Vaccines for Chickenpox and Measles

Chickenpox Vaccine

• The chickenpox vaccine is recommended for people 12 months of age or older.
• Two doses of the vaccine are recommended, one at 12-15 months old and another at 4-6 years old.
• People 13 years of age and older who have never had chickenpox or received the vaccine should get two doses, 28 days apart.

ProQuad Vaccine

• ProQuad is a combination vaccine that contains measles, mumps, rubella, and varicella (chickenpox) vaccines.
• It is licensed for use in children 12 months through 12 years old.

Herpes Zoster (Shingles)

• Herpes zoster is a recurrent infection caused by the reactivation, multiplication, and spread of the virus among the ganglion.
• Symptoms include:
  • Pre-eruptive phase: headache, tiredness, sensitivity to light, and fever.
  • Acute eruptive phase (2-4 weeks): rash, macules, and clusters of fluid-filled blisters that crust over.
  • Pain, burning, numbness, or tingling.
• The rash typically develops on one side of the torso, one eye, or the neck or face.
• Complications include:
  • Post-herpetic neuralgia (PHN), which is long-term nerve pain that persists after relief of blisters.
  • Reactivation increases with age, weakened immune system, and emotional stress.

Diagnosis and Treatment

• Diagnosis is made through direct fluorescent antibody (DFA) testing of vesicular fluid or a corneal lesion, and PCR.
• Treatment is usually symptomatic, but may include:
  • Oral acyclovir or valacyclovir for severe cases.
  • Analgesics, corticosteroids, and adjuvant analgesics like gabapentin or pregabalin.
  • Topical lidocaine patch 5%, gabapentin, pregabalin, opioids, tricyclic antidepressants (TCAs), and topical capsaicin cream and patch.

Avian Influenza

• Human infections with avian influenza A(H5N1) viruses were first reported in 1997 in Hong Kong.
• Human infections with avian influenza A(H7N9) viruses were first reported in 2013 in China.
• Symptoms include:
  • Flu-like symptoms
  • Conjunctivitis
  • Pneumonia
  • Severe respiratory distress
  • Death
• Prevention involves:
  • Avoiding contact with infected poultry or contaminated surfaces.
  • Hand hygiene and good food handling.

Swine Flu

• The swine flu virus is A/H1N1pdm09.
• It was declared a pandemic by the WHO in 2009, but the pandemic was declared over in 2010.
• Symptoms include:
  • Fever, cough, sore throat, body aches, headache, chills, and fatigue.
  • Vomiting and diarrhea are more common in swine flu than in seasonal flu.
  • Severe cases can lead to pneumonia, ARDS, sepsis, and death.
• Treatment involves:
  • Antivirals like oseltamivir, zanamivir, and peramivir.
  • NAIs are susceptible to M2 blockers.

Corona Viruses

• Corona viruses are positive-strand RNA viruses.
• There are four main subtypes: alpha, beta, gamma, and delta.
• Symptoms include:
  • Respiratory symptoms
  • Fever
  • Cough
  • Shortness of breath and breathing difficulties
• In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, renal failure, and even death.
• SARS-CoV was first recognized in China in 2002 and caused 774 deaths worldwide.
• Since 2004, there have been no known cases of SARS-CoV.
• Transmission occurs through:
  • Hand-to-mucus-membrane contact
  • Respiratory droplets
  • Airborne transmission
  • T-zone contact (eyes, nose, and mouth)

General Prevention Measures

• Standard recommendations to reduce exposure to and transmission of a range of illnesses include:
  • Washing hands with soap and water or using alcohol-based hand rubs.
  • Covering mouth and nose when coughing and sneezing.
  • Avoiding touching eyes, nose, and mouth.
  • Adopting safe food practices.
  • Avoiding close contact with anyone showing symptoms of respiratory illness.
  • Maintaining social distancing.
  • Practicing self-quarantine and seeking early medical care.

Rhinoviruses (Common Cold)

• Rhinoviruses are the most common cause of the common cold.
• Transmission occurs through aerosol droplets and hand-to-nose contact.
• Pathogenesis involves infection of the mucosa of the upper respiratory tract and conjunctiva.
• Symptoms include sneezing, nasal discharge, sore throat, cough, headache, and chills.
• Prevention and treatment involve:
  • No vaccination due to the large number of serotypes.
  • Symptomatic treatment with NSAIDs, antihistamines, and oral decongestants.

Respiratory Syncytial Virus (RSV)

• Transmission occurs through respiratory droplets.
• Clinical findings include:
  • Runny nose, coughing, sneezing, fever, decreased appetite, and wheezing.
  • Breathing difficulties.
• It is a very common cause of bronchitis in infants.