CHAPTER ONE

INTRODUCTION

1.0 General Introduction

This is a case study on chicken pox. Chicken pox is a highly contagious viral infection which is caused by the Varicella Zoster virus (WHO 2015). It affects mostly children within the age range of 0 to 14 years and sometimes adults especially people with weakened immune system. Chicken pox presents with signs and symptoms such as: itchy blister like rash on the skin which later scabs, the rash first appears on the chest, back and face and then spreads over the entire body, fever, fatigue, loss of appetite, headache, (CDC 2018). Signs and symptoms of chicken pox according to (CDC 2014) appear after an incubation period of 10 to 21 days after exposure varicella Zoster. Chicken pox can be prevented through the administration of vaccine. Therefore, this work seeks to look at case management of a patient with chicken pox.

1.1 Background to the Study

Varicella Zoster virus was isolated from vesicular fluid of chicken pox lesions in cell culture by Thomas Weller in 1954.Subsequent laboratory studies of the virus led to the development of a live attenuated varicella vaccine in Japan in 1970. This vaccine was licensed for use in the United States OF America in March 1995. The earliest clear reference to chicken pox is an emergence of its latent form as shingles also called zoster. However, Professor Neil Ferguson, head of department of infectious disease epidemiology at London Imperial College, chicken pox was caused by a small fury mammal that live around our ancestors with last case occurring about 70 years ago. He further explained that chicken pox belongs to the herpes virus family, confirming its presence in the genetic code of DNA found in all living things (CDC 2013).

Chicken pox is a disease considered to be under control since the introduction of the vaccine against varicella virus. According to (WHO 2012), varicella also known as chickenpox is a highly contagious disease caused by the Varicella Zoster Virus (VZV). It is important to note that this disease occurs worldwide in the absence of a vaccination programme and subsequent Immunization, the epidemiology of this disease differs between temperate and tropical climates and the reason accounted to this is said to be because properties of the (VZV) are sensitive to heat, climate, population etc.  This condition is highly transmissible through droplets or direct contact with chicken pox lesions. Chicken pox has a higher morbidity and mortality rate in infants and individuals who are immunocompromised. More to that, when an individual becomes infected with the varicella virus, it remains latent in nerve cells and may be reactivated causing secondary infection herpes zoster also known as ‘shingles ‘occurring in adults above 50 years. However, this can be prevented following the administration of live attenuated vaccine based on VZV strain which was developed in Japan in the 1970s (WHO 2015). Before immunization against this condition, the cases each year were almost the total number of children born (Atkinson, 2011). Chicken pox recorded about 6400`deaths globally in 2015 (GBD2015) as compared to 8900 in 1990 (GBD2013). According to Oxford University (2014), death occur in 1 out of 60000 cases.

1.2 Objectives of the Study

This case study was carried out at the Bokwaongo Integrated Health center.

 1.2.1 General Objective

To provide holistic nursing care to patient with chickenpox from the period of admission to discharge at the Bokwaongo Integrated Health center.

1.2.2 Specific objectives

1. To assess a patient with chickenpox throughout her stay in the hospital.
2. To identify the needs of patient with chickenpox during her stay in the health facility.
3. To identify the nursing interventions used in the care of patient with chicken pox during her stay in the hospital.
4. To evaluate patient’s response to care given to her throughout her stay in the health facility.
5. To educate patient on her disease condition and care given.