Recurrence of the disease is unlikely, since the primary contact with the pathogen in her body produces antibodies circulating in the blood throughout life. Specific antiviral treatment of chickenpox in a child in most cases not required. All ongoing therapeutic measures aimed only at facilitating the patient and prevention of complications.
Pathogenesis
Entrance gate varicella virus - the mucous membranes of the upper respiratory tract, where the virus replication, followed by lymphatic pathogen enters the bloodstream. At the end of the incubation period, is developing viremia.
Virus is fixed in cells of ectodermal origin, predominantly in epithelial cells of the skin and mucous membranes of the respiratory tracts, of the oropharynx. May result in the intervertebral ganglia, cerebellar cortex and cerebral hemispheres, basal ganglia. In rare cases, generalized form affects the liver, lungs, gastrointestinal tract. In the skin the virus causes the formation of vesicles filled with serous contents, wherein the virus is in a high concentration. In severe forms of the disease Generalized vesicles and superficial erosions detected on the gastrointestinal mucosa, trachea, bladder and renal pelvis, urethra, conjunctiva of the eye. In the liver, kidney, lung and CNS identify small foci of necrosis at the periphery with hemorrhages.
In the pathogenesis of a significant role to the cellular immunity, mainly T-cells system in which inhibition is observed more severe course of the disease. After decrease in acute manifestations of primary infection, the virus persists for life in the spinal nerve ganglia.
Epidemiology
The source of the virus - the patient from the last day of the incubation period of up to 5 days after the appearance of the last eruption. The main route of transmission - airborne. The virus can spread over distances up to 20 m (through passages in neighboring apartments and rooms even from one floor to another). Possible mechanism of vertical transmission of the virus through the placenta.
Susceptibility to varicella is very high (at least 90%), with the exception of children during the first 3 months of life, who remain passive immunity.
The incidence characterized by a pronounced seasonality, peaking in the autumn and winter months. Ill mostly children. Postinfectious immunity stressful, supported the persistence of the virus in the body. By reducing its tension arises herpes zoster.
Symptoms of chickenpox
The incubation period for varicella in children (from the moment of introduction, before the first signs of chickenpox) 11-23 days (see. Photo). During this period, the penetration of agent through the mucosa of the upper respiratory tract, then the multiplication and accumulation of the virus in the epithelial cells of the mucous membranes.
1) When the maximum accumulation of agent varicella it extends through the lymphatic and blood vessels, causing the occurrence of the following periods - prodromal or rash.
2) prodromal period of chickenpox - (this period may not be) there is only a small proportion of people and lasts for 1 day. Characterized scarlatiniform rash with preservation of several hours and further their disappearance temperature to rise 37-38⁰S and intoxication. Most often this period is a reaction to viremia.
3) rashes Period - varicella begins acutely (immediately after or prodromal period) and lasts for 3-4 days and bole. Most often, the temporary border between them, and not at all. As well as the prodromal period, a response to the viremia and is characterized by the following symptoms:
- an increase of regional lymph nodes (may not be)
- fever 37-39 ° C maintained throughout the period of precipitation and each new impulse lesions accompanied by the rise of temperature,
- rash of chickenpox appears on the 1 day of intoxication, with podsypaniyami 5 days - some already are, while others are just emerging. Therefore, the impression of a false polimrfizma (a variety of rashes in the same patient: both bubbles and blemishes, and brown at the same time). Favorite localization and phasing, like measles, is not (a rash may even be on the scalp - an important differential diagnostic indication as to the oral mucosa, genital girls conjunctiva / cornea, larynx, and with the further ulceration wound per 5 days). Already 1 day red spot turns into a bubble, and a few days later a rash appears on the body surface as a "dew" with transparent content, which becomes turbid after 1-2 days, and more in 1-2 days bubble dries and turns into a crust, disappears in 1-3 week.
4) Patient varicella ceases to be infectious, once stopped and podsypaniya formed crust. Accompanied by itching rash of varying intensity. With good antiseptic treatment of lesions they do not leave behind a scar, but ignoring these rules of hygiene there is a secondary infecting bacteria with the surface lesion followed kozhis germentativnogo layer and scarring / scars as in smallpox, but not as rough.
Other features and shape the flow of chickenpox
Other signs and symptoms depend on the shape of the flow of chickenpox:
- In mild varicella proceeds without temperature rashes appear within 2 - 3 days. Most often, these symptoms are typical of chickenpox in children under one year.
- In moderate rash illness lasts between 2 - 5 days and accompanied by fever. Temperature chickenpox in children raised to 39 - 40 C. Elements of the rash itch. Noted sleep disturbances, moodiness.
- In severe cases the fever appears wavy and accompanies every new eruption. The temperature rises to 40 C. rash period is 7 - 10 days. In children, there are headaches, coughing, delirium. In severe chickenpox can be diarrhea and vomiting. These symptoms are more typical for the flow of chickenpox in adolescents.
Features of current atypical chickenpox:
| rudimentary form | characterized by asymptomatic. Children may show signs of acute respiratory infections, but no fever and rash. |
| gangrenous form | rash elements coalesce, and nagnivayut infected, leading to gangrene and skin melting. |
| hemorrhagic form | It characterized by vascular lesions. |
| generalized form | It affects internal organs, leading to their dysfunction and multiple organ failure. |
It looks like chickenpox: photo
The photo below shows how the disease manifests itself in children.
complications
The most serious and common diseases that occur due to the effect of herpes pathogens in the body of a child, is varicella pneumonia and meningitis. Difficult to treat forms of the disease are atypical chickenpox:
- Gangrenosum - the spots on the internal surfaces of the esophagus and bladder that causes bleeding.
- Bullous - confluent rash over the whole body with obvious signs of a purulent infection.
- Haemorrhagic - disease progresses, along with a bacterial infection.
- Generalized - chickenpox in immunocompromised children, flowing with lesions of the mucous membranes, both external bodies and internal systems.
In any case, detection or diagnosis of this form of chickenpox sick child is sent for examination and treatment in the hospital.
Infection with chickenpox in infants (first 3 months of life)
Is recorded rarely, because maternal antibodies indulge kid still in utero through the placenta, but if this does not occur, the following symptoms are observed:
- prodromal period lengthens to 4 days with moderate / severe symptoms of intoxication;
- against high temperatures can join cerebral symptoms (visible ripple fontanelle will talk about the increased intracranial pressure, convulsive readiness and dr.proyavleniya);
- rash abundant and slower flows phasing (ie, staining, then the bubbles after the scabs and pigmentation) and the period of eruption becomes protracted - to 9 days instead of 5;
- often a bacterial complications.
How to treat chicken pox?
Children with chickenpox usually receive treatment at home. The first compulsory component of the treatment of varicella is bed rest for a period of fever.
Special diet for chickenpox is not assigned, but excessive drinking - an integral part of the treatment, as a very important function - detoxification (rids the body of toxins).
Drug treatment is carried out both general and local. General may include several groups of drugs:
- antihistamines - are appointed if the rash is accompanied by intense itching;
- NSAID - are assigned to lower temperature (typically used Paracetamol and ibuprofen, aspirin, in this case, is contraindicated due to the risk of serious complications - Reye's syndrome);
- antivirals (the most effective in this respect considered as acyclovir, but it is not indicated for mild form of the disease);
- in the case of septic complications of the disease - antibiotics.
Local treatment involves meticulous care of affected skin, aiming at prevention of secondary infection with rash elements. Typically for treatment of lesions using brilliant green solution of potassium permanganate or fukortsinom. To avoid residual traces on the site of lesions, it is strongly not recommended to tear the crust. Because the virus is unstable in the environment, it should be washed regularly and often ventilate the room.
How long is chicken pox?
The first or second day of the disease without rash tested with the temperature at 2-3 day is first bubbles may appear further rash may last from 2 to 9 days depending on the severity of the disease. The child must be at least 10 days at home, and then all of 14, taking into account its infectiousness. Write out the children, even if the crust on wounds has not disappeared, it can take up to 3 weeks.
When the patient is not contagious chickenpox?
Chickenpox infectious patients becomes, when does not know about it - 2-3 days before the rash appears, and the rash appears after about 2 weeks after infection.
Chickenpox patient ceases to be contagious when the rash does not appear new and the old are covered by a crust and scabs fall off (when the bubbles podzhivaet, the virus is not released into the environment).
On average, the quarantine of chickenpox for the individual child - 2-3 weeks from the first eruption.
preventive measures
For the prevention of chickenpox or vaccination complications may be used (attenuated live virus administration) or the administration of immunoglobulins (antibodies specific to the virus Varicella zoster).
Vaccination is recommended for children after one year. It protects the body against varicella for 10 years and longer. Although sometimes vaccinated people may still get sick with chickenpox, but occur it will already be in a mild form. Administration of vaccines ( "Okavaks" drugs, "Varivax" and "Varilriks") is especially important for women planning pregnancy, if earlier they have not had chickenpox. With their aid and emergency prevention of chickenpox may be carried out, if there was a contact with a carrier of infection. To prevent development of the disease, the vaccine should be entered within 48-72 hours after contact with a carrier of infection.
Introduction protivovetryanochnogo immunoglobulin ( "Zostevir" drug) is important for people exposed to sick chickenpox or shingles that have a high probability of developing severe complications from the disease chickenpox. These people include pregnant women, children with cancer, with HIV, organ transplant, children with severe chronic systemic diseases, premature weighing 1 kg, newborns, who have not had a mother chickenpox.
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Answers to questions about chickenpox
The child had a fever and there were pimples all over the body and hair. It is chicken pox?
- Only an experienced doctor after internal examination of the child can be diagnosed chickenpox.
How to distinguish chickenpox from allergies?
- Varicella is usually a fever, the child is experiencing a general malaise. Allergic rash finer, multiple, identical in size, larger than the previous eruption repeated, they do not happen on the mucous membranes. Characteristic features of the rash of chickenpox: appears on the second or third day after the temperature has form individual bubbles that occur in stages, new bubbles are smaller old cover all areas of the body.
The child was diagnosed with "chicken pox" just after examination by a doctor, I put entitled to such a diagnosis without having to pass tests?
- If there is a child's typical chickenpox rash competent diagnosis is made after the inspection and collection of complaints. Assays are only necessary when prolonged or complicated course of the disease.
Do I have to feed the baby, if it turns out there (he had chicken pox)?
- The body fights infection, and it is he needs power, so that feed is undoubtedly necessary. But in the digestion of food is wasted, too, a lot of energy. Therefore, during chickenpox if the child refuses the usual food, replace it with chicken broth and jelly.
How many times suffer from chickenpox?
- If one person suffered chicken pox, he produces lifelong immunity. Only in rare cases are re-infection in children under 12 years of age they flow easily, adults - and for the first time, and re-runs hard, in spite of the disease suffered by a child. Information about the chickenpox infection for the third time in the medical sources there.
The child has chickenpox, some folk remedies, we can use it to quickly recovered?
- For any infectious disease, and chickenpox including assistance in the main appropriate treatment will be vitamin berry fruit drinks or herbal teas, but you need to be sure that the child is not allergic to them (ie, the child has already tried this tea and allergies do not arose.
The child has chickenpox girlfriend. I went to visit them, when he was just sick with chickenpox. Can I "drag" your child to chickenpox?
- If you are not infected, you and your baby you are not contagious. Chickenpox is not transmitted through third parties.
Chickenpox in children, in most cases, easily tolerated, without any consequences. More common in preschool and primary school children. Seasonal nature, more often in the fall and winter. On average, every 5 years there are outbreaks of chickenpox: massively sick children in kindergartens and schools.
