9 Management and prevention No specific treatment for rubella Avoidance of droplets for 7 days after rash Vaccine in non pregnant women at child bearing age and hospital
personels Avoided vaccine 1 month before pregnancy and during pregnancy No evidence that vaccine induced malformation<1%> 10 11
12 13 14 15
VARICELLA ZOSTER VIRUS Dr askari 16 Varicella zoster virus Double stranded DNA herpes virus Acquired predominantely during childhood
95% of adults have serological evidence of immunity Transmitted by direct contact or respiratory transmission
Incubation period is 10_21 days Contagious from 1 day prior to the onset rash until lesion crusted over 60_95%risk of infection after exposure in non immune women 17 Clinical manifestations 1_2 days flu like sx
Pruritic vesicular lesions crusted over 3_7days Infection tend to be more sever in adult Mortality is prodominately due to varicella pnemonia perticulary in pregnancy Pnemonia :fever,tachypnea,dry
cough,pluretic pain,nodullar 18 Diagnosis Usually diagnosed clinicaly Tzank smear Tissue culture Direct fluorescent antibody testing
In fetus with nucleic acid amplification technique on amniotic fluid 19 Fetal varicella infection Chiken pox occure during first half of
pregnancy fetus may developed congenital anomaly Congenital infection after 20 weeks are uncommon 20 Congeital varicella sx
Chorioretiniris Microphethalemia Cerebral cortical atrophy Growth restriction Hydronephrosis Skin or bone defects 21
Risk of congenital infection 0.4% before 13 weeks 2% 13_20 weeks 22 Peripartum infection
Exposure before or during delivery poses a serious threat to newborn with attack rate 25_50% and mortality rate 25% IgVZV should be administered to neonate born to mother who have clinical evidence of VZV 5 days before up to 2 days after delivery
23 Exposure to virus Exposed seronegative pregnant
women need to given varizIG within 96hrs of exposure Isolated this pregnant women from other pregnant women Considered CXR Most women require only supporative care
Pneumonia managed in hospital with IV fluid and IV acyclovir 500 mg/m2 24 vaccination Live virus vaccine: Varivax<1995> in adolescents and
adults with no history of varicella with 2 doses given 4 to 8 weeks apart with 97%seroconversion Zostavax <2006> not recommended for individuals younger than 60 years 25 26
27 28 29 30
31 32 Thanks for your attention Thanks for your attention
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