Chickenpox is considered one of the most common infectious diseases - it is a disease that in most cases occurs in childhood; adults are less likely to suffer from this disease. This disease is difficult to confuse with another, since it has characteristic symptoms in the form of watery rashes all over the body that cause itching.
With proper and timely treatment, the disease goes away very quickly, but scratching the acne may leave unsightly small scars on the body. As a rule, people suffer from the disease once in a lifetime, after which the body produces cells that are able to fight the chickenpox virus.
Relapses are possible in exceptional cases, when the first time the disease was mild.
What is chickenpox?
Chickenpox (varicella) is an infectious disease that develops acutely and is characterized by the appearance of a number of specific symptoms. The disease is very contagious, therefore, when the first symptoms appear, a quarantine regime for the patient is recommended.
The carrier of chickenpox is the Varicella Zoster virus, and the disease is transmitted by airborne droplets, so all people who have been in contact with the patient, have not been vaccinated against the disease and have not had it are at risk.
The disease goes through several stages of development, which are characterized by special symptoms. Chickenpox stages:
- Infection and incubation period. At this stage, the virus enters the body, most often through the mucous membrane of the mouth or nose. During the incubation period, the disease does not manifest itself in any way, there are no signs and the person is not contagious.
- The first symptoms of chickenpox. The virus develops in cells and the immune system begins to actively fight it, which provokes an increase in temperature and headache. From the onset of the first symptoms, a person becomes infectious to others, so he should be quarantined.
- Acute stage of disease development. At this stage, nerve cells and skin are damaged, and the first rashes appear.
- The final stage is characterized by an improvement in general health, normalization of temperature and the cessation of the appearance of skin rashes. The person no longer poses a threat to others and he can return to his usual way of life.
There are several forms of chickenpox, typical and atypical, the latter, in turn, is divided into several types:
- The rudimentary form develops in those who received an injection of immunoglobulin during the incubation period, as well as in children who have residual immunity. This type of chickenpox is characterized by a mild course of the disease, the rash appears in minimal quantities, and there is no fever or deterioration in health.
- Hemorrhagic. A severe form of the disease that occurs in people with immunodeficiency or those taking hormones. The main characteristic symptoms are very high temperature, pronounced intoxication of the body, hemorrhage in the skin and nosebleeds are often observed. The main danger of this form is the high probability of death.
- Visceral form. This type appears in premature infants, newborns, and people with immunodeficiency syndrome. The form is characterized by a severe and prolonged course, a prolonged period of fever and profuse skin rashes. Damage to internal organs and the nervous system is often observed.
- Gangrenous form. A rare form of chickenpox, which is characterized by high intoxication, a long period of treatment and the appearance of large rashes on which crusts with necrosis form in a short time. After the crusts fall off, ulcers and scars remain. As a rule, this form is characterized by a complication in the form of sepsis, and often the disease ends in death.
Causes of chickenpox development
The main cause of chickenpox is infection with a virus.
In medicine at the moment there is no clear answer why some people become infected with chickenpox and others do not, but a significant factor in infection is weakened immunity. The reasons contributing to the development of the disease include:
- Weakened immunity, which can be caused by various factors: chemotherapy, the presence of immunodeficiency, a child’s weakened body, taking medications of a certain group, for example, antibiotics.
- Close contact with a person who is a carrier of the chickenpox virus and is sick with this disease.
- Lack of chickenpox vaccination.
Signs of chickenpox
The first symptoms of chickenpox may appear 10-20 days after contact with a patient and are expressed by the following signs:
- A significant increase in body temperature up to forty degrees, the appearance of fever.
- Enlarged lymph nodes.
- The appearance of a headache.
- Lack of appetite, general weakness of the body.
- Chickenpox rash is a specific sign of the disease. By its nature, it consists of a huge number of single blisters filled with liquid, which are very itchy and cause a lot of discomfort. Initially, blisters appear on the mucous membranes, stomach and face, after which they spread throughout the body. The appearance of new blisters and the persistence of a high temperature can last for several days, after which all symptoms subside and only an itchy rash remains, which also goes away with time. It is important to remember that it is strictly forbidden to scratch the blisters, otherwise scars may remain.
In adults, the disease is much more complex and severe: very high fever that persists for a long time; profuse rashes, localized on the mucous membranes. Often patients with this diagnosis are hospitalized and treated under the supervision of doctors.
Diagnosis of chickenpox
Diagnosing the disease is very simple based on specific signs (the appearance of a rash and fever), which can be done independently at home.
To obtain advice and confirm the diagnosis, you must seek help from a pediatrician or therapist (you should not go to the hospital to prevent the spread of the disease, but call a doctor at home).
Chickenpox treatment
You can treat chickenpox at home on your own if there are no complications.
After examining the patient, the doctor prescribes a number of medications and gives recommendations that will help alleviate the patient’s condition. The main thing is to correctly follow all the doctor’s recommendations and not scratch the skin to avoid infection or the formation of unsightly scars. How to treat chickenpox at home:
- Taking antihistamines that will help alleviate the patient's condition will relieve itching. These drugs include: Diazolin, Suprastin, Loratadine. The dosage of antiallergy drugs is prescribed by a doctor and depends on the patient’s age, the number of rashes and other factors.
- Medicines that normalize body temperature. It is important to remember that it is strictly forbidden for a child to give medications containing aspirin (acetylsalicylic acid), since such medications can lead to the development of a dangerous disease - Reye's syndrome. For children, Paracetomol, Panadol, Nurofen are most often used.
- Taking soothing baths will also help relieve itching. For preparation, you can use oatmeal, ground into powder and added to water, or soda.
- Antiviral therapy: Acyclovir, Famciclovir, Herpevir. Taking drugs in this group can reduce the manifestation of symptoms.
- It is important to maintain hygiene: change bed linen and clothes often; Wipe the rash thoroughly to prevent infection.
- Using brilliant green or a solution of potassium permanganate will help dry the blisters and speed up the drying process. In addition, such treatment will help monitor the appearance of new rashes and track the moment of the appearance of the last blisters.
- If there are rashes in the oral cavity, you should rinse your mouth with furatsilin, an infusion of herbs (calendula, oak bark). In addition, you should not eat spicy, overly salty or sour foods. If the conjunctiva is affected, instilled interferon should be used.
- Drink plenty of fluids to remove toxins from the body, restore hydration and improve overall health.
- Ultraviolet treatment is used after crusts have formed - this procedure will speed up the exfoliation process.
In the absence of timely treatment, complications may develop that will cause significant harm to health. They are much less common in children, since they are all vaccinated against chickenpox and their body copes with the disease faster.
In older people, the development of complications is very common, and men suffer the disease much more severely than women.
Chickenpox is especially dangerous during pregnancy, since infection in the first trimester can provoke infection of the fetus and lead to pathological changes in the fetus.
Being in an interesting position, girls should limit contact with people with chickenpox, even if they themselves have already been sick or have been vaccinated.
Frequently asked questions about chickenpox
Is it possible to get chickenpox a second time?
Recurrence of chickenpox is extremely rare, because, as a rule, after an illness, immunity to the chickenpox virus is developed. Most often, people who have a significantly weakened immune system (in particular, HIV-infected people, those with leukemia after chemotherapy, and those with donor organs) get sick for the second time.
- What to apply to chickenpox?
- What is the incubation period for chickenpox?
- How to treat chickenpox in adults?
To quickly heal blisters, doctors recommend using a 1% alcohol solution of brilliant green or a 5% solution of potassium permanganate.
Lubricating the rash will prevent the development of infection and speed up the drying of the crust. Rubbing the skin with glycerol or water with vinegar or alcohol will help reduce itching. It may take 10-21 days from the moment of contact with a sick person until the first signs appear.
Treatment of chickenpox in adults includes basic therapy, as in children (antihistamines, antivirals, drugs to reduce fever).
For older people, stronger drugs are used, including aspirin to lower the temperature and drugs to fight the strong virus.
Disease prevention
The main method of prevention is the chickenpox vaccine. Children and adolescents receive vaccinations during which they are given a live viral infection, which helps develop immunity from the disease or reduces the severity of the disease.
Often a combined vaccination is carried out, which includes vaccination against measles, rubella and chickenpox.
In special cases, vaccination with immunoglobulin is carried out to increase the immune response to the chickenpox virus.
This drug is administered into the body no later than 36 hours after contact with a patient with chickenpox. As a rule, this type of vaccination is indicated in the following cases:
- During pregnancy, women who have not had chickenpox and have not been vaccinated against this disease.
- Premature babies.
- Newborn babies whose mothers have obvious signs of chickenpox.
- Adults and children who have a weakened immune system and do not produce antibodies to the chickenpox virus.
Source: https://24doctor.info/disease/vetryanka/
Signs of chickenpox in a child (photo). Methods of infection with chickenpox and the course of the disease in children and adults
The spread of the virus is people with chickenpox and herpes zoster. Infection occurs through the air and through droplets, so it is easy to catch chickenpox on the street.
The disease cannot be transmitted through everyday contact with common household items. The peak risk of infection occurs at the initial stage of the disease, namely at the beginning of the appearance of rashes.
However, the patient is at risk of infection 24 hours before the vesicles appear. When the first rash is detected, the patient should be isolated at home.
☝Since the pathogen is located in the contents of the vesicles (rash), after it dries and a crust forms on it, the risk of infection is reduced.
Due to the presence of certain antibodies in the body, children under 3 months are rarely susceptible to the disease. If the mother does not have immunity, the baby remains “unprotected” and may get sick. Chickenpox most often occurs in childhood.
Development of chickenpox
????In rare cases, recurrent disease is possible.????
The chickenpox epidemic usually occurs in the autumn and winter periods. Infection of the body occurs through the upper respiratory tract, where the virus multiplies. With the help of the lymphatic system, the virus spreads throughout the body, infecting the cells of the mucous membranes. The epidermis is also affected.
The formation of small cavities begins on the skin, which, when merging, form a bubble with watery contents. At the beginning of formation, the contents of the bubbles are transparent, but later become cloudy.
!!!Complications can occur in the spinal cord, brain, cerebellum and spread to other internal organs.
After an illness, the Herpesviridae virus remains in the human body. As a result, with immunosuppression there is a risk of herpes zoster.
Age period of disease incidence
Forms of chickenpox
Chickenpox has a classification with various forms of the disease.
Typical chickenpox occurs in mild, moderate or severe forms.
➡️A mild form of chickenpox in children is accompanied by a slight increase in temperature (no more than 38 degrees). It is not recommended to reduce this temperature. A vesicular rash with a transparent filling appears on the skin, the mucous membrane is not affected.
Mild form of chickenpox
With a moderate form, the temperature can reach 39 degrees. The duration of the rash increases to 4-6 days, often localizing to the mucous membranes (throat, eyes, etc.). Determining the diagnosis is not difficult.
Average form of chickenpox
The severe form of chickenpox is characterized by large ulcers that spread throughout the child’s body and affect the mucous membranes. The increase in body temperature reaches 40 degrees. Convulsions, brain and central nervous system damage are possible.
Severe chickenpox
Atypical chickenpox also has several forms, but may differ in the nature of the rash and some symptoms. With the rudimentary form of atypical chickenpox, the child may not be bothered by the temperature at all, and the rash may have a different appearance and resemble a nodule. The disease in this form is sluggish and often goes unnoticed.
Atypical form (no rash)
The visceral or generalized form occurs in children against the background of severe immunosuppression. The course of the disease is extremely severe. Internal organs are affected and an unfavorable outcome (death) is possible.
Generalized form of chickenpox
The hemorrhagic form affects children with hematological pathologies. A distinctive feature is the bloody contents of the vesicular rashes. Dangerous due to hemorrhages in the mucous membranes. Nosebleeds and bloody vomiting are possible.
The hemorrhagic form has a poor prognosis.
Hemorrhagic form of chickenpox
In the gangrenous form, an inflammatory process begins around the vesicle, after which a small but deep ulcer forms. A secondary infection may occur. Many organs are affected.
Gangrenous form of chickenpox
Many people think that the main source of the disease is blisters that appear on the body. In fact, this is mucus that accumulates in the nasopharynx of a child carrying the virus. Mucus forms faster than rashes. Therefore, a child can infect others a week before visible symptoms appear.
From the carrier, the virus initially enters the open space, after which it settles on the mucous membrane of the mouth and nose of healthy children. This can happen at any time - during games, communication, or simply when being in the same room.
Chickenpox in a child
The incubation stage lasts from 7 to 21 days. These days, the already infected person feels completely healthy, the pathogen does not show itself. It is worth noting that the source of the virus is not necessarily the direct carrier of VZV.
How does the disease begin and progress?
The incubation period for chickenpox infection is from 7 to 21 days (7-10 days for babies under one year old). These days, no symptoms have yet been observed. But the infectious agent, having entered the body through the respiratory tract, quickly multiplies, and the number of viral cells increases.
If no more than 4 days have passed from the moment of contact with a sick person to the administration of a drug containing antibodies to the infection (immunoglobulin injection), the development of the disease can be avoided, or chickenpox will occur in a milder form.
The duration of the prodromal period (the stage between the incubation period and the first manifestations of specific symptoms of an infectious disease) for chickenpox is 1, 2 days. There are no specific symptoms of the disease yet.
The acute period of the disease is characterized by the appearance of the first rashes. An itchy skin rash begins on the stomach, back, or face. It then spreads throughout the body, including the scalp.
In some children, the rash is localized on the mucous membranes (in the mouth, eyes, genitals). The first papules look like mosquito bites. New rashes appear in waves. The process of rash formation continues:
- from 5 to 9 days in children of preschool and school age;
- 10-14 days in infants up to one year old.
Simultaneously with the appearance of the rash, the body temperature rises. Moreover, the severity of fever correlates with the abundance of rashes. When a new wave of rash appears, the temperature rises again. With chickenpox, it fluctuates around 37 - 38°C, but can rise to 39°C and higher.
In the first days of the disease, new elements of the rash appear continuously. After 2-4 days, the papules turn into thin-walled vesicles filled with serous fluid with a high concentration of the virus. The blisters then burst, leaving open wounds.
Small children scratch the itchy rash, tear off dried scabs, which leads to the formation of scars. In addition, a secondary infection may develop.
Your doctor may prescribe antihistamines. Treatment with special antiseptics, such as good old brilliant green or fucorcin solution, will help cool the skin, soften the itching and speed up healing.
- cindol suspension;
- calamine lotion;
- fucorcin solution;
- acyclovir ointment
It is recommended to drink plenty of fluids (herbal infusions, tea, fruit drinks, vitamin compotes), gentle nutrition and rest. It is necessary to ventilate the room, change bedding as often as possible, and avoid synthetic underwear and clothing.
The recovery period begins when new rashes stop forming. If you lubricate pimples with brilliant green or fucorcin solution, it will be easy to track this moment.
One of the most common childhood diseases is chickenpox. If your child attends a kindergarten or other preschool institution, most likely the disease will not bypass your child.
To avoid complications and other troubles, every parent should know how to distinguish chickenpox from allergic rashes and other diseases.
In our article we will look at how chickenpox begins in children.
Chickenpox is an infectious disease characterized by the appearance of watery blisters. It is caused by the herpes virus. The disease is contagious and is transmitted by airborne droplets.
- Most people develop chickenpox between the ages of 3 and 12 years.
- At an older age, chickenpox is very difficult to tolerate: the body temperature during the acute period of the disease is 39 degrees or higher, and the risk of complications is high.
- For this reason, many parents deliberately bring their children into the company of people with chickenpox in order to protect the child from possible complications at an older age.
As a rule, infection occurs only within 2 days before the bubbles appear, as well as within the first 5 days from the onset of the rash. On average, a child's chickenpox quarantine lasts about 20 days.
Stages of rash development
If you are sure that your child has been in contact with someone with chickenpox, be on alert, as the child’s infection is inevitable. The incubation period ranges from 11 to 25 days.
Most often, about two weeks pass before the first signs of the disease begin to appear.
During this period of time there are no changes in well-being, there are no symptoms. If possible, keep your child away from public places. If there is a child under one year of age in the home, contact with the sick person should be avoided if possible.
Children under one year of age suffer the disease with difficulty; serious complications may develop, in which vital organs are affected. For this reason, it is very important to know the first signs of chickenpox in a child.
As soon as the symptoms of chickenpox become apparent, provide the sick person with separate dishes, as well as bedding and personal hygiene products. Many doctors believe that there is no need to isolate the patient from other children. Children at a younger age tolerate the disease much easier.
The ideal time for chickenpox is considered to be between 3 and 6 years of age. Fortunately, after suffering from chickenpox, the risk of recurrence of the disease is eliminated, since the body develops a strong immunity to this infection.
The first symptoms of the disease are often confused with a common acute respiratory disease, and the appearance of spots and blisters with an allergic reaction (urticaria).
Visual change in chickenpox rash
| Period of the disease | Characteristic |
| First day | The child complains of general malaise: weakness, drowsiness, aching joints. The child refuses food and is constantly naughty. No other signs are observed. |
| The rash appears on average 2 days after the onset of the disease | When a rash appears, parents wonder where chickenpox starts? In fact, the course of the disease is individual.
In the photo below you can see different locations of the rash: |
| A day later | The rash spreads throughout the body, the spots become like a drop of water. Usually during this period the child is worried about high body temperature and severe itching. |
| Next few days | Over the course of several days, the blisters continue to spread throughout the body. After 3-4 days, the liquid in the bubbles begins to darken and the bubbles burst. |
| The liquid then flows out and gradually dries out. A small crust forms at the site of the bubble, which cannot be torn off on your own. After a few more days, the crusts fall off on their own and do not leave a trace on the skin. |
Chickenpox in children lasts approximately 20 days. It is very important that the child does not scratch the blisters. If the membrane is broken, there is a high risk of infection entering the wound. In this case, a scar remains on the skin that remains for life.
In general, the course of the disease at different ages is practically no different. The only difference is the duration of chickenpox.
- Young children experience the disease much faster than teenagers.
- Children over 12 years of age can have severe chickenpox. In addition to rashes with fever, the child may be bothered by nausea and vomiting.
Initially, the rash is easily confused with an allergy.
- First signs of a rash
- In the photographs below you will see how chickenpox begins in children and how the disease develops.
- Rachael Jess
Doctor Komarovsky believes that every child should have chickenpox before the age of 12, so as not to torment him at an older age. During this period of time, the disease is tolerated without complications in a milder form.
Komarovsky claims that the appearance of watery blisters on the body is not always chickenpox. In some cases, this is how an allergic reaction manifests itself. The main indicator is an increase in body temperature, which can rise to 39 degrees.
In some cases, the temperature fluctuates at subfebral levels (37.0-37.4).
What to do at the first signs of chickenpox in a child?
Komarovsky recommends contacting your doctor to make an accurate diagnosis. He also believes that treatment should be prescribed by a doctor; self-medication with “green stuff” is not the best option for children, because today there are many medications that will alleviate the patient’s suffering.
Parents' experience
Based on reviews from mothers, we can conclude that the first signs of incipient chickenpox are blistering rashes on the body. Body temperature rises only 3-4 days after the rash.
But the opinions of parents differ, as some argue that the development of chickenpox began precisely with an elevated body temperature. 90% of mothers noted that the rashes began on the face and scalp.
Source: https://one-zdorov.ru/vetryanka-techenie-bolezni-detey-dnyam/
Chicken pox
Chickenpox (or chicken pox ) is an infectious disease that is caused by the herpes and manifests itself in the form of a blistering rash.
Chickenpox spreads through airborne droplets, as well as through direct contact with secretions from the respiratory system of an infected person and fluid contained in the skin rashes of sick people.
Sometimes chickenpox can be transmitted through contaminated household items and clothing. Those who have already had chickenpox receive lasting immunity to this disease; cases of recurrent chickenpox are extremely rare. However, the virus still remains in the body for some time, and is capable of causing shingles in almost 15% of cases.
Usually, almost all children aged 7 to 14 years suffer from chickenpox, but recently this disease has affected adults and occurs in severe forms. Babies under 6 months of age get sick very rarely, because...
usually have antibodies from a mother who has had chickenpox. If a woman gets chickenpox in the early stages of pregnancy, then in most cases a fetal defect develops, and if in the last months, this leads to disease in the fetus.
It should be noted that susceptibility to the disease is very high.
Typically, the incubation period of the disease lasts from 10 to 20 days, and at the initial stage there are no symptoms.
Chickenpox manifests itself as a rash on the face, and then on the entire body, including mucous membranes, approximately 10-14 days after the first contact with an infected person, as well as a sharp increase in body temperature to 38, and even 39 degrees. Doctors compare the rash that occurs with chickenpox to drops of water spilled on a hot frying pan.
Most often, such a rash lasts from one to two weeks, after which the blisters burst, yellowish crusts form, gradually fall off, leaving no scars on the skin, but pigmentation may appear.
In most cases, the disease is quite mild. In difficult cases, in newborns, especially in the presence of concomitant diseases, the virus can affect the liver and kidneys, lungs, and even bone marrow; convulsions, damage to the nervous system, and even death can occur.
The source of the disease is a person suffering from chickenpox. It is dangerous for others from the onset of the disease and for several days after the formation of the last bubbles.
Usually, you can catch chickenpox through airborne droplets, when a sick person coughs or sneezes , or from touching liquid from a chicken pox; the virus itself is tenacious and can penetrate through ventilation systems into neighboring apartments.
Chickenpox symptoms
The first symptom of chickenpox is a rash, with a simultaneous increase in temperature to 37.5-39 degrees. At the same time, the patient is bothered by headache , weakness, and sometimes sore throat and vomiting, i.e. symptoms of intoxication .
The rash appears approximately 7-14 days after exposure to someone with chickenpox. Initially, a symptom of chickenpox is the appearance of rounded pink spots , which gradually begin to rise above the skin, forming bubbles with clear liquid (their diameter is from 1 to 5 mm).
Pink-red rims form around the bubbles, which resemble drops of water. The liquid itself contains live viruses. Gradually they burst, become covered with yellow crusts, after about two weeks, and fall off.
The rashes are located on the face and scalp, and quickly spread throughout the body and mucous membranes of the mouth, genitals.
New blisters appear constantly, they are located between the old ones, and therefore the rash looks heterogeneous. At the same time, there are redness, blisters and crusts. And each new wave of rashes is accompanied by an increase in body temperature.
Usually the patient is bothered by itching , and rashes on the mucous membranes cause particular inconvenience. Therefore, treatment of chickenpox is more symptomatic. Many children, and especially young ones, scratch the blisters and tear off the scabs.
Remember that this can cause pustules , and subsequently scars on the skin. However, with uncomplicated chickenpox, scars do not remain; only temporary pigmentation is possible.
Diagnosis of chickenpox
This disease is very easy to diagnose. To make a diagnosis of chickenpox, it is necessary to detect typical elements of the rash. Other research methods, such as blood and urine tests, will not provide additional information. If symptoms of chickenpox are detected in a pregnant woman, as well as in adults suffering from chronic diseases, you should immediately consult a doctor.
Treatment of chickenpox
Chickenpox is usually treated at home with bed rest, drinking plenty of fluids and proper hygiene. Bed linen must be clean. To speed up the drying of the bubbles, they need to be lubricated with a 1% solution of brilliant green , 10% solution of potassium permanganate ( potassium permanganate ) or a solution of methylene blue . These substances dry out rashes and disinfect wounds.
To reduce itching antiallergic drugs such as Diazolin and Tavegil .
At the same time, you can treat the skin with water with the addition of vinegar and dusting with talcum powder. After the bubbles have dried, warm baths will be helpful.
acyclovir may be prescribed to prevent the development of severe forms of chickenpox .
To avoid scratching the blisters and causing infection, trim your nails regularly and keep your hands clean.
In complicated forms of the disease, as a treatment for chickenpox, as well as in late pregnant women, immunoglobulin , which promotes the release of antibodies to chickenpox.
The doctors
Medicines
Complications of chickenpox
Complications of chickenpox are observed in severe variants of its course.
In older children, acute cerebellar ataxia , causing problems with muscle coordination; in adults, the symptoms of chickenpox will be supplemented by manifestations of varicella pneumonia .
Sometimes damage to the kidneys, joints, heart and lungs may develop. Bacterial complications arise due to infection of the blisters during scratching, and most often occur in weakened children.
It is believed that it is much better to have chickenpox as a child than as an adult, so chickenpox vaccination is not mandatory for childhood vaccinations.
Diet, nutrition for chickenpox
Diet for chickenpox
- Efficacy: therapeutic effect after 5-7 days
- Terms: no more than 14 days
- Cost of products: 1500-1600 rubles per week
List of sources
- Anderson, T. Human infectious diseases. Dynamics and control: trans. from English / T. Anderson, R. May, ed. GI. Marchuk. - M.: Mir, Scientific World, 2004.
- Yunusova H.A. Chicken pox / Kh.A. Yunusova, F.S. Shamsiev. - M.: University Book, 1999.
- Kuskova T.K., Belova E.G., Migmanov T.E. Chicken pox // Attending physician. - 2004. - No. 1.
- Uchaikin V. f. Guide to infectious diseases in children. - M.: GEOTAR Medicine, 2004.
Source: https://medside.ru/vetryanaya-ospa
Chicken pox: treatment, symptoms, prevention, signs, causes
Atypical rashes are observed in patients with immunodeficiency and manifest as fulminant hemorrhagic skin damage or can be minimally expressed in the presence of systemic damage.
Systemic complications are rare in children with a normal immune system, but can often occur in adults and immunocompromised patients. In the UK, 20 previously unaffected adults die every year.
Secondary bacterial infections. The most common complication, observed in 20-50% of adult patients hospitalized with chickenpox, is responsible for 50% of chickenpox-related deaths. In children, superinfections predominate: septicemia and staphylococcal skin lesions (including toxic shock syndrome) or bacterial pneumonia.
Viral pneumonia. It occurs in adults with a frequency of 1 in 400 cases and is accompanied by a 20% mortality rate. This complication is more common in smokers. Characterized by cough, shortness of breath, hypoxia, and diffuse pneumonitis on x-ray.
Hepatitis. Severe hepatitis occurs rarely, except in immunocompromised patients.
Encephalitis. The incidence in adults is 0.1%, characterized by a 20-30% mortality rate.
Cerebellar ataxia. It occurs in children with an incidence of 1 in 4000 cases and usually goes away on its own.
Reye's syndrome. Observed during epidemics of chickenpox in children when taking acetylsalicylic acid.
Treatment of chickenpox
- Symptomatic treatment.
- Valacyclovir or famciclovir for patients >12 years of age, immunocompromised patients, and other patients considered at risk for severe disease.
A mild form of the disease requires only symptomatic treatment.
Relieving itching and preventing scratching of the skin, which invites secondary bacterial infection, can be challenging. Wet compresses or for severe itching, systemic antihistamines and colloidal oatmeal baths may help.
Concomitant use of large doses of systemic and local antihistamines may cause encephalopathy and should be avoided.
To prevent secondary bacterial infection, patients should bathe regularly and keep their underwear, hands, and nails clean. Antiseptics should not be used unless the lesions are infected; the infection is treated with antibiotics.
Oral antivirals, when administered to immunocompetent patients within 24 hours of the onset of the rash, slightly reduce the duration of symptoms and severity. However, because the disease is benign in children, antiviral treatment is not usually recommended.
The use of the oral medications valacyclovir, famciclovir, or acyclovir must be carefully considered and justified. This is especially true for immunocompromised patients and healthy people, including patients > 12 years of age, people with skin conditions (especially eczema), people with chronic lung disease and those on corticosteroid therapy.
Acyclovir is a less desirable choice because its oral bioavailability is poorer, but it can be given.
Patients should not start school or return to work until the last lesions have crusted over.
Antiviral and antimicrobial therapy
Children with a normally functioning immune system. Antiviral therapy is not indicated. Bacterial infection should be suspected in patients whose condition is severe enough to require hospitalization.
Adults without immunological problems with moderate severity of the disease. Aciclovir is prescribed orally on the first day when the rash appears, which normalizes body temperature and reduces the number of rashes.
Adults without immunological problems with signs of pneumonitis.
Pregnancy. Acyclovir is not approved for use during pregnancy, but appears to be safe and not teratogenic. Pregnant women have a high risk of severe disease, so if during the first day when the rash appears, their condition worsens, then the need to prescribe acyclovir should be discussed with an expert.
An adult or child with immunological problems. Acyclovir is indicated in all cases. For mild disease and minimal immunosuppression, acyclovir is prescribed orally at a dose of 800 mg five times a day. In more severe immunosuppression, for example, after organ transplantation, as well as in the presence of signs of disseminated chickenpox, acyclovir is administered intravenously.
Prevention
Chickenpox is contagious 48 hours before the onset and approximately five days after the first elements of the rash appear.
Patients should be kept in a separate room with neutral or negative pressure, not in contact with immunocompromised patients, and cared for by immunocompetent health care workers while taking precautions. Shingles is much less contagious if the skin of the face or other exposed areas of the body are not affected.
Infection provides lifelong immunity. Potentially susceptible people should carefully prevent contact with people capable of transmitting infection.
Vaccination . Vaccination is especially important for women of childbearing age and adults with underlying chronic diseases.
A serological test to determine immunocompetence status is not usually required before vaccination in adults.
Although the vaccine can cause chickenpox in immunocompetent patients, the disease is usually mild (< 10 papules or blisters) and short-lived and causes few systemic signs.
Vaccination is contraindicated:
- Patients with moderate to severe concomitant disease.
- Patients with weakened immune systems.
- Pregnant women.
- Patients taking large doses of systemic corticosteroids.
- Children using salicylates.
Prevention after infection . Once infected, chickenpox can be prevented or reduced by the use of intramuscular varicella-zoster virus immunoglobulin, which is available as a new drug under investigation from FFF Enterprises (800-843-7477).
Candidates for post-exposure prophylaxis include people with leukemia, immune deficiency, or other severely debilitating disease; susceptible pregnant women, and newborns whose mother became ill with chickenpox within 5 days before birth or 2 days after birth.
Immunoglobulin should be administered within the first 4 days after contact with a patient with chickenpox, and then it can change the course or prevent the development of the disease. All susceptible healthy patients eligible for vaccination should be vaccinated as soon as possible.
The vaccine may be effective in preventing or reducing the disease within 3 days and possibly 5 days after exposure.
Prevention of chickenpox in high-risk patients
Hyperimmune immunoglobulin (IgG against the Varicella-zoster virus) is effective in preventing or alleviating chickenpox if the drug is prescribed within 10 days after contact with a carrier of the infection. The drug must be prescribed to everyone susceptible (i.e.
those who do not have IgG antibodies to the Varicella-zoster virus in their blood, which requires 48 hours to determine in the laboratory) patients with immunodeficiency after contact with a patient with smallpox or herpes zoster.
Immunoglobulin should be prescribed to IgG-negative pregnant women with such contact and to newborns whose mothers suffered a primary chickenpox infection 7 days before and 7 days after birth.
Prescribing acyclovir for the prevention of chickenpox (7-14 days after exposure) is effective in certain groups of patients, but is not licensed.
The supply of hyperimmune immunoglobulin is limited and under strict control. You should first contact a virologist and microbiologist.
The varicella vaccine is currently undergoing licensure and may eventually be administered to certain groups of patients who are not immune to chickenpox and other high-risk patients. The vaccine is live, so it should not be administered to patients with immunodeficiency.
Herpes zoster (shingles)
The infectious-inflammatory process occurs as a result of activation of a virus that is in a latent period in the sensory ganglia. The risk increases with age and the presence of immunodeficiency.
The vesicular rash occurs in one dermatome, several dermatomes, or in immunocompromised patients can be disseminated (in a patient without immunodeficiency, up to 20 disseminated vesicles can normally be observed).
With relapses or rashes in several dermatomes, immunodeficiency should be suspected.
Complications
- Most often observed in patients with damage to the immune system.
- Secondary bacterial infection.
- Postherpetic neuralgia.
- Ophthalmological complications: keratitis involving the trigeminal nerve occurs in 10% of patients (ocular herpes zoster). Retinal necrosis is rarely observed.
- Aseptic meningitis: Pleocytosis in the cerebrospinal fluid and an asymptomatic course are usually observed.
- Cerebral angiitis leading to contralateral hemiparesis.
- Transverse myelitis: mainly in patients with immune system damage.
- Spread of the rash over the skin: more than 20 vesicles outside the affected dermatome determines a high risk of systemic dissemination of the infection.
- Systemic dissemination: Viral damage to the lungs, liver, and brain occurs primarily in immunocompromised patients.
Treatment of herpes zoster
An adult patient with normal immunity. Valacyclovir, famciclovir and acyclovir are likely to reduce the duration of postherpetic neuralgia when administered within two days of the onset of the disease.
Ocular herpes zoster. The cornea is stained with fluorescein to detect keratitis; if visual acuity decreases and ocular involvement is suspected, consultation with an ophthalmologist is required. In the presence of keratitis, acyclovir or trifluoridine ointment and intravenous acyclovir or valacyclovir or famciclovir are prescribed locally.
Uncomplicated herpes zoster in an immunocompromised patient. Acyclovir is prescribed to prevent dissemination. For moderate immunosuppression (for example, against the background of long-term administration of glucocorticoids), oral forms of acyclovir, famciclovir or valacyclovir are used. In severe immunosuppression, intravenous acyclovir is indicated.
Disseminated herpes zoster. Intravenous administration of acyclovir is indicated.
Source: https://www.sweli.ru/zdorove/meditsina/infektsionnye-bolezni/vetryanaya-ospa-lechenie-simptomy-profilaktika.html
Chicken pox: symptoms, differential diagnosis, treatment, vaccination
One of the exanthematous diseases of childhood, caused by the varicella zoster virus. The varicella zoster virus is an exclusively human virus. The incubation period is 14 days (ranges from 9 to 21 days).
Chickenpox is characterized by fever, weakness, and a generalized pruritic vesicular rash. The disease usually develops in childhood and is self-limiting. Adverse disease outcomes are more common among frail people: adolescents, adults, and pregnant women.
Chickenpox is caused by a primary infection of the varicella-zoster alphaherpesvirus in people without immunity to the virus. Clinically, the disease manifests itself in the second viremic phase of virus development.
Exposure to varicella zoster virus (VZV) initiates the production of host antibodies and cell-mediated immune responses that are important for the early control and limitation of the spread of primary varicella infection.
After the initial manifestation, the virus persists for life in the cranial nerves and dorsal root ganglia. In about one-third of cases, the varicella zoster virus may reactivate in the future with the development of shingles.
Chickenpox occurs when a susceptible person is exposed to the varicella-zoster virus (VZV), either through direct contact with lesions or through airborne transmission.
After contact, the virus spreads to regional lymph nodes, causing the development of the primary phase of viremia.
On days 4-6, the infection spreads to the liver, spleen and other cells of the reticuloendothelial system.
The secondary viremic phase occurs around day 9, when mononuclear cells transfer the virus to the skin and mucous membranes, causing the classic vesicular rash. Varicella zoster virus causes vasculitis of small blood vessels and degeneration of epithelial cells, leading to the formation of fluid-filled vesicles containing high levels of virus.
The virus is detected in the nasopharynx 1–2 days before the onset of the rash, and patients are already infectious before the appearance of the rash. Patients remain infected for at least 5 days and until all lesions have scabbed over. The incubation period lasts for 14 days.
Moderate disease (low risk of severe disease): In healthy children, the disease is usually mild and self-limiting, characterized by malaise, pruritus (pruritus), and a temperature of up to 39 °C (102 °F) for 2–3 days.
Severe illness: Associated with complications such as pneumonia, neurological damage, hepatitis, secondary bacterial infection and even death.
Moderate risk of developing severe disease:
- Patients aged 13 years and older
- Those who develop a chronic skin condition (such as atopic dermatitis)
- Those with underlying lung disease
- Patients receiving salicylate therapy
- Those receiving short-term or intermittent courses of oral corticosteroids.
High risk of developing the disease:
- Immunocompromised patients (eg, organ transplant, chemotherapy, HIV infection)
- Newborns
- Those chronically taking high-dose oral corticosteroids or systemic immunosuppressants
- Pregnant women.
Key diagnostic factors
- Key risk factors: exposure to the virus, young age, immune status and profession.
- Fever:
- Usually 3 days) or recurrent fever.
- Vesicular rash:
- Clinically described as “dew drops on a rose petal.” The rash usually first appears on the face, head, or torso and then spreads to the extremities.
- The lesions first appear as macules and quickly develop into vesicles containing fluid.
- As the disease progresses, early lesions become covered with a crust, and new ones appear on the periphery. The appearance of lesions in the form of “droplets” (for example, acute/healing at different stages of development) is characteristic of chickenpox.
- Vesicles on mucous membranes:
- Most often found in the nasopharynx, but also on other mucous membranes such as the conjunctiva, mouth and vulva.
- Other diagnostic factors:
- itching
- headache
- fatigue/weakness
- a sore throat
- tachycardia
Diagnostics
Anamnesis
Varicella zoster virus is usually acquired through contact with a patient with chickenpox (or, less commonly, herpes zoster), and many patients have a history of such exposure.
Contact in children often occurs at home, at school or in a kindergarten setting.
Varicella is contagious with a contagiousness rate of up to 90% in susceptible family members, but the contagiousness rate in school or daycare settings appears to be lower.
It is necessary to establish a history of chickenpox disease; Between 4.5% and 13.3% of people with chickenpox infection report a history of the disease.
It is also important to reconsider pre-immunization with the varicella vaccine.
Patients (or parents) may recall having a prodrome that included fever, fatigue, headache, and/or sore throat before the onset of the rash.
In healthy children, the disease is usually mild and self-limiting, with malaise, itching and fever up to 39°C for 2-3 days. However, some groups of patients are susceptible to serious illness and complications such as pneumonia, neurological complications, hepatitis, secondary bacterial infection and even death.
Secondary bacterial infection should be considered in patients with persistent (ie, >3 days) or recurrent fever. Children and adults with known immunosuppression due to cancer, immunodeficiency, organ transplantation, HIV infection, or corticosteroid use are at greater risk of developing complications from chickenpox.
Women who develop chickenpox 2 to 5 days before giving birth have a high risk (17% to 30%) of transmitting the virus to their newborn. Due to the lack of maternal immunity to varicella zoster virus (VZV), these children are at risk of severe infection.
Physical examination
Chickenpox in patients is often diagnosed by the presence of a rash characteristic of chickenpox. The rash is vesicular and usually appears first on the face, head, or trunk and then spreads to the extremities. Classically described as “dew drops on a rose petal,” vesicular lesions contain clear contents and are surrounded by a rim of congestion.
The lesions appear scattered, so that in different parts of the body they are at different stages of development. The lesions usually continue to appear for several days and completely crust over within 7 to 10 days. Vesicular rashes may also occur in the oropharynx and other mucous membranes.
Rarely, chickenpox may manifest as hemorrhagic vesicles or purpura.
Laboratory research
Clinical data is often sufficient to make a diagnosis. In high-risk patients, adults, or other patients in whom the diagnosis is unclear, laboratory findings confirm the diagnosis. PCR testing of skin lesions or CSF is highly sensitive and helps to quickly establish an accurate diagnosis.
Culture of the vesicle contents can confirm the diagnosis, but requires a minimum of 21 days to obtain a positive response.
A Tzanck smear of vesicular fluid will show multinucleated giant cells; however, this test is less commonly used for diagnosis because it is not as accurate as direct fluorescence antibody (DFA) and is not specific for varicella zoster virus.
Skin scrapings of the base of new vesicles can be used for direct antibody fluorescence testing, which is rapid and quite sensitive for this disease.
Serology is not useful in confirming acute illness because early tests are negative. However, serological tests may be useful in adult immunization programs to identify people who do not need vaccination.
A large number of serological tests are available to detect antibodies to the varicella zoster virus.
Tests include complement fixation (CF), direct fluorescence antibody (DFA), latex agglutination (LA), and enzyme-linked immunosorbent assay (ELISA).
LA should not be used in acute illness, but the assay may be useful in determining seroconversion after vaccination or confirming immune status.
Serological testing is recommended for pregnant women who are suspected of being infected and have an unknown immune status.
If results are negative or not available within 10 days of exposure, varicella zoster immunoglobulin (VZIG or VariZIG) should be administered. If immunoprophylaxis is not available, oral acyclovir should be prescribed.
Ultrasound is recommended for pregnant women with chickenpox to screen for the effects of infection on the fetus.
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Source: https://www.eskulap.top/infekcionnaye-bolezni/vetrjanaja-ospa-simptomy-lechenie-profilaktika/
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