Varicella Zoster Virus: Definition & History

Instructor: Lisa Cauthen

Lisa is a Registered Nurse with a 14 years of experience and a Masters Degree in Nursing Education. She has certifications in CPN, ACLS, PALS, and NRP.

Chikenpox and shingles are commonly known to cause itchy and painful rashes in the community. This lesson will discuss the history and definition of varicella zoster virus (VZV) which can cause chickenpox and shingles.

Varicella Zoster Virus

Did you ever go to a chickenpox party? I did. It was 1983 and one child on the street came down with chickenpox. The phones begin to ring inviting everyone to a 'party' to expose all the children to chickenpox. Everyone was there, and we had a blast. That is, until a week later when we all came down with a fever and itchy, blistery rash. Gee, thanks, Mom.

Varicella zoster virus (VZV) is a member of the herpesvirus group, and like other herpesviruses, it has the ability to take a dormant state in the body following the initial infection. The primary infection from VZV is varicella, commonly known as chickenpox, while the secondary infection is herpes zoster, known as shingles. Many years can go by between the two illnesses while the virus remains dormant, but the exact amount of time varies.

VZV History

Chickenpox-like rashes were described by ancient civilizations and were long recognized as members of the herpesvirus family. However, varicella (chickenpox) was not differentiated from smallpox until the late 19th century. It was also noted at that time that there were clinical similarities between varicella and zoster. In 1954, when samples were taken from lesions from both a varicella patient and a zoster patient, VZV was identified. The name varicella comes from variola in Latin, referring to smallpox while zoster means girdle or belt in Greek.

Varicella

Chickenpox, or varicella, is the illness caused by VZV, and until the 1990s chickenpox was a common childhood infection. It is spread through droplets from the respiratory tract and causes malaise and fever for one to two days before a rash begins. The rash typically begins on the head, followed by the trunk then arms and legs. In healthy children the illness is generally mild with fever lasting two to three days total. Children with underlying medical disorders and adults may have a more severe form of the illness including respiratory and gastrointestinal problems. Complications are infrequent among healthy children, and recovery from varicella infection usually results in lifetime immunity. A second occurrence of varicella is rare.

Herpes Zoster

Shingles, or herpes zoster, is illness resulting from reactivation of the latent VZV infection. The reasons for reactivation are not well understood and vary, but they can include age, immunosuppression and having had varicella as an infant (rather than a child). Zoster illness generally presents with two to four days of localized pain and parasthesia (numbness or tingling) followed by a linear rash that follows a sensory nerve. There are few, if any, systemic symptoms of zoster. The most common complication from zoster is postherpetic neuralgia (PHN) which involves persistent pain in the area of the rash after the lesions have resolved. PHN can last a few months to several years.

Progression of Shingles
Shingles Diagram

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