Question about chicken pox

MelH · Oct 30, 2002

okay...I have never had the chicken pox before and my pt had or has something that resembles shingles...it has not been diagnosed but just in case he does I am asking this question. Before going into the room I had no knowlege that this pt could possibly have this (his nurses didn't know either). I have had one shot of the varicella zoster ( I am suppose to have 2..waitng on the 2nd). My question is does anyone know if the chances of me getting the virus are good? or since I had the one shot would I be okay? Do you think I have enough antibodies? Has anyone experienced this before? Just a little concerned! Thanks!

NurseDennie, BSN, RN · Oct 30, 2002

Hmmm - Interesting set of questions....

Did you have the chickenpox shot when you were younger, too? Didn't you have to have a titer to see if you have antibodies before you started clinicals?

It's hard to tell how much danger from being exposed, until you know if the person really has shingles or not. Shingles is a clinical diagnosis, and the lab tests for shingles are very expensive, so your patient probably won't have them (from my experience).

Shingles is caused by the same virus that causes chickenpox so you can't have shingles if you haven't had chickenpox. So IF you didn't have the shot (you said you didn't have chickenpox) and if your patient has shingles, then you stand a fairly bad risk of getting chickenpox whilst she/he has open blisters. Chickenpox is VERY contagious.

The virus from chickenpox doesn't go away - it goes to live in the nerve cells. In herpes simplex, it lives in the nerves right there in and around the jaw, so when a person is getting a new fever blister, he feels a tingle or burning before he gets the blister as the virus works its way through the nerve back to the skin. Same thing happens with shingles - it's just shingles because the virus goes to live in the nerve root and there's a LOT of nerve area to cause damage in on the way back to the surface.

(I was the enrollment nurse in a shingles prevention vaccination research study, so I'm "up" on shingles).

From the research study, I learned that people are pretty much 100% sure to have had chickenpox or at least been good and exposed to it if they're old enough not to have had the shot.

I know that didn't help much, as far as how to take care of your patient. The only "up" side to all that is that famvir is very effective against this virus, with minimal side-effects compared to other anti-virals.

Love

Dennie

NurseDennie, BSN, RN · Oct 30, 2002

Hmmm - Interesting set of questions....

Did you have the chickenpox shot when you were younger, too? Didn't you have to have a titer to see if you have antibodies before you started clinicals?

It's hard to tell how much danger from being exposed, until you know if the person really has shingles or not. Shingles is a clinical diagnosis, and the lab tests for shingles are very expensive, so your patient probably won't have them (from my experience).

Shingles is caused by the same virus that causes chickenpox so you can't have shingles if you haven't had chickenpox. So IF you didn't have the shot (you said you didn't have chickenpox) and if your patient has shingles, then you stand a fairly bad risk of getting chickenpox whilst she/he has open blisters. Chickenpox is VERY contagious.

The virus from chickenpox doesn't go away - it goes to live in the nerve cells. In herpes simplex, it lives in the nerves right there in and around the jaw, so when a person is getting a new fever blister, he feels a tingle or burning before he gets the blister as the virus works its way through the nerve back to the skin. Same thing happens with shingles - it's just shingles because the virus goes to live in the nerve root and there's a LOT of nerve area to cause damage in on the way back to the surface.

(I was the enrollment nurse in a shingles prevention vaccination research study, so I'm "up" on shingles).

From the research study, I learned that people are pretty much 100% sure to have had chickenpox or at least been good and exposed to it if they're old enough not to have had the shot.

I know that didn't help much, as far as how to take care of your patient. The only "up" side to all that is that famvir is very effective against this virus, with minimal side-effects compared to other anti-virals.

Love

Dennie

Vsummer1 · Oct 30, 2002

Most facilities require you to have a titer done, or proof of immunization BEFORE you can go there. I guess your facility wasn't one of those? Shame on them!

I had no record of chicken pox. But, for my physical they required a titer. You may have had these tests done for school also, could you check with them? I would not have been allowed on the floor without my proof of either the titer or the full series, which is why they send prospective students the requirements WAY in advance. Full MMR (all three titers)plus hep a & b were also required.

Vsummer1 · Oct 30, 2002

Most facilities require you to have a titer done, or proof of immunization BEFORE you can go there. I guess your facility wasn't one of those? Shame on them!

I had no record of chicken pox. But, for my physical they required a titer. You may have had these tests done for school also, could you check with them? I would not have been allowed on the floor without my proof of either the titer or the full series, which is why they send prospective students the requirements WAY in advance. Full MMR (all three titers)plus hep a & b were also required.

2MagnoliaTrees · Oct 30, 2002

I'm 37 and have never had chicken pox or the vaccine. My 2 sons have both had it and numerous children at the school I work in have had it but I've never gotten it. Had never even had a cold sore until one of my students spit in my face. YUK!!!!!!!!!!!!! I've tended to students with scabies, Indian Fire, pink eye, ringworm, and every other imaginable thing but have never gotten any of it.

2MagnoliaTrees · Oct 30, 2002

I'm 37 and have never had chicken pox or the vaccine. My 2 sons have both had it and numerous children at the school I work in have had it but I've never gotten it. Had never even had a cold sore until one of my students spit in my face. YUK!!!!!!!!!!!!! I've tended to students with scabies, Indian Fire, pink eye, ringworm, and every other imaginable thing but have never gotten any of it.

Agnus · Oct 31, 2002

I ask questions like this of the http://www.cdc.gov. If anyone has the definitive answer the do.

Agnus · Oct 31, 2002

I ask questions like this of the http://www.cdc.gov. If anyone has the definitive answer the do.

Vsummer1 · Oct 31, 2002

Originally posted by 2MagnoliaTrees
I'm 37 and have never had chicken pox or the vaccine. My 2 sons have both had it and numerous children at the school I work in have had it but I've never gotten it. Had never even had a cold sore until one of my students spit in my face. YUK!!!!!!!!!!!!! I've tended to students with scabies, Indian Fire, pink eye, ringworm, and every other imaginable thing but have never gotten any of it.

I didn't think I had it either. But the titer came back and it says I did! I must have had a very, very mild case.

Vsummer1 · Oct 31, 2002

Originally posted by 2MagnoliaTrees
I'm 37 and have never had chicken pox or the vaccine. My 2 sons have both had it and numerous children at the school I work in have had it but I've never gotten it. Had never even had a cold sore until one of my students spit in my face. YUK!!!!!!!!!!!!! I've tended to students with scabies, Indian Fire, pink eye, ringworm, and every other imaginable thing but have never gotten any of it.

I didn't think I had it either. But the titer came back and it says I did! I must have had a very, very mild case.