Varicella Zoster Virus (VZV)
Varicella Zoster Virus (VZV)

Varicella zoster virus (VZV) is one of eight herpes viruses known to infect humans (and other vertebrates). He often causes chickenpox in children; also disease shingles (herpes zoster) and postherpetic neuralgia (nerve pain skin) in adults.

Primary VZV infection is chickenpox (varicella), which rarely lead to complications including encephalitis (acute inflammation of the brain) or pneumonia (pneumonia). Even if the clinical symptoms of chicken pox has been resolved, VZV becomes dormant (inactive) in the nervous system of infected people (but one day could become active again). Approximately 10-20% of cases, VZV becomes active kembalii later known as herpes zoster or shingles. Serious complications of shingles include postherpetic neuralgia, zoster multiplex, myelitis (inflammation of the nerves of the brain), herpes ophthalmicus, and zoster sine herpete.

Varicella zoster virus can be latent in the nerve cell body and at small frequencies in non-neuronal satellite cells of dorsal root, in connection with cranial nerves and autonomic nerve ganglion, without causing any symptoms. In an immunocompromised individuals (low immunity), several years or decades after a chickenpox infection, the virus can reappear in the nerve cells and transmitted through the nerve axons causing skin infections in an area that contains the nerve. The virus spreads from one or more ganglia along nerves throughout the segment and infect the

dermatome (area of ​​skin supplied by the spinal cord) caused a rash illness. Although the rash can heal itself usually within two to four months, some patients experience residual pain still felt nervous for months or years, a condition called postherpetic neuralgia.

Transmission
Transmission can occur through contact with contaminated air, especially on many people in it like school. Transmission can also occur through skin touching between individuals.

Herpes zoster in the skin
Herpes zoster in the skin

The signs and symptoms
Early symptoms of shingles are headache, fever, and discomfort, these symptoms are nonspecific, and can lead to misdiagnosis. These symptoms are usually followed by a burning sensation of pain, itching, hyperesthesia (oversensitivity), or paresthesia (“agitated”: tingling, tingling, and numbness). The pain may be felt in the extreme dermatome (skin layer), the sensations are often described bebentuk spicy / hot, tingling, pain, stiff and throbbing, and can spread rapidly with a sense of tingling. In many cases, after 1-2 days (but sometimes for 3 weeks) the initial stage is followed by the characteristic appearance: skin rash. The pain and rash most often occurs in the whole body, but can appear on the face, eyes or other parts of the body. At first, the rash that appears similar to the appearance of disease Hives (Urticaria), but unlike hives, herpes zoster causes skin changes limited to the skin, usually shaped strip / line or as a pattern on the belt / belt that is limited to one side of the body and not cross the midline (?). Zoster sine herpete explain all the patients who have symptoms of herpes zoster except this characteristic rash.

Later, the rash becomes vesicular (like the texture of volcanic rock), the formation of a small rash contains fluid, fever and discomfort in the body. Vesicles (bubbles) eventually becomes gray and dark because diiisi with blood. Exfoliation occurs advance of seven to ten days later, and usually fall off and heal the skin but sometimes after a severe rash can cause scarring and skin discoloration.

Herpes may have additional symptoms, depending on the layer of skin is involved. Herpes zoster ophthalmicus appears to the eye and occurs in approximately 10-25% of cases. This is because the virus becomes active in the ophthalmic region of the trigeminal nerve. In some patients, there are also other symptoms of inflammation of the eye such as conjunctivitis, keratitis, uveitis, and optic nerve palsies that can sometimes cause chronic eye inflammation, and loss of vision. Herpes zoster oticus, also known as Ramsay Hunt syndrome type II, involves the ear. He is the spread of the virus from facial nerve to the vestibulocochlear nerve. Symptoms include hearing loss and vertigo.

Diagnosis
Can be asked at the doctor.

Treatment
The goal of treatment is to limit the progress and duration of pain, shorten the duration of episodes of shingles, and reduce complications. Treatment of symptoms is needed to prevent complications of postherpetic neuralgia.

Antiviral drugs inhibit VZV replication and reduce the ability and duration of herpes zoster with minimal side effects, but no effect for preventing postherpetic neuralgia. Aciclovir is the drug to standard treatment, but new drugs valaciclovir and famciclovir similar drugs showed efficacy over earlier than the first drug. These drugs are used both as a preventative (eg in AIDS patients) as well as therapy during the acute phase. Antiviral treatment is recommended for all individuals who are either immune to HZV their body, should be given within 72 hours after the appearance of the rash appears. Complications that occur in individuals with herpes zoster can be reduced by giving infusan + aciclovir. In people at high risk with a recurrent attack of shingles can be given the drug for five days of oral aciclovir.

Patients with mild to moderate pain can be treated with over-the-counter analgesics. Topical lotions containing calamine can be used on rashes or bubbles and soothing. Occasionally, severe pain requiring opioid drugs like morphine. After peeling lesions, can be given capsaicin cream (Zostrix). Topical lidocaine and nerve blocks development of drugs can also reduce pain.

(There are additional paragraphs, can be read / Home by clicking on the address below: ‘Herpes zoster’).

Vaccine
VZV vaccine contains a weakened virus. However, many people vaccinated as a child after will still get chickenpox disease after adult. This is because there is a possibility the vaccine does not last long in the body. So far, clinical data have shown that the vaccine could be effective for more than 10 years in preventing varicella infection in healthy individuals and breakthrough infection can occur but usually ringan.Bagaimanapun, still more people who were helped because of this vaccine. In the 80’s, the vaccine developed by Merck, Sharp & Dohme of virus strains that have been attenuated by Michiaki Takahashi and colleagues in the 70’s.

In 2006, the United States Food and Drug Administration approved Zostavax for the prevention of shingles. Zostavax is more concentrated on the Varivax vaccine formulation that is designed to get the immune response to adults because of decreased ability didapatkanya vaccine as a child because of age.

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