Chickenpox risk factors: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Bot: Removing from Primary care)
 
(33 intermediate revisions by 8 users not shown)
Line 2: Line 2:
{{Chickenpox}}
{{Chickenpox}}
{{CMG}}
{{CMG}}
{{MJM}}
{{MJM}} {{ARK}}
 
==Overview==
Risk factors which increase the likelihood of contracting [[chickenpox]] include, people without a history of [[chickenpox]] in the past, individuals who are not [[Immunization|immunized]] against [[chickenpox]], [[newborns]], especially those born [[Premature birth|prematurely]] (less than 1 month or born to mothers who never contracted [[chickenpox]] prior to [[pregnancy]]), [[immunocompromised]] individuals, [[cancer]] patients and the use of [[immunosuppressant]] drugs.


==Risk Factors==
==Risk Factors==
Risk factors which increase the likelihood of contracting [[chickenpox]] are as follows: <ref name="pmid10673675">{{cite journal |vauthors=Leung TF, Chik KW, Li CK, Lai H, Shing MM, Chan PK, Lee V, Yuen PM |title=Incidence, risk factors and outcome of varicella-zoster virus infection in children after haematopoietic stem cell transplantation |journal=Bone Marrow Transplant. |volume=25 |issue=2 |pages=167–72 |year=2000 |pmid=10673675 |doi=10.1038/sj.bmt.1702119 |url=}}</ref><ref name="pmid17391119">{{cite journal |vauthors=Miller GG, Dummer JS |title=Herpes simplex and varicella zoster viruses: forgotten but not gone |journal=Am. J. Transplant. |volume=7 |issue=4 |pages=741–7 |year=2007 |pmid=17391119 |doi=10.1111/j.1600-6143.2006.01718.x |url=}}</ref>


===High Risk Patients===
*No history of [[chickenpox]]
 
*Not [[Immunization|immunized]] for [[Chickenpox|varicella]]
Although all susceptible patients in health care settings are at risk for severe varicella and complications, certain patients without evidence of immnunity are at increased risk:
*[[Newborns]], [[Preterm birth|preterms]] and [[Infant|infants]] born to unsensitized mothers
*Pregnant women.
*[[Pregnancy]]
*[[Premature infants]] born to susceptible mothers.
*[[Premature infants|Infants born at less than 28 weeks gestation]] or who weigh less than or equal to 1000 grams regardless of maternal [[Immune System|immune]] status.
*Infants born at less than 28 weeks gestation or who weigh ≤1000 grams regardless of maternal immune status.
*[[Immunodeficiencies|Immunodeficient states]]:
*Immunocompromised persons (including those who are undergoing immunosuppressive therapy, have [[malignant]] disease, or are immunodeficient).
**[[Cancer]] patients
 
**Use of [[immunosuppressant]] drugs
====Immunocompromised Patients====
* Immunocompromised persons who get varicella are at risk of developing [[visceral dissemination]] (VZV infection of internal [[organs]]) leading to [[pneumonia]], [[hepatitis]], [[encephalitis]], and disseminated [[intravascular coagulopathy]]. They can have an atypical varicella [[rash]] with more [[lesions]], and they can be sick longer than immunocompetent persons who get [[varicella]]. The lesions may continue to erupt for as long as 10 days, may appear on the [[palms]] and [[soles]], and may be [[hemorrhagic]].
 
====People with HIV or AIDS====
*Children with HIV infection tend to have atypical rash with new crops of [[lesions]] presenting for weeks or months. [[HIV]]-infected children may develop [[chronic infection]] in which new lesions appear for more than one month. The lesions may initially be typical [[maculopapular]] vesicular lesions but can later develop into non-healing [[ulcers]] that become [[necrotic]], [[crusted]], and [[hyperkeratotic]]. This is more likely to occur in HIV-infected children with low [[CD4]] counts.
 
*Some studies have found that VZV dissemination to the [[visceral organs]] is less common in children with HIV than in other immunocompromised patients with VZV infection. The rate of complications may also be lower in HIV-infected children on antiretroviral therapy or HIV-infected persons with higher CD4 counts at the time of varicella infection. [[Retinitis]] can occur among HIV-infected children and adolescents.
 
*Most adults, including those who are HIV-positive have already had varicella disease and are VZV seropositive. As a result, varicella is relatively uncommon among HIV-infected adults.
 
====Neonates====
* Varicella infection in pregnant women can lead to viral transmission via the placenta and infection of the fetus. If infection occurs during the first 28 weeks of gestation, this can lead to fetal varicella syndrome (also known as congenital varicella syndrome). Effects on the fetus can range in severity from underdeveloped toes and fingers to severe anal and bladder malformation. Possible problems include:
 
** Damage to brain: [[encephalitis]], [[microcephaly]], [[hydrocephaly]], [[aplasia]] of brain
** Damage to the eye (optic stalk, optic cap, and lens vesicles), [[microphthalmia]], [[cataracts]], [[chorioretinitis]], [[optic atrophy]]
** Other neurological disorder: damage to cervical and lumbosacral [[spinal cord]], motor/sensory deficits, absent deep [[tendon reflex]]es, anisocoria/[[Horner's syndrome]]
** Damage to body: [[hypoplasia]] of upper/lower extremities, anal and bladder [[sphincter]] dysfunction
** Skin disorders: ([[cicatricial]]) skin lesions, [[hypopigmentation]]
 
* Infection late in gestation or immediately post-partum is referred to as neonatal varicella. Maternal infection is associated with premature delivery.  The risk of the baby developing the disease is greatest following exposure to infection in the period 7 days prior to delivery and up to 7 days post-partum. The neonate may also be exposed to the virus via infectious siblings or other contacts, but this is of less concern if the mother is immune. Newborns who develop symptoms are at a high risk of pneumonia and other serious complications of the disease. <ref name="pregnancy">{{cite web | author=Royal College of Obstetricians and Gynaecologists | title=Chickenpox in Pregnancy | url=http://www.rcog.org.uk/resources/Public/pdf/greentop13_chickenpox0907.pdf | date=September 2007 | accessdate=2008-04-12}}</ref>
 
====Pregnant Women====
*Pregnant women who get varicella are at risk for serious complications; they are at increased risk for developing [[pneumonia]], and in some cases, may die as a result of varicella.
 
*If a pregnant woman gets varicella in her 1st or early 2nd [[trimester]], her baby has a small risk (0.4 – 2.0 percent) of being born with [[congenital]] varicella syndrome. The baby may have scarring on the skin, abnormalities in [[limbs]], [[brain]], and [[eyes]], and low birth weight.
 
*If a woman develops varicella rash from 5 days before to 2 days after delivery, the newborn will be at risk for [[neonatal varicella]]. In the absence of treatment, up to 30% of these newborns may develop severe neonatal varicella infection.
 
====Infants without Passive Immunity====
 
*Children under one year of age whose mothers have had [[chickenpox]] are not very likely to catch it. If they do, they often have mild cases because they retain partial [[immunity]] from their mothers' blood. Children under one year of age whose mothers have not had [[chickenpox]], or whose inborn [[immunity]] has already waned, can get severe [[chickenpox]].


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Needs overview]]
[[Category:Viral diseases]]
[[Category:Pediatrics]]
[[Category:Poxviruses]]
[[Category:Infectious disease]]
[[Category:Overview complete]]
[[Category:primary care]]


{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Dermatology]]
[[Category:Pediatrics]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]
[[Category:Pulmonology]]

Latest revision as of 20:53, 29 July 2020

Chickenpox Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chickenpox from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT scan

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chickenpox risk factors On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Chickenpox risk factors

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chickenpox risk factors

CDC on Chickenpox risk factors

Chickenpox risk factors in the news

Blogs on Chickenpox risk factors

Directions to Hospitals Treating Chickenpox

Risk calculators and risk factors for Chickenpox risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S. Aravind Reddy Kothagadi M.B.B.S[2]

Overview

Risk factors which increase the likelihood of contracting chickenpox include, people without a history of chickenpox in the past, individuals who are not immunized against chickenpox, newborns, especially those born prematurely (less than 1 month or born to mothers who never contracted chickenpox prior to pregnancy), immunocompromised individuals, cancer patients and the use of immunosuppressant drugs.

Risk Factors

Risk factors which increase the likelihood of contracting chickenpox are as follows: [1][2]

References

  1. Leung TF, Chik KW, Li CK, Lai H, Shing MM, Chan PK, Lee V, Yuen PM (2000). "Incidence, risk factors and outcome of varicella-zoster virus infection in children after haematopoietic stem cell transplantation". Bone Marrow Transplant. 25 (2): 167–72. doi:10.1038/sj.bmt.1702119. PMID 10673675.
  2. Miller GG, Dummer JS (2007). "Herpes simplex and varicella zoster viruses: forgotten but not gone". Am. J. Transplant. 7 (4): 741–7. doi:10.1111/j.1600-6143.2006.01718.x. PMID 17391119.


Template:WikiDoc Sources