What illness prevented by proper vaccination does this toddler have?
A mother brings her 15-month-old daughter to your office for evaluation of a rash and fever. She says the rash started one day and the fever developed the next day. Her daughter has had all of her vaccinations up to 10 months. The mother sheepishly admits that she hasn't had time to bring her daughter in since her 10-month check-up. On examination you see a mildly sick-appearing toddler with a 102-degree temperature. Looking at her skin you see at least 100 of a variety of papules, vesicles, and ulcers in different stages of development.
A) Varicella (chickenpox)
B) Measles
C) Smallpox
A) Varicella (chickenpox)
Normally the first vaccine for varicella is given at 12 to 15 months. The characteristic rash in waves of lesions is in a pattern of papules, vesicles, ulcers, and scabs. Because of the number of persons who still get shingles (an outbreak of varicella in one dermatome following the original infection by years), there is still enough virus in the United States to easily get chickenpox without vaccination. This child is regarded as contagious to others until all of the lesions are “scabbed over.” Smallpox would appear different in that all of the lesions would be in the same stage of development.
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