The varicella-zoster virus is a type of herpes. Or rather: herpes virus varicella zoster (Varicella zoster), type 3 herpes viral infection. The “trademark” sign of chickenpox is a bubble rash, which often covers the whole body (although there are cases of local rashes). In the past, each such pimple was supposed to be smeared with brilliant green, therefore, in our country, chickenpox is firmly associated with children in a green speck.
Dr. Komarovsky even has a joke about this: “A green spotted rash is a characteristic symptom of chicken pox.” Bubbles, bursting, cause itching, which can lead to scratching and secondary infection of wounds. Autumn-Winter is considered the “favorite” season of the disease, and epidemic outbreaks are recorded once every 5 years.
Children from the age of 1 to 10-12 years old are mostly ill with chickenpox, and the majority of the sick are among toddlers of 3-4 years.
Susceptibility to the virus of chickenpox is very high because it is very volatile – it overcomes distances up to 20 m, from floor to floor, through ventilation. Chickenpox is transmitted through the mucous membranes of the eyes and upper respiratory tract. But there are several ways to get into a strange organism from a patient with a virus.
The virus flies literally, “in the wind”: by airborne droplets – when talking, coughing, crying loudly, shouting. Goes contact-household method – infection with saliva or liquid from the pimple.
Transmitted by direct touch. A pregnant woman with chickenpox can infect her baby because the virus passes transplacentally, i.e. through the placental barrier from mother to fetus.
In order to get chickenpox, it is enough to talk with a patient with chickenpox, or a patient with shingles (herpes zoster), and infection with chickenpox will occur even with fleeting contact with him. The period of infection with chickenpox in patients begins at the end of the incubation period (48 hours before the rash appears) and lasts until the 5th day after the last pimple appeared.
Moreover, the incubation period of chickenpox in children and adults is not typical and does not manifest itself within 1-3 weeks (minimum 7 days), so it’s impossible to say exactly when the 48 hours will come before acne appears.
The incubation period, that is, the time from the moment of introduction to the first signs of chickenpox is 11-23 days. During this period, the pathogen penetrates through the mucous membrane of the upper respiratory tract, then it multiplies and accumulates in the epithelial cells of these mucous membranes.
After the maximum accumulation of the pathogen varicella, it spreads through the lymphatic and blood vessels.
In some patients (they are very few), the end of the incubation period is marked by scarlet-like rashes. This may be the first signs of chickenpox in children and adults.
Such a state lasts, literally, one day, several hours, then the rashes disappear, the temperature rises to 37-38⁰С.
After the incubation period, the period of rash begins. These are the most obvious and first signs of chickenpox in children and adults.
The period of rash lasts for 3-5 days, while the lymph nodes increase, the temperature rises to 37-39 ° C, remaining throughout the entire period of rash. Also, each new push of eruptions, usually accompanied by a rise in temperature.
A rash in chickenpox appears on day 1 of the onset of intoxication, with swelling (appearance of new pimples) within 5 days – some acne is gone, and others are just appearing. Therefore, it seems that the patient has pimples of different types: bubbles, spots and crusts at the same time.
There is no favorite localization of the rash, rashes can be even on the scalp, on the oral mucosa, genitals in girls and women, conjunctiva / cornea, larynx. All these pimples ripen and heal within 5 days, and the rash is accompanied by itching of varying intensity. Against itching, various doctors recommend using antihistamines, wet wraps, or even baths.
During the first day, the red spot turns into a blister and after a couple of days the rash looks on the surface of the body as “dew drops” with transparent contents, which grow cloudy after 1-2 days, and after another 1-2 days the blister dries out and turns into a crust falling off 1-3 weeks.
As Dr. Komarovsky wittily said when he talked about chicken pox: “Decorating a child with brilliant green is a personal matter of his parents, determined by their love of painting and has no relation to treatment.” But in the meantime, brilliant green does not treat chickenpox, but a medical marker. , with which on the body of the patient mark the appearance of new pimples. As soon as new objects for coloring with green paint cease to appear on the skin of a child with chickenpox, and old pimples become crusted – that’s all, the child is no longer contagious. Nowadays, pimples smear with brilliant green only those who firmly believe that it is one of the indispensable means of treating chickenpox.
But this is a fallacy. Cure pimples can not, you can just wait until they pass. And in order to avoid secondary infection of the skin, it is necessary to prevent scratching in the acne area.
To do this, you need to purchase other drugs in pharmacies that are specially designed to eliminate the symptoms of such diseases. They relieve itching, dry, have a cooling effect and, by the way, are also not completely colorless.
A patient with chickenpox ceases to be contagious as soon as the appearance of new acne has ceased, and on all existing crusts. The recovery period lasts for 3 weeks from the end of the rash and is characterized not only by the loss of crusts, but also the development of lifelong immunity. After the fall of the crusts dark spots remain, which disappear within a few weeks.
Scar does not remain if there was no secondary infection.
Newborns who are breastfed, up to 6 months, usually do not get sick because of antibodies received from the mother, but only if the mother herself had previously had chickenpox or was vaccinated. If the mother did not transmit these antibodies to the baby (she herself does not have them), then the baby can get sick with chickenpox.
Note that we are talking about babies who are breastfed. Babies on artificial feeding, do not have such protection of antibodies.
In a sick infant, the disease is severe. Against the background of high temperature, intracranial pressure may increase, which will be indicated by the visible ripple of the spring, convulsions.
The rash of such babies is abundant and the aging of the rash is slower, acquiring a protracted nature – up to 9 days, instead of 5. Often there are bacterial complications.
For this reason, all newborns whose mothers did not get chickenpox or were infected several days before giving birth, as well as all premature babies up to 1 kg, regardless of the infectious history of the mother, must be given a special immunoglobulin. This is not a vaccine against chickenpox, but a temporary protection against it, until the child is sufficiently strengthened to cope with this virus on its own, unless, of course, the mother chooses the disease to be vaccinated.
It is worth noting that children who are not in the team, children under 3 years old, as a rule, very rarely have the opportunity to catch chickenpox. Adults also suffer from this disease not often.
In typical cases (and this is the majority of cases of chicken pox), the diagnosis of the disease is established on the basis of characteristic clinical data of the disease. The clinical picture of chicken pox is so characteristic that there is simply no need for additional diagnostics.
However, in some cases, when the disease is not quite typical, it may be necessary to conduct a differential diagnosis of varicella with other viral infectious diseases, mainly those that are accompanied by similar symptoms. This, above all, is about the flu, parainfluenza, measles, in some cases differential diagnosis with rubella may be required.
To do this, a blood test.
The doctor, of course, will not confuse these diseases. For doubting patients, one should keep in mind their obvious differences.
When chickenpox is most often observed polymorphic rash, that is, on the skin at the same time there are spots, and crusts, and bubbles. For rubella, only a pinkish rash can be observed.
With chickenpox, the temperature can rise to 40 ° C, with rubella it occasionally reaches 39 ° C. Rubella virus is dangerous for the fetus, varicella-zoster virus does not pose such an acute danger to pregnant women.
Chickenpox may be complicated by inflammation of the skin, with rubella this does not occur. Chickenpox rarely occurs with catarrhal phenomena, with rubella almost always there is redness of the pharynx, catarrh of the upper respiratory tract.
If a child of the first year gets sick with chickenpox, treatment is carried out only under the supervision of a doctor with possible hospitalization, because the course of infectious processes in young children proceeds with a tendency to generalization, frequent and severe complications and high mortality!
In children aged 2 to 10-12 years after the diagnosis (with primary chickenpox), there is no specific treatment for uncomplicated chickenpox (and patients are not colored with green paint). All manipulations with sick chickenpox are associated with relief of symptoms, namely: a decrease in temperature with antipyretic drugs (except aspirin) and the removal of pruritus, if any.
If the child does not look sluggish, if the temperature is not too high, then you should not convince him that he is very sick and needs bed rest. Children up to 10-12 years old tolerate chickenpox easily enough.
And the only thing that usually hurts them is the itching of a chickenpox rash. This problem is solved by the use of antihistamine drugs.
So that the child does not comb the skin in places of chickenpox, parents will have to watch him, distract him. It is also necessary to monitor the child’s nails, and very small ones can wear special mittens – “scratches”. There is also a “grandmother’s” way to help a child with severe itching, even if antihistamines do not help, is a pen.
In the past, kiddies relieved an itch with a goose feather – with its help mothers “scratched” especially disturbing spots on the skin, without creating scratches.
A month after recovery from chicken pox, the doctor examines the patient, with an appointment for immunological examination and passing specialists. Prophylactic vaccinations can not be done within 1 month.
In the recent past, quarantine for chickenpox was as common as the war paint with green paint on children affected by this virus. But now, kindergartens and schools with a mass incidence of chicken pox in quarantine, as a rule, do not close.
Groups and classes in which children with chickenpox are identified continue to function, but they can establish temporary (up to three weeks) bans on outdoor activities, on contacts with children from other groups (classes), and on admission of new children to them. .
It is a well-known fact: it is better to get sick with “childhood” diseases in childhood, ideally – even at preschool age. Chickenpox in adults is one of the most striking examples of this.
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