Herpes Varicella-Zoster Infections
Basic Information
Definition
The primary infection caused by the varicella-zoster virus is chickenpox. Reactivation of the latent varicella-zoster virus results in herpes zoster or shingles.
Epidemiology & Demographics
• It is generally spread by direct contact of virus with the upper respiratory tract or conjunctiva.
• Patients are contagious from 1 to 2 days before the onset of rash until lesions have crusted. The incubation period is 10 to 21 days or up to 28 days if varicella zoster immune globulin (VZIG) is given.
• In temperate climates, varicella has been a disease of childhood with a peak in late winter and early spring. The epidemiologic pattern is expected to change with immunization.
• Zoster is more common after 50 years of age. It is also seen in children who had varicella at a young age and in immunocompromised children.
Clinical Presentation
Varicella
• Varicella is a systemic infection characterized by fever and a generalized vesicular, pruritic rash.
• The rash typically develops in crops over 2 to 4 days, changing from papule to vesicle to crusted lesion over about 5 days.
• Infants born to mothers who develop varicella 5 days before to 2 days after delivery are at increased risk for severe disease.
• Bacterial superinfection with Streptococcus pyogenes or Staphylococcus aureus is the most frequent complication. These infections may be life threatening.
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