NAME : RUDIANTO YUDA ASMARA

PRODI S1 KEPERAWATAN
TK II SEMESTER IV
M. KULIAH : ENGLISH

TUBERCULOSIS
1. Background of the problem
Chickenpox is a highly contagious disease caused by primary infection with varicella
zoster virus (VZV). It usually starts with vesicular skin rash mainly on the body and head rather
than at the periphery and becomes itchy, raw pockmarks, which mostly heal without scarring. On
examination, the observer typically finds skin lesions at various stages of healing and also ulcers
in the oral cavity and tonsil areas. Children are most commoly found with this disease.
Chickenpox is an airborne disease which spreads easily through coughing or sneezing by
ill individuals or through direct contact with secretions from the rash. A person with chickenpox
is infectious one to two days before the rash appears. They remain contagious until all lesions
have crusted over (this takes approximately six days). Immunocompromised patients
are contagious during the entire period as new lesions keep appearing. Crusted lesions are not
contagious.
Chickenpox has been observed in other primates, including chimpanzees and gorillas.
The origin of the term chicken pox, which is recorded as being used since 1684, is not
reliably known. It has been said to be a derived from chickpeas, based on resemblance of the
vesicles to chickpeas, or to come from the rash resembling chicken pecks.Other suggestions
include the designation chicken for a child (i.e., literally 'child pox'), a corruption of itchingpox, or the idea that the disease may have originated in chickens. Samuel Johnson explained the
designation as "from its being of no very great danger

2. Definition
Chickenpox is highly infectious. The virus spreads from person to person by direct
contact or through the air by coughing or sneezing. It takes from 10-21 days after contact with an
infected person for someone to develop chickenpox. People with chickenpox are contagious a
day or two before the rash appears and until all blisters have formed scabs.
In children, chickenpox most commonly causes an illness that lasts about 5-10 days.
Children usually miss 5 or 6 days of school or childcare due to their chickenpox. Their symptoms
may include high fever, severe itching, an uncomfortable rash, dehydration, and headache. About
1 child in 10 has a complication from chickenpox -- infected skin lesions, other infections,
dehydration from vomiting or diarrhea, exacerbation (worsening) of asthma and pneumonia -that is serious enough to warrant a visit to the doctor.
Certain people are especially likely to have a serious illness from chickenpox. These atrisk groups include infants, adolescents, and adults and people with weak immune systems from
either illnesses or from medications such long-term steroids or chemotherapy.
Chickenpox has nothing at all to do with chicken. The name was meant to distinguish this
"weak" form of the pox from smallpox. "Chicken" is used here, as in "chickenhearted," to mean
weak or timid. The "pox" of chickenpox is no major matter unless it becomes infected (through
scratching) or occurs in an immunodeficient person.
However,

there

can

be

very

major

problems

from

chickenpox

includingpneumonia and encephalitis and reactivation of the same herpes virus is responsible
for shingles (zoster).

Chickenpox

is

responsible

for

more

deaths

than measles (rubeola), mumps, whooping cough (pertussis) and H. flu (Haemophilus influenzae
type B) meningitis combined. Contrary to what many people believe, chickenpox is by no means
a mild disease.
A healthy person can die from the disease. From 1990 to 1994, before there was a vaccine
available, there were about 50 chickenpox deaths in children and 50 chickenpox deaths in adults

every year in the US. Most of these persons were healthy or did not have a medical illness such
as cancer that placed them at higher risk of getting severe chickenpox. Most of the healthy adults
who die from chickenpox contract the disease from their unvaccinated children.
The current aim in the US is to achieve universal (or come as close as possible to
universal) immunization of children with the chickenpox vaccine. The rationale for
childhood chickenpox vaccination is not just to protect the children but also to protect everyone
with whom they come in contact, including adults (who can die from the chickenpox) and
pregnant women (so that the unborn baby does not get chickenpox). Because chickenpox in
children is usually not serious, some people think it is safe to let children get the disease.
However, it is never possible to predict who will have a mild case of chickenpox and who will
have a serious or even deadly case of disease. Now that there is a safe and effective vaccine
available, it is not worth taking this risk.
A person can get chickenpox more than once but it is uncommon to do so. For most
people, one infection is thought to confer lifelong immunity.
3. Causes and symptoms
The early (prodromal) symptoms in adolescents and adults are nausea, loss of appetite,
aching muscles, and headache. This is followed by the characteristic rash and/or oral
sores,malaise, and a low-grade fever that signal the presence of the disease. Oral manifestations
of the disease (enanthem) not uncommonly may precede the external rash (exanthem). In
children the illness is not usually preceded by prodromal symptoms, and the first sign is the rash
or the spots in the oral cavity. The rash begins as small red dots on the face, scalp, torso and
upper arms and legs; progressing over 1012 hours to small bumps, blisters andpustules;
followed by umbilication and the formation of scabs.
At the blister stage, intense itching is usually present. Blisters may also occur on the
palms, soles, and genital area. Commonly, visible evidence of the disease develops in the oral
cavity & tonsil areas in the form of small ulcers which can be painful or itchy or both; this
enanthem (internal rash) can precede the exanthem (external rash) by 1 to 3 days or can be
concurrent. These symptoms of chickenpox appear 10 to 21 days after exposure to a contagious

person. Adults may have a more widespread rash and longer fever, and they are more likely to
experience complications, such as varicella pneumonia
Because watery nasal discharge containing live virus usually precedes both exanthem
(external rash) and enanthem (oral ulcers) by 1 to 2 days, the infected person actually becomes
contagious one to two days prior to recognition of the disease. Contagiousness persists until all
vesicular lesions have become dry crusts (scabs), which usually entails four or five days, by
which time nasal shedding of live virus also ceases.
Chickenpox is rarely fatal, although it is generally more severe in adult men than in
women or children. Non-immune pregnant women and those with a suppressed immune system
are at highest risk of serious complications. Arterial ischemic stroke (AIS) associated with
chickenpox in the previous year accounts for nearly one third of childhood AIS. The most
common late complication of chickenpox is shingles (herpes zoster), caused by reactivation of
the varicella zoster virus decades after the initial, often childhood, chickenpox infection.
4. Medical Treatment
Treatment mainly consists of easing the symptoms as there is no actual cure of the
condition. Some treatments are however available for relieving the symptoms while the immune
system suppresses the virus in the body. As a protective measure, patients are usually required to
stay at home while they are infectious to avoid spreading the disease to others. Also, sufferers are
frequently asked to cut their nails short or to wear gloves to prevent scratching and to minimize
the risk of secondary infections.
The condition resolves by itself within a couple of weeks but meanwhile patients must
pay attention to their personal hygiene. The rash caused by varicella zoster virus may however
last for up to one month, although the infectious stage does not take longer than a week or two.[36]
Although there have been no formal clinical studies evaluating the effectiveness of
topical application of calamine lotion, a topical barrier preparation containing zinc oxide and one
of the most commonly used interventions, it has an excellent safety profile. It is important to
maintain good hygiene and daily cleaning of skin with warm water to avoid secondary bacterial
infection. Scratching may also increase the risk of secondary infection.

Acetaminophen (paracetamol) but not aspirin may be used to reduce fever. Aspirin use by
someone with chickenpox may cause the serious, sometimes fatal disease of the liver and
brain, Reye syndrome. People at risk of developing severe complications who have had
significant exposure to the virus may be given intra-muscular varicella zoster immune globulin
(VZIG), a preparation containing high titres of antibodies to varicella zoster virus, to ward off the
disease.

Children

If oral acyclovir is started within 24 hours of rash onset it decreases symptoms by one
day but has no effect on complication rates. Use of acyclovir therefore is not currently
recommended for immunocompetent individuals (i.e., otherwise healthy persons without known
immunodeficiency or on immunosuppressive medication). Children younger than 12 years old
and older than one month are not meant to receive antiviral medication unless they are suffering
from another medical condition which would put them at risk of developing complications.
Treatment of chickenpox in children is aimed at symptoms while the immune system
deals with the virus. With children younger than 12 years cutting nails and keeping them clean is
an important part of treatment as they are more likely to scratch their blisters more deeply than
adults. Aspirin is highly contraindicated in children younger than 16 years as it has been related
with a potentially fatal condition known asReye's syndrome.
Some parents believe that it is better for children to contract chickenpox than to get the
vaccine, and they deliberately expose their children to the virus, sometimes by taking them to
"chickenpox parties." Some doctors counter that children are safer getting the vaccine, which is a
weakened form of the virus, than getting the disease, which can be fatal

Adults

Infection in otherwise healthy adults tends to be more severe. Treatment with

Adults are also advised to increase water intake to reduce dehydration and to relieve headaches.
Painkillers such asparacetamol (acetaminophen) are also recommended as they are effective in
relieving itching and other symptoms such as fever or pains. Antihistamines relieve itches and
may be used in cases where the itches prevents sleep, because they are also sedative. As with
children, antiviral medication is considered more useful for those adults who are more prone to
develop complications. These include pregnant women or people who have a weakened immune
system.
Sorivudine, a nucleoside analogue has been reported to be effective in the treatment of
primary varicella in healthy adults (case reports only), but large-scale clinical trials are still
needed to demonstrate its efficacy.
After recovering from chickenpox, it is recommended by doctors that adults take one
injection of VZV immune globulin and one injection of varicella vaccine or herpes zoster
vaccine.

Preventions
http://en.wikipedia.org/wiki/Chickenpox
http://www.medterms.com/script/main/art.asp?articlekey=2702