Nursing management of childhood chickenpox infection.

Chickenpox is an extremely contagious infectious disease caused by varicella zoster virus (VZV). It is a common childhood illness characterised by an itchy vesicular rash and fever, which usually resolves spontaneously without medical intervention. Serious, and rarely fatal, complications can occur, including pneumonia, central nervous system infection, overwhelming secondary bacterial infections, especially with Group A streptococcus, and necrotising fasciitis. Therefore it is crucial that emergency department (ED) nurses can recognise the signs and symptoms that indicate deterioration. This article reviews best practice management of children with chickenpox, gives up-to-date guidance on the safe use of antipyretics, the avoidance of ibuprofen and discusses immunisation against VZV. It also includes implications for nursing practice and a case study that illustrates some of the challenges that ED nurses may encounter.

Impacto de la vacunación universal frente a la varicela en Navarra, 2006-2010 / Impact of universal varicella vaccination in Navarre, 2006-2010

Fundamento. En 2007 se introdujo la vacunación universalfrente a la varicela en el calendario vacunal deNavarra. Este estudio tiene por objeto evaluar el impactode dicha medida en la incidencia de varicela tanto enlas cohortes vacunadas (efecto directo), como en las novacunadas (efecto indirecto).Material y métodos. La varicela es una enfermedad dedeclaración obligatoria individualizada. Analizamos laincidencia anual por grupos de edad entre 2006 y 2010.Del conjunto mínimo básico de datos al alta hospitalariase tomaron los ingresos con diagnóstico principal de varicelao de varicela complicada de los años 2006 a 2009.Resultados. La incidencia de varicela ha disminuido un93,0%, desde 8,04 casos por 1.000 habitantes en 2006 a0,56 por 1000 habitantes en 2010 (p<0,0001). En niñosde 1 a 6 años (cohortes vacunadas), la incidencia de lavaricela ha disminuido un 96,3%. En las cohortes vacunadasa los 10 y 14 años, también se observa un descensodel 93,6% en niños de 10 a 14 años, y de un 85,0% enlos de 15 a 19 años. En los grupos de edad no vacunadosobservamos descensos del 88,2% en los niños menoresde un año, del 73,3% en los de 7 a 9 años, y del 84,6% enpersonas mayores de 20 años.En 2006 se produjeron 25 ingresos hospitalarios por varicelaen Navarra y en 2009 esta cifra descendió a 7. Latasa de ingresos descendió un 73%.Conclusión. La introducción de la vacunación universalde la varicela en Navarra ha llevado a una disminuciónrápida y muy pronunciada de la incidencia de la varicela,tanto en vacunados como en no vacunados(AU)

Background. In 2007 universal varicella vaccinationwas introduced in the childhood immunization scheduleof of Navarre. The aim of this study is to evaluate theimpact of this measure on the incidence of varicella inboth vaccinated cohorts (direct effect) and in the unvaccinated(indirect effect).Material and methods. Varicella is a notifiable disease.We analyzed the annual incidence by age groups between2006 and 2010. Hospital admissions with varicellaor complicated varicella as the principal diagnosis wereobtained from the minimum basic data set on hospitaldischarges for the years 2006 to 2009.Results. The incidence of varicella has decreased by93.0%, from 8.04 cases per 1,000 inhabitants in 2006 to0.56 per 1,000 inhabitants in 2010 (p<0,0001). In childrenfrom 1 to 6 years (vaccinated cohorts), the incidenceof varicella has fallen by 96.3%. In the cohortsvaccinated at 10 and 14 years, a decrease of 93.6% canalso be observed in children from 10 to 14 years, and of85.0% in those of 15 to 19 years. In the unvaccinated agegroups we can observe falls of 88.2% in children underone year, of 73.3% in those of 7 to 9 years, and of 84.6%in people over 20 years.In 2006 there were 25 hospital admissions due to varicellain Navarre and in 2009 this figure decreased to 7. Therate of admissions fell by 73%.Conclusion. The introduction of universal varicellavaccination in Navarre has resulted in a rapid and verysteep reduction of the incidence of varicella in bothvaccinated and unvaccinated people(AU)

Varicella exposure in a child at risk of being immunosuppressed.

The child with asthma and other atopic symptoms presents many management problems to the pediatric nurse practitioner (PNP) responsible for his or her care. When such a child has an exacerbation of asthma while concomitantly being at risk for contracting varicella after having received parenteral corticosteroids, the consequences can be devastating. The many decisions the PNP must make include modifications to current medications to keep the primary illnesses under control while considering prophylactic and other therapeutic measures to make certain that the threats to the health of the child and the family from varicella are minimized. A case example is used to illustrate the decision-making process in such a situation. Guidelines are drawn from the recent literature, including the recent guidelines on asthma management from the National Heart, Lung and Blood Institute/National Asthma Education and Prevention Program.

Varicella zoster infection in the immunocompromised child.

PURPOSE: To describe varicella zoster virus infection in the immunocompromised child and provide guidelines to decrease the risk of infection and complications for these children. POPULATION: Children infected with varicella zoster virus, particularly those with a compromised immune system. CONCLUSIONS: Varicella zoster virus infection can have serious consequences for children with malignancies and infection with the human immunodeficiency virus, as well as children on chronic steroid therapy. PRACTICE IMPLICATIONS: The advanced practice nurse often is responsible for identifying those children at increased risk for VZV infection and its complications and for planning and implementing interventions to decrease the risks to the immunocompromised child.

Chickenpox.

Although often dismissed as a minor childhood illness, chickenpox is potentially very serious if contracted by certain vulnerable adults, pregnant women or neonates. This Update examines the course of the illness and implications for nurses.

Herpes Simple y Varicela Zoster en pacientes seropositivos al VIH y SIDA. Diagnóstico en el Instituto "Pedro Kourí". Función de la Enfermera / Herpes simplex and zoster varicella in HIV and AIDS seropositive patients diagnosed at the \"Pedro Kouri\" Institute of Tropical Medicine. Nurses'role

Se realizó un estudio retrospectivo y descriptivo el cual estuvo constituído por seropositivos al VIH y SIDA y se tomó una muestra de 90 pacientes con infecciones por herpes simples y varicela zoster, a quienes se les aplicó el porcentaje. Dentro de las infecciones oportunistas, aquellas causadas por microorganismos de la familia Herpes viridae: virus del herpes simple tipo 1 y 2, varicela zoster, citomegalovirus, virus de Epstein Barr son muy frecuentes en estos pacientes. Se analizó la función de enfermería en la atención a pacientes seropositivos al VIH y SIDA con infecciones por herpes simple y varicela zoster durante un período de 2 años. La infección por herpes simple (88,8 por ciento de los casos) resultó ser la de mayor incidencia y su localización genital, la más frecuente. El 100 por ciento de las lesiones de la piel y las mucosas regresaron. Se comprueba la eficacia de los cuidados de enfermería en estas infecciones y se hace énfasis en la importancia del cumplimiento de las medidas de bioseguridad en estos pacientes

Herpes Simple y Varicela Zoster en pacientes seropositivos al VIH y SIDA. Diagnóstico en el Instituto "Pedro Kourí". Función de la Enfermera / Herpes simplex and zoster varicella in HIV and AIDS seropositive patients diagnosed at the "Pedro Kouri" Institute of Tropical Medicine. Nurses'role

Se realizó un estudio retrospectivo y descriptivo el cual estuvo constituído por seropositivos al VIH y SIDA y se tomó una muestra de 90 pacientes con infecciones por herpes simples y varicela zoster, a quienes se les aplicó el porcentaje. Dentro de las infecciones oportunistas, aquellas causadas por microorganismos de la familia Herpes viridae: virus del herpes simple tipo 1 y 2, varicela zoster, citomegalovirus, virus de Epstein Barr son muy frecuentes en estos pacientes. Se analizó la función de enfermería en la atención a pacientes seropositivos al VIH y SIDA con infecciones por herpes simple y varicela zoster durante un período de 2 años. La infección por herpes simple (88,8 por ciento de los casos) resultó ser la de mayor incidencia y su localización genital, la más frecuente. El 100 por ciento de las lesiones de la piel y las mucosas regresaron. Se comprueba la eficacia de los cuidados de enfermería en estas infecciones y se hace énfasis en la importancia del cumplimiento de las medidas de bioseguridad en estos pacientes(AU)

[Herpes simplex and varicella zoster in HIV seropositive and AIDS patients diagnosed at the "Pedro Kouri" Institute of Tropical Medicine. Nurses' role]. / Herpes simple y varicela zoster en pacientes seropositivos al VIH y SIDA. Diagnosticado en el Instituto "Pedro Kourí". Función de la enfermera.

A retrospective and descriptive study composed of HIV and AIDS seropositive patients was conducted, 90 patients with infections caused by herpes simplex and zoster varicella were taken as a sample. Percentage was applied to them. Within the opportunistic infections, those caused by microorganisms from the Herpes viridae family, such as herpes simplex virus type I and II, cytomegalovirus, hoster varicella, and Epstein Barr's virus are very frequent among these patients. The nursing role in the attention to HIV and AIDS seropositive patients with infections produced by herpes simplex and zoster varicella was analyzed during two years. Herpes simplex infection (88.8% of the cases) showed the highest incidence and its genital localization was the most frequent one. 100% of the lesions of the skin and of the mucous membranes were cured. The efficiency of nursing care in these infections was proved and emphasis was made on how important it is to fulfil the biosafety measures with these patients.

Childhood chickenpox: its impact on child and family.

Sixty-nine parents took part in nine discussion groups designed to explore the effect of childhood chickenpox on the behaviour of the affected child, on family routines and on the parents themselves. Although most parents thought of chickenpox as a relatively trivial illness, it was found that there was considerable disruption to family organization and plans and, often, great strain was imposed on a parent, usually the mother. Some families incurred extra financial burdens in terms of time taken from work, the purchase of over the counter preparations, childminders and special treats for the sick child. It was apparent that parents needed more information and reassurance about the nature and course of the illness.

Varicella encephalitis.

Varicella or chickenpox is a common, generally benign contagious disease caused by the varicella-zoster virus. The high degree of communicability of chickenpox during early childhood (generally 2-8 years of age) can be appreciated by the presence of protective antibodies in 85-90% of children. Although considered to be a mild disease, reported cases of severe and life-threatening complications such as encephalitis have been reported. Treatment involves the use of antiviral agents such as acyclovir. The role of the nurse in the care of the child with varicella encephalitis is to assist a family toward a sense of structure and feeling of helping through prearranged teaching times, structured communication and promoting family involvement in every facet of the child's recovery.