By Mae Lyn M.

Caberte
 Chickenpox is a common childhood skin
disease caused by a viral infection. The virus
involved is called the varicella-zoster virus.
Today, chickenpox is less common in the
United States due to universal vaccination
with the varicella virus vaccine, though it
still occurs in populations that are not
routinely vaccinated. Varicella-zoster virus is
often categorized with the other common so-
called "viral exanthems" (viral rashes) such as
measles (rubeola), German measles
(rubella), fifth disease (parvovirus B19),
mumps virus, and roseola (human herpesvirus
6), but these viruses are unrelated except for
their tendency to cause rashes.
 Symptoms tend to appear 14 to 16 days after the
initial exposure but can occur anytime from 10
days up to 21 days after contact with the virus.
Chickenpox is characterized by one to two days
of mild fever up to 102 F, general weakness, and
a rash, often the first sign of the disease. Rarely,
a person may have the disease without the rash.
The rash of chickenpox develops in crops with
raised red spots arriving first, progressing to
blisters that burst, forming open sores, before
crusting over. This process usually starts on the
scalp, then the trunk (its area of greatest
concentration), and finally the arms and legs.
Any area of skin that is irritated (by diaper rash,
poison ivy, eczema, sunburn, etc.) is likely to be
hard hit by the rash. The rash is typically very
itchy (pruritic).
 Chickenpox is very highly contagious. It is
easily passed between members of families
and school classmates through airborne
particles, droplets in exhaled air, and fluid
from the blisters or sores. It also can be
transmitted indirectly by contact with
articles of clothing and other items exposed
to fresh drainage from open sores. Patients
are contagious up to five days (more
commonly, one to two days) before and five
days after the date that their rash appears.
When all of the sores have crusted over, the
person is usually no longer contagious.
 Most of the treatments for chickenpox are
aimed at decreasing the symptoms, such as
severe itching. Acetaminophen (Tylenol) can
be used to decrease the fevers and aches
often associated with the initial presentation
of the viral infection. Children should never
be given acetylsalicylic acid (Aspirin) or
aspirin-containing cold medications because
of the risks for developing Reye's syndrome
(a severe acquired metabolic disease
associated with liver and brain dysfunction
and death).
 Complications can and do occur from chickenpox.
Infection of the open pox sore by bacteria can injure the
skin, sometimes causing scarring, especially if the patient
scratches the inflamed area. Bacterial skin infection is, in
fact, the most common complication of chickenpox in
children. The next most common complications in children
affect the central nervous system and include a disorder of
the cerebellar portion of the brain (cerebellar ataxia with
wobbliness, dizziness, tremor, and altered speech),
encephalitis (inflammation of the brain with headaches,
seizures, and decreased consciousness), damaged nerves
(nerve palsies), and Reye's syndrome, a potentially fatal
combination of liver and brain disease that can be
associated with aspirin. (Children with fever should not
take aspirin.) Especially serious complications can occur in
patients with AIDS, lupus, leukemia, and cancer.
Complications also occur in people taking immune-
suppressing drugs, such as cortisone-related medications.
Newborn infants whose mothers have chickenpox in the
last trimester of pregnancy are at increased risk from the
disease. If the mother develops the disease from five days
before to two days after delivery, the fatality rate for the
baby is up to 30%.
 Most people develop lifetime immunity to chickenpox
after the first occurrence and never experience it
again. But the virus can sometimes resurface later in
life as shingles (zoster). The current aim in the U.S.
and many other countries is to achieve universal (or
nearly universal) immunization of children with the
chickenpox vaccine. The vaccination requires only
two shots. The first vaccination is given at about 1
year of age, and the second (booster) is given at 4
years of age. If an older person has not had
chickenpox, the shot may be given at any time. There
have been few significant adverse reactions to the
chickenpox vaccine. All children, except those with a
compromised immune system, should have the
vaccination. Vaccination has been associated with a
90% decrease in the incidence of chickenpox and
significantly lower complication rates in those who do
develop the symptoms.
 Dengue fever is a disease caused by a family
of viruses that are transmitted by
mosquitoes. It is an acute illness of sudden
onset that usually follows a benign course
with symptoms such as headache, fever,
exhaustion, severe muscle and joint pain,
swollen glands (lymphadenopathy), and rash.
The presence (the "dengue triad") of fever,
rash, and headache (and other pains) is
particularly characteristic of dengue. Other
signs of dengue fever include bleeding gums,
severe pain behind the eyes, and red palms
and soles.
 Dengue goes by other names, including
"breakbone" or "dandy fever." Victims of dengue
often have contortions due to the intense joint
and muscle pain, hence the name breakbone
fever. Slaves in the West Indies who contracted
dengue were said to have dandy fever because of
their postures and gait.
 Dengue hemorrhagic fever is a more severe form
of the viral illness. Manifestations include
headache, fever, rash, and evidence of
hemorrhage in the body. Petechiae (small red or
purple blisters under the skin),
bleeding in the nose or gums, black stools, or
easy bruising are all possible signs of
hemorrhage. This form of dengue fever can be
life-threatening and can progress to the most
severe form of the illness,
dengue shock syndrome
 After being bitten by a mosquito carrying the virus, the
incubation period ranges from three to 15 (usually five to
eight) days before the signs and symptoms of dengue
appear. Dengue starts with chills, headache, pain upon
moving the eyes, and low backache. Painful aching in the
legs and joints occurs during the first hours of illness. The
temperature rises quickly as high as 104 F (40 C), with
relative low heart rate (bradycardia) and
low blood pressure (hypotension). The eyes become
reddened. A flushing or pale pink rash comes over the face
and then disappears. The glands (lymph nodes) in the neck
and groin are often swollen.
 Fever and other signs of dengue last for two to four days,
followed by a rapid drop in body temperature
(defervescence) with profuse sweating. This precedes a
period with normal temperature and a sense of well-being
that lasts about a day. A second rapid rise in temperature
follows. A characteristic rash appears along with the fever
and spreads from the extremities to cover the entire body
except the face. The palms and soles may be bright red
and swollen.
 Because dengue fever is caused by a virus, there
is no specific medicine or antibiotic to treat it.
For typical dengue, the treatment is purely
concerned with relief of the symptoms
(symptomatic). Rest and fluid intake for
adequate hydration is important. Aspirin and
nonsteroidal anti-inflammatory drugs should only
be taken under a doctor's supervision because of
the possibility of worsening hemorrhagic
complications. Acetaminophen (Tylenol) and
codeine may be given for severe headache and
for the joint and muscle pain (myalgia).
 Typical dengue is fatal in less than 1% of cases.
The acute phase of the illness with fever and
myalgias lasts about one to two weeks.
Convalescence is accompanied by a feeling of
weakness (asthenia), and full recovery often
takes several weeks.
 The transmission of the virus to mosquitoes
must be interrupted to prevent the illness.
To this end, patients are kept under
mosquito netting until the second bout of
fever is over and they are no longer
contagious.
 The prevention of dengue requires control or
eradication of the mosquitoes carrying the
virus that causes dengue. In nations plagued
by dengue fever, people are urged to empty
stagnant water from old tires, trash cans,
and flower pots. Governmental initiatives to
decrease mosquitoes also help to keep the
disease in check but have been poorly
effective.
 To prevent mosquito bites, wear long pants and
long sleeves. For personal protection, use
mosquito repellant sprays that contain DEET
when visiting places where dengue is endemic.
Limiting exposure to mosquitoes by avoiding
standing water and staying indoors two hours
after sunrise and before sunset will help. The
Aedes aegypti mosquito is a daytime biter with
peak periods of biting around sunrise and sunset.
It may bite at any time of the day and is often
hidden inside homes or other dwellings,
especially in urban areas.
 There is currently no vaccine available for
dengue fever. There is a vaccine undergoing
clinical trials, but it is too early to tell if it will
be safe or effective. Early results of clinical
trials show that a vaccine may be available by
2012.
 Personal protective equipment (PPE) is used
by healthcare providers to protect
themselves from injury or infection. There is
personal protective equipment to keep
rescuers safe from physical injuries, from
chemical hazards, and from infection. Lay
rescuers should follow their professional
counterparts by practicing universal
precautions and using PPE to provide
protection from infection when assisting
victims in an emergency.
The best way to prevent the spread
of disease is to wash hands with
soap and warm water after every
contact with a medical victim.
Unfortunately, soap and water are
not always available. Make sure
your medical supplies include a
form of waterless hand cleaner.
Exam gloves come in three common
types: latex, nitrile, and vinyl. Many
people develop allergies to the
protein found in latex. Nitrile and
vinyl are much more hypoallergenic.
Find out more about exam gloves.
Many lay rescuers do not want to
perform the rescue breathing part
of CPR because of the close contact
required with the victim. The best
way to avoid that squeamish feeling
is to be prepared. CPR masks
provide an important barrier
between rescuer and victim.
Blood or other potentially infectious
material sprayed or splashed in the
face of a rescuer can enter the
mouth or nose and spread an
infection. Use a face mask
whenever blood or other body fluids
may become airborn.
Protect your eyes from injury as
well as infection by obtaining the
correct type of eye protection.
Rescuers can choose from
combination mask and eye
protection that does not provide
protection from injury, or they can
choose more robust protection. Pick
the correct eye protection for you.
Contaminated sharps must be
deposited into a puncture-proof
container. These containers protect
sanitation workers from injury as
well as other rescuers.
Full-body gowns are not used very
often outside of the hospital. There
is no good reason for this, it is just
common practice across the
country. Put the correct gown in
your first aid kit and avoid the need
to dispose of your favorite shirt or
blouse.
Contaminated waste should be
placed into a red, bio-hazardous
waste container to distinguish it
from regular garbage. When working
with an ambulance, it is common
for the ambulance crew to allow lay
rescuers to dispose of their
contaminated items in the
ambulance's bio-hazard container.
“Prevention is better than
cure.”

Desiderius Erasmus
Caberte, Mae Lyn M.