Canada, 2016).

The manifestation of chickenpox is usually high among teenagers below the age of 15 years, with most cases among children between the age of 1 year to 4 years old. Before the vaccine was developed, varicella, was the most common disease among most children mounting to about 4 million cases annually, with an average of 105 deaths, and hospitalization of over 10,500 patients. according to the CDC, more than 95% of adults in the United States, experience the infection at least once at some point in their lifetime (Lo et al., 2019). However, the development of the vaccine reduced the morbidity and mortality of the infection dramatically, with only a few individuals being affected with mild symptoms. Implementation of the two-dose vaccine for every child older than a year has greatly reduced the outbreak of the infection.

As of 2003, the healthcare system of the united states recommended that all the cases of chickenpox infection be reported (Giesecke, 2017). The CDC recommended three initial core variables that were based on the age, severity of the disease and the vaccination status of the patient. Additionally, it was also recommended that the demographic, epidemiologic and clinical data be reported together with information regarding the outcome of the infection to the patient. The CDC formulated varicella messaging guide to help in direct documentation of information regarding the infection by respective respondents.

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Social Determinants of Health

The social determinants of health as defined by the Healthy People 2020, are the conditions within the environment in which

Epidemiology Paper Assignment Chickenpox Essay

Epidemiology Paper Assignment Chickenpox Essay

individuals are born, raised, learn, play, work, worship and age that affect a variety of human functioning, health and general quality of life, in addition to their risks and outcomes. Some examples of social determinants of health that contribute to the development of chickenpox include access to healthcare and educational services, availability of resources, public safety and cultural believes among others (Lo et al., 2019). research has also shown that personal behavior and genetic factors cannot fully explain the health disparities of infectious diseases on their own. Complex, overlapping and integrated social structures, and economic systems also need to be reviewed to be able to fully understand the morbidity and mortality of a given infectious disease (Currie, World Health Organization, & Health Behaviour in School-aged Children, 2012). People without medical health insurance covers, or who have a low income tend to be at high risk of developing chickenpox infection as they may fail to seek medical attention on a regular basis due to the high costs. Consequently, language barrier or shortages in the distribution of the vaccine to certain communities might also contribute greatly to the development and spread of chickenpox infection. Individual who are also unable to acquire proper education might also fall as victims of the infections due to lack of knowledge on the importance of vaccinating their children at the right time, and the measures that they need to take when one of their loved ones are infected. Given that chickenpox is contagious, social structures comprising of high education and public awareness is recommended to equip community members of the preventive measures such as high hygiene to prevent the spread of the virus.   

The Epidemiologic Triangle

The epidemiologic triangle is composed of three main aspects, the susceptible individual or host, the environment and the causative agent. The triangle is very crucial when analyzing the natural history of a particular disease. The information analyzed using the epidemiologic triangle is crucial especially when trying to prevent the spread of a contagious disease. For instance, controlling and preventing the spread of a contagious disease starts by identifying the weak points in the triangle to be able to eliminate the threat. This can be achieved by implementation of prevention activities in addition to enhancing the efforts of reducing the seriousness of the disease by considering variables such as severity of the disease, illness length, treatment costs, long-term and short-term effects of the disease, and the death risks as a result of the infection (Gershon, 2018). The epidemiologic triangle helps connect the link between the causative agent of chickenpox which is the varicella-zoster virus and the primary host who are the humans. It also displays the modes of transmission such as sneezing and coughing which exposes the healthy individual to respiratory droplets containing the virus, that cause infection upon inhalation. Consequently, the triangle provides a link between the times of the year when the outbreak of the infection is high. For instance, chickenpox outbreak fluctuates seasonally in temperate regions, with high cases during early spring and the months of winter. In the United States, high incidences of chickenpox are within the months of March to May and lowest from September to November. With the above information, it is important for community members to be notified in case of an outbreak to put in place preventive measures to reduce the spread of the infection.

The Role Of The Community Health Nurse

Community health nurses play a significant role in promoting the health and lifestyle of members of a given community. It is required that all community health nurses must have basic information on communicable diseases, with a clear understanding of the causative agents, a period of incubation, modes of transmission, the symptoms of the disease, the preventive measures, and the available treatment options and care plan. Having this information will help the nurse focus more on the management of the symptoms of the infection while preventing its spread. community health nurses are also required to conduct patient and community awareness on the importance of chickenpox vaccination, how it is transmitted, how to manage the symptoms at home and how to prevent the spread of the infection among community members. it is also the obligation of the community health nurse to identify chickenpox risk factors, and how to keep the community members safe from the disease. Given that chickenpox is a highly contagious disease, the community health nurse, will be required to make frequent reports using the guidelines provided by the CDC to analyze the progress of the infection, and come up with the necessary recommendation that can help reduce its morbidity (Harkness, & DeMarco, 2016). With adequate information, the community health nurse will be able to assess the treatment options that have been used to manage chickenpox and their outcome from feedback provided by community members. as such, only productive methods will be reinforced in the future with better interventions to make sure that the disease does not cause future burden in healthcare.

National Agencies And Organizations Addressing Chickenpox

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) are the main organizations which collect data and provide up to date information about chickenpox. The CDC has so far provided adequate information about presenting sign and symptoms of chickenpox, how it is transmitted, the causative agent, complications, prevention and treatment options, mortality and morbidity among others. the organization has also provided a kid-friendly fact sheet which provides information about the disease to children in a friendly and interesting manner (Lo et al., 2019). The WHO on the provides the same information as the ones provided by the CDC in addition to travel risks, and measures to be taken when traveling to a chickenpox endemic area. Additionally, there are two main foundations for chickenpox, the National Shingles Foundation and the National Foundation for Infectious Diseases (NFID). The NFID, a nonprofit organization was developed mainly to help in creating public awareness and educate healthcare professionals on the causes, prevalence, treatment, and prevention of various contagious diseases such as chickenpox. The organization is aimed at promoting the health of individuals across the globe, through education. The National Shingles Foundation, on the other hand, is also a non-profit organization focused on fighting against varicella zoster virus through education and research.

The Global Implications of Chickenpox

According to the WHO, chickenpox is an extremely contagious viral infection that is distributed worldwide. The universal childhood varicella vaccination program was introduced and implemented in the united states in 1995 to help prevent chickenpox epidemic. The vaccine is currently available across the world, but it is only in a few countries such as Germany, Korea, Japan, and Australia where coverage rates have been extensively attained (Hirose, Gilio, Ferronato, & Ragazzi, 2016). In these countries, the vaccine has been able to attain significant outcome with a great reduction in morbidity and mortality rates as a result of chickenpox. Non the less, several countries still experience a shortage of the virus, such as the third world countries, making the disease still a worldwide epidemic. The global chickenpox burden is still very high, at 4.2 million severe cases, and 4200 deaths yearly.

In conclusion, the chickenpox burden was high before the varicella zoster vaccine was discovered in 1995. The disease burden, however, decreased by about 90% between 1995 to 2005 (Hawker et al., 2018). Currently, only a few cases of the disease are being reported. However, there is still a need for continued public awareness on the importance of the vaccine, and preventive measures that can be taken to prevent the spread of the disease. New treatment options have also been introduced which are helping patients suffering from the disease manage their condition. Chickenpox is a global epidemic and needs to be addressed with more seriousness to be able to curb the disease completely.

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