A 12-year-old child developed fever with multiple crops of vesicular rash starting from the face spreading towards the trunk.
(I) Mention the mode of transmission and spread of the probable viral agent. Prepare a flowchart of the course of the
infection in humans. Mention three tests for laboratory diagnosis of the agent.
(II) Discuss the post-exposure preventive strategies.
The probable viral agent is Varicella-Zoster Virus (VZV), causing chickenpox.
(I) Mode of Transmission, Spread, Flowchart, and Lab Tests:
Mode of Transmission and Spread: VZV spreads primarily via airborne respiratory droplets from nasopharyngeal secretions and by direct contact with fluid from skin lesions. It is highly contagious.
Flowchart of Infection Course:
Exposure to VZV (Respiratory Droplets/Contact)
↓
Replication in nasopharynx/lymph nodes
↓
Primary Viremia (spread to reticuloendothelial system)
↓
Secondary Viremia (spread to skin and other organs)
↓
Vesicular Rash (starts face/trunk, "crops") & Fever
↓
Resolution of acute infection
↓
Latency in dorsal root ganglia
Laboratory Tests: PCR detects VZV DNA, Serology (IgM/IgG) detects acute or past infection, and DFA detects VZV antigens in lesion scrapings.
(II) Post-Exposure Preventive Strategies: Varicella vaccine within 3–5 days, VZIG within 96 hours for high-risk individuals, and antivirals like acyclovir if started early reduce severity and complications.
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