Varicella, or, as it is also called, chickenpox is an acute infectious disease caused by a virus. Chickenpox, one of the most common childhood diseases.
The varicella virus is a varicella-zoster virus that contains DNA from the family Herpesviridae (belongs to the herpes virus).
The source of infection is a sick person (it becomes infectious one day before the appearance of the first rash and within 5 days after the appearance of the last elements of the rash). It should be noted that patients with shingles can be the source of infection.
The virus is found in the vesicles, at the stage of the scabs, it is no longer detected.
The infection is caused by droplets in the air and in the air, hence the name of chickenpox (the disease is spread by the wind). This disease is very contagious, so the majority of the population tolerates chickenpox in childhood. Chickenpox in infants and children up to 6 months is extremely rare, since this group of children has transplacental passive (through the placenta) and lactogenic (through milk) passive immunity of the mother.
The easiest way is to have chickenpox in children 2 to 12 years old. Newborns, babies and adults (if they get sick) – suffer from chickenpox a lot more.
Clinical manifestations of chickenpox.
Like many other infectious diseases, chickenpox advances cyclically. The symptoms of windmills in children depend on the period of the illness.
Thus, with chickenpox, there are several periods.
Incubation period (occult): during this period the accumulation of the virus takes place, there are no clinical manifestations. The duration of this period is 11 to 23 days.
The prodromal period, or the period of precursors, this period is observed in approximately 10% of patients. Characterized by the fact that in 1-3 days dyspeptic disorders are detected, there may be manifestations by type of acute respiratory viral infection and a prodromal punctate rash that precedes the appearance of the typical elements of varicella.
The period of eruption is the most vivid period, which allows you to determine if it is chickenpox. For this period it is characterized by the appearance of maculo-papulo-vesicular eruption.
First, a red spot appears, then a papule (an element that protrudes above the surface of the skin, dense to the touch) and a characteristic vesicle (a bottle full of serous content). This period with a typical form of chickenpox lasts 2-5 days. The eruptions are accompanied by itching and have an uneven character, with each wave of such eruptions accompanied by an increase in body temperature.
The symptoms of intoxication are more pronounced with abundant rashes, in small children and with chicken pox in babies.
Varicella is characterized by a false polymorphism of rash, that is, at the same time in the skin you can see a spot and a papule and a vesicle and even a scab, which is called false because they are not different elements, but different stages they are an element.
After 3-4 days, the vesicles begin to dry and scabs form, which disappear in 2-3 weeks of disease and, in most cases, disappear without a trace.
There is no favorite location for chickenpox, it appears throughout the body, including the scalp and mucous membranes.
Several forms of chickenpox.
There are typical and atypical forms.
Typical include those cases in which there is characteristic vesicular eruption. Typical options for severity are divided into light, medium heavy and heavy.
- The mild course is characterized by: a mild rash, moderate increase in body temperature up to 38.5 degrees, symptoms of minimally expressed intoxication.
- Moderate course: a rash is abundant, appears in the mucous membranes of the eyes, mouth, genitals, large elements, fever reaches 39.5 degrees, symptoms of intoxication are moderate.
- Severe: a rash is abundant, with large vesicles, hyperthermia is observed, the symptoms of poisoning are very pronounced, the development of neurotoxicosis with convulsions is possible.
Atypical forms of varicella include: rudimentary (the easiest), generalized (with damage to internal organs), hemorrhagic, gangrenous. In addition to the rudimentary, all other atypical forms are very heavy.
Downstream of chickenpox are distinguished:
- smooth flow
- flow without complications
- with complications
Complications of chickenpox
Chickenpox in children can occur with complications. The complications can be early, that is, they appear at the height of the disease or later in the stage of the scabs.
Complications can be viral in nature and may be the result of a bacterial infection.
With chickenpox, complications can arise from various organs and systems.
Complications of nervous system damage: encephalitis, meningoencephalitis, facial and optic nerve palsy, transverse myelitis, hypothalamic syndrome.
Complications of visceral organs and respiratory tract: Ray syndrome, myocarditis, pericarditis, endocarditis, hepatitis, keratitis, glomerulonephritis, croup in the period of skin rash, pneumonia.
Bacterial complications of chicken pox: phlegmon, abscess, streptoderma, erysipelas, lymphadenitis, stomatitis, purulent conjunctivitis, keratitis, pneumonia.
Chickenpox in babies and newborns
Chickenpox in babies can occur lightly and rudimentarily in the presence of transplacental passive immunity. In the absence of passive immunity, the development of varicella in an infant is observed with an increase in general infectious toxic manifestations. At the height of the lesions increases toxicosis, neurotoxicosis, possible visceral injuries, hemorrhagic soaking of the vesicles.
Often sediments are attached.
In newborns, congenital varicella can occur in cases where the mother became ill on the last day before birth. Congenital varicella occurs in newborns in severe or moderate forms.
Treatment of chickenpox
The treatment of chickenpox in children is done in the home with light and moderate forms. Patients with severe forms, as well as in the presence of factors that aggravate the course and prognosis of the disease, are indicated for hospitalization.
Treatment for typical forms that occur without complications is usually symptomatic. In addition, attention should be paid to a rational diet and hygiene measures.
At high body temperatures above 38 degrees, fever-reducing agents can be administered. The medicines of choice are acetaminophen, ibuprofen.
When varicella is contraindicated, an antipyretic such as acetylsalicylic acid (aspirin).
Fight against itching
Very often, with chickenpox, the child is worried about the severe itching of the skin. In turn, the combing of the bubbles leads to the appearance of new sites of infection, and also increases the likelihood that the vesicles remain in place of bubbles (smallpox) throughout life.
What to do to relieve itching of the skin:
- Make sure the child’s nails are short, you can put special gloves for the little ones:
- Bedding and underwear are changed daily.
- The clothing must be loose cotton.
- Distract the child in all possible ways (we play, we read books, we occupy)
- The temperature in the room should be comfortable so that the child does not overheat, because the more you sweat, the more it stings.
- Give the child plenty of drink, preferably compote, since a sedative can receive a decoction of chamomile or mint.
- Antihistamines, have antipruritic and sedative effects (suprastin, loratadine, claritin, cytrizin, tavegil, etc.).
- You can use creams and ointments. The following agents have antipruritic effects: Iricar (homeopathic remedy), Gistan (dietary supplement based on medicinal herbs), phenistil-gel, calamine lotion (a good preparation has antipruritic and antiseptic action.) You can use calendula alcohol tincture ( the elements) Dries well, disinfects and relieves the itching of Zindol (suspension with zinc oxide).
- Bath in the windmill. As for the bathrooms, the opinions of the doctors are not unequivocal, someone categorically prohibits swimming and someone recommends taking them daily. However, from experience, it has been observed that the baths reduce the itching of the skin, only that they must be taken correctly. Before the period of falling of the scabs, while bathing, you can not use cloths, hard towels or care products. The bath should be with a weak solution (0.05%) of potassium permanganate or with a decoction of herbs (chamomile, string, calendula). It is also better not to use detergents. The regularity of the bathrooms depends on the condition of the child. If the itching is severe, you can take a bath every day. After bathing, do not rub the baby with a towel, just soak it. After that, you can cover each element of the rash with one of the paint antiseptics.
As for the treatment of elements with a 1% solution of greens or other dye, the opinions differ again. The treatment is done to prevent bacterial infection and dry the vesicles. Thus, in the opinion of Dr. Komarovsky, in the case of chickenpox in babies, the treatment of the elements with green paint is not obligatory at all and only serves to discover when the last element of the eruption appeared.
Therefore, whether or not to process the elements depends on you.
In severe forms of chickenpox, antiviral therapy is indicated. The drug of choice is acyclovir.
When accessing a bacterial infection, antibacterial therapy is shown.
When treating chickenpox in babies, due to the severity of the process, detoxification therapy may be necessary.
In typical cases, the prognosis is favorable, the disease ends with complete recovery and the formation of long-lasting immunity.
With severe and atypical forms, as well as with the addition of complications, especially in young children, the prognosis can be bad. Early treatment, the right therapy will help avoid adverse effects.