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This patient has been selected because prevention and control of infection is very critical in crowded institutions like prison, immigrant camps, hostels and oldage homes. Inappropriate control of infection can lead to an outbreak and shut down of the organization. The name of the patient will not be disclosed for purpose of confidentiality. The case is presented after obtaining consent for presentation and discussion.
60 year old Mr. X was imprisoned 2 months ago. One one morning, he was noticed to have fever and malaise. Within 48 hours, Mr. X developed vesicular eruptions over the thoracic region. The physician in-charge was contacted and on examination, it was confirmed that the signs and symptoms of Mr. X relate to shingles. On inquiry, Mr. X revealed that he never contracted chicken pox in childhood and he was never vaccinated for chicken pox or shingles. There was no other case identified at the time. The physician in coordination with Infection Control and Prevention Board drew some guidelines for the management of the disease and also prevention of spread of the disease to other inmates of prison and staff.
Shingles or Herpes Zoster, a viral infection caused by the virus varicella -zoster virus or VZV is a common problem in older adults like Mr. X (Cadogan, 2010). In childhood, this virus causes chicken pox. Following a clinical or sub-clinical attack in childhood, the virus remains dormant in the spinal ganglia. In adulthood, this virus can cause Shingles, which is deadlier than chicken pox. Shingles is a syndrome and is characterized by vesicular rash that is painful and unilateral. Most of the times, the distribution is dermatomal. The rash of Shingles first appears as patchy erythema with or without induration, followed by development of grouped herpetiform vesicles over the ertythematous base. However, in immunosuppression, the infection can spread and cause severe systemic illness involving of multiple organs and multiple
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