Herpes zoster is a common disease caused by?

ESIC Nursing Officer 2016 (shift-1)

Applied Microbiology & Infection control

Easy

Appeared in: ESIC Nursing Officer 2016 (shift-1)

Explanation

Herpes zoster (shingles) is caused by the reactivation of the Varicella-Zoster Virus (VZV), the same virus that causes chickenpox.
After a primary chickenpox infection, the virus becomes latent (dormant) in the dorsal root ganglia (sensory nerves).
Years later, often due to weakened immunity, the virus reactivates and travels along the nerve path to the skin, causing a characteristic painful, unilateral vesicular rash.

Option A: Herpes zoster is an infectious disease caused by a virus, not a primary hematologic condition. While a systemic infection can cause changes in blood counts, the origin of the disease is not in the blood.
Option C: This is a close distractor. While herpes zoster manifests with severe nerve involvement and pain (neuralgia), the root cause is the viral infection attacking the nerve. The nerve disorder is a consequence, not the primary etiology.
Option D: The development of shingles is unrelated to external skin cleanliness. It is an internal process involving the reactivation of a latent virus.

Visual 1: Diagram - Pathophysiology of Herpes Zoster. This visual should illustrate the Varicella-Zoster Virus lying dormant in the dorsal root ganglion and then reactivating and traveling down the sensory nerve to the skin to form lesions. This clarifies the link between the virus and the nerve pathway.
Visual 2: Image - Clinical Presentation of Shingles. A photograph showing the classic unilateral, vesicular rash in a dermatomal distribution on a patient's torso. This helps in recognizing the hallmark sign of the disease.

Clinical Relevance

Nursing practice connection: Knowing Etiology of Herpes Zoster (Shingles) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must prioritize prompt identification of shingles and administration of antiviral medications (e.g., acyclovir), ideally within 72 hours of rash onset, to reduce the severity and duration of the illness and decrease the risk of postherpetic neuralgia (PHN).
Pain management is a critical nursing intervention. This includes administering prescribed analgesics, suggesting cool compresses, and educating the patient to keep the lesions clean and dry to prevent secondary bacterial infections.
Infection control is important. While shingles is less contagious than chickenpox, nurses should implement contact precautions until lesions are crusted over, especially around immunocompromised patients and those who have not had chickenpox.

How to Approach the Question

First, identify the key term in the question: 'Herpes zoster' (shingles).
The question asks for the 'cause' of the disease. This requires recalling the etiology of this specific condition.
Consider each option. 'Viral infection' is a common cause of many rash-producing illnesses.
Differentiate between the cause and the effects or location of the disease. Herpes zoster strongly affects the nerves ('nerve disorder'), but this is what it affects, not what causes it.
Eliminate unlikely causes. 'Blood disorder' and 'unhygienic skin conditions' are not the known mechanisms for shingles, which is an internal reactivation.
Conclude that the primary etiological agent is a virus, making 'Viral infection' the correct answer.

Concept Tested & Keywords

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