The incubation period and duration of infection with the chickenpox virus. When to call a doctor. Photo of the initial stage of chickenpox in children

Children who attend kindergarten or school are more likely to get sick - places with a large crowd of people.

The disease is caused by one of the herpes viruses (herpesvirus type 3). Chickenpox is a highly contagious disease. The virus is transmitted from a sick person to a healthy person by airborne droplets (when talking, staying in one small room). With a current of air, chickenpox can spread over long distances (up to 20 m). Infection can also occur from a patient with shingles (caused by the same type of herpes virus). The virus is unstable in the external environment, so the final disinfection after the patient is not carried out.

A person with chickenpox becomes contagious two days before the rash appears, and remains contagious for the first 5 to 7 days after the rash appears.

The incubation period for chickenpox is 7-21 days. The virus enters the human body through the mucous membranes of the nose, mouth and pharynx. Then the virus spreads throughout the body by lymph and blood, penetrates the skin and mucous membranes, where it multiplies. The targets for the virus are the cells of the spiny layer of the skin and the epithelium of the mucous membranes. After a primary infection, the virus resides for life in the neurons of the spinal ganglia, ganglia of the facial and trigeminal nerves. Like all herpesviruses, the varicella-zoster virus has the ability to suppress the immune system - resulting in impaired humoral and cellular immune responses and impaired innate resistance to infection.

Chickenpox immunity is non-sterile; causes immunity to a new infection and does not ensure the removal of the virus from the body. The virus resides for life in the spinal ganglia, the nuclei of cranial nerves that are associated with areas of the skin most affected by primary infection. Reactivation of the virus occurs in conditions of weakened immunity in the form of herpes zoster.

Symptoms of chickenpox in children

The disease manifests itself primarily as a feverish condition, a sharp increase in body temperature up to 39-40 degrees, and a headache. The most striking sign of chickenpox is a rash and itching.

A rash in the form of small, fluid-filled blisters may cover a large part of the body and mucous membranes. The bubbles burst quite quickly and turn into small sores, which must be treated with an aqueous solution of brilliant green or potassium permanganate, acyclovir and other ointments as prescribed by a doctor. While healing, the rash is covered with a crust, which gradually disappears, thereby demonstrating recovery. Usually the rash heals without a trace, but if you comb it, scars and scars may remain on the skin after healing.

In children, chickenpox occurs in a simpler form than in adults, who may suffer from complications in the future.

It is extremely rare that chickenpox can occur without rashes and blisters - in this case, an additional consultation with a specialist is necessary to clarify the diagnosis.

Chickenpox treatment

Chickenpox usually goes away on its own within a week or 10 days. In this case, the temperature can return to normal after two or three days, although, in some cases, it persists throughout the entire period of illness.

The treatment of chickenpox is symptomatic (i.e., the manifestations of the disease are treated: high fever, skin rash), since medicine at this stage does not know how to prevent or cure this disease. The goal of treatment is to prevent suppuration of the vesicles. Zelenka is perfect for this, you can use Castellani liquid, an aqueous solution of fucorcin or potassium permanganate, etc. Children tolerate alcohol solutions very painfully.

Bathing a child with chickenpox is necessary to prevent the occurrence of a secondary skin infection. In this case, you can not use a washcloth and it is better not to use soap, adding a weak solution of potassium permanganate to the bath. Create the most comfortable conditions for the baby's skin: do not wear tight and tight clothes, use only cotton underwear.

If your child is worried about severe itching, tell the doctor about it: he will prescribe antiallergic drugs.

When the temperature rises above 38 ° C, chills, the child must be given antipyretics (paracetamol, ibuprofen).

A person with chickenpox is isolated at home for nine days from the onset of the disease. In preschool institutions, quarantine is established for 21 days.

Complications of chickenpox

Complications of chickenpox are rare and are most often associated with inaccurate treatment of rashes and their suppuration, which subsequently leads to scarring.

It is extremely rare for weakened children to have severe forms of chickenpox with damage to the brain and internal organs. Such forms of the disease are treated in hospitals, using special therapeutic methods.

Vaccine and vaccination against chickenpox

The vaccine adequately protects against chickenpox and its complications. It is recommended for children aged 12 months and older, as well as adolescents and adults who have not previously had chickenpox and have not received vaccinations. The vaccine protects against the disease for 10 years or more. Rarely, people who receive the chickenpox vaccine may get chickenpox, but the disease will be mild.

Currently, in the United States, Japan and some other countries, chickenpox vaccination is mandatory for the admission of a child to a preschool. But in Russia, vaccination of children against chickenpox has not yet become widespread, and this remains the choice of parents.

It is worth noting that some people with a weakened immune system (due to illness or drugs that affect the immune system) should not be vaccinated, as they may develop complications. Therefore, a patient with a weakened immune system should consult a doctor before receiving the chickenpox vaccine.

Among children, chickenpox is the most common viral infection, but often adults also experience this pathology. In order to relieve the discomfort that a rash characteristic of the disease causes, you need to know how chickenpox is treated and what will speed up the healing process. Therapy will vary slightly depending on the age of the patient.

Windmill: description

Among diseases transmitted by airborne droplets, chickenpox can be distinguished as a representative of a group of highly contagious. The causative agent is a herpes virus called Varicella-Zoster. It combines two pathologies: chicken pox and shingles (herpes). The first is typical for children, and the second is more common in older people.

The virus is unstable in environmental conditions and exposure to ultraviolet radiation. It has been proven that the susceptibility of the human body to it is 100%, but if you get chickenpox once, then re-infection will not occur. The body develops strong immunity (lifelong).

In European countries, the outbreak of chickenpox in children's groups react calmly and do not take drastic measures (quarantine). It is believed that a child should be ill in preschool or adolescence, because adults are much more difficult to tolerate viral pathology. Having found the characteristic signs, you should immediately consult a doctor who will make a final diagnosis and tell you how to treat chickenpox at home (with a mild course) and prevent infection of others. Adult patients sometimes cannot do without hospitalization.

Reasons for the development of chickenpox

The very name of the disease speaks of the way it spreads - along the wind, that is, the airborne type of transmission of the virus is meant. The main reason for the development of chickenpox is contact with an infected person. The danger of infection appears even before the appearance of rashes on the body. Therefore, the incidence of children attending collective classes (kindergarten, school, creative circles) is significantly higher than that of adults.

Since chickenpox has a viral etiology, a weak immune system allows it to quickly enter the body. In the autumn-winter period, the number of patients who applied for medical help with signs of illness increases significantly. How to treat chickenpox and make you feel better, a qualified specialist will tell you by writing a therapy regimen. Self-medication can lead to complications, so even the use of alternative methods should be discussed with your doctor first.

Chickenpox symptoms

The incubation period lasts 2-3 weeks, and during this time the disease does not manifest itself in any way. Rarely, patients feel weakness, malaise. This is due to the transition of the virus from the respiratory system to the lymph and damage to other organs. The day before the rash appears, the patient becomes dangerous to others. The prodromal period in children passes in a blurred form, which in most cases does not allow timely detection of the disease. How much to treat chickenpox depends on the condition of the patient.

Early symptoms of chickenpox infection include:

• A rapid increase in temperature to 39 ° (maybe less).
• Simultaneously with fever, a rash appears in the form of rare pink spots.
• The appearance of vesicles with a clear liquid inside.
• Headache.
• Loss of appetite.

In the first days of the disease, rashes may appear on the mucous surface of the oral cavity, in the genital area. As the disease progresses, the old vesicles dry up, and new papules form nearby. It is strictly forbidden to comb them to prevent infection and scarring.

Features of the disease in adults

The symptoms of chickenpox in adults are more pronounced, which significantly worsens the patient's well-being. Waves of rashes can last up to 2 weeks. High temperature lasts longer, intoxication of the body causes dizziness, photophobia, body aches. In this case, it is important to know how to treat chickenpox in adults. At home, it is not always possible to cope with some forms of infection (such as hemorrhagic, gangrenous, typical severe and generalized).

Adults are more likely to suffer from the complications that chickenpox causes. For example, a rash on the cornea of ​​the eye can lead to partial loss of vision. The virus can cause abnormalities in the development of the fetus in early pregnancy.

Chickenpox in children

Babies under 5 years of age are most susceptible to the varicella-zoster virus. Children with good immunity tolerate the disease easily, rashes may be minor, and the temperature will not rise at all. When the defense system is weakened, for example, after a long illness, taking antibiotics or chemotherapy drugs, the virus can cause complications to the internal organs. Parents should always be on the lookout and know how chickenpox is treated in childhood.

Congenital chickenpox occurs in many babies whose mothers were infected with chickenpox a few days before birth, and the antibodies have not yet had time to develop and get into the body of the fetus. This is fraught with the development of pneumonia, encephalitis. Every third newborn child with such complications dies.

If the mother of an infant had chickenpox before pregnancy, then you don’t have to worry about the baby’s health. With milk, he will be given antibodies that protect the newborn from infection during the first months of life.

If the disease is mild, therapy can take place on an outpatient basis, with the isolation of the patient. Hospitalization may be needed for infants with a weakened immune system or with a severe course of the disease.

How to treat chickenpox at home correctly and without consequences? Only by following the doctor's orders. Parents should immediately realize that it is pointless to give antibiotics to a child in this situation, since viral pathology is not amenable to their effects. They do more harm than cure chickenpox. An exception is the situation when a bacterial infection has joined. Therefore, it is necessary to prevent peeling and scratching of the bubbles. An open wound is the main route for harmful microbes to enter. Taking antihistamines (Diazolin, Claritin, Suprastin) will help relieve itching. Lubrication of pimples with brilliant green is also practiced.

Water procedures during the period of illness are allowed, but in no case should the skin be rubbed. A weak solution of potassium permanganate (potassium permanganate) or a decoction of oak bark must be added to the water. This will help to avoid the spread of the rash and soothe irritation, itching. When parents are interested in how to treat chickenpox in children, in addition to brilliant green, doctors often recommend using Calamine lotion. It combines the action of an antiseptic and an antihistamine and promotes the speedy healing of blisters. As an antipyretic, it is recommended to take drugs based on paracetamol.

Antiviral drugs and immunostimulants for chickenpox

Varicella-Zoster is treatable with antiviral drugs. They are prescribed by the doctor, guided by the age of the patient.

The most commonly used drugs based on acyclovir:

• "Zovirax" (cream, tablets, injection ampoules, eye ointment).
• "Acyclovir" (eye and topical ointment, tablets, powder for the preparation of an injection solution).
• Virolex (tablets, ointment, lyophysilate).

The recovery of the patient also depends on the state of the immune system. Diseases of various etiologies and drug therapy only worsen its performance. Simultaneously with antiviral agents, immunostimulants based on interferon are prescribed. The substance is able to reduce the number of rashes and shorten the period of the disease. The attending physician will select the appropriate medicine and explain how to treat chickenpox.

At home, an adult, like a child, needs to stay in bed, drink plenty of fluids, and follow a diet.

Chickenpox in the mouth

Chickenpox rash on the oral mucosa delivers a lot of trouble and discomfort. Chewing and swallowing becomes painful for the baby, so you can not even try to feed him. What to do when chickenpox appears in the mouth? What is the most effective treatment? Doctors advise rinsing with decoctions of medicinal herbs. The best thing for this is chamomile, which has an antiseptic and anti-inflammatory effect, or a string.

Several times a day it is necessary to rinse the mouth with a weak solution of potassium permanganate, soda or just salt water. Itching and inflammation will help remove sea buckthorn oil, which you need to gently wipe the sores. Adults can use ice cubes to reduce mouth discomfort. Whatever method is chosen, before treating chickenpox, it is necessary to consult a specialist.

Bubbles with chickenpox in the oral cavity burst faster than on the skin. For the duration of the illness, it is necessary to abandon solid foods that can injure the mucous surface, and switch to soft, enveloping food. It can be jelly, milk porridge, cream soup.

What to smear rashes?

Red spots, which turn into liquid blisters over time, are a hallmark of a disease such as chicken pox (chickenpox). How to treat, besides brilliant green, a specific rash? The question is of interest to everyone who is faced with this disease. The opinion that Zelenka treats these rashes is erroneous. It dries and disinfects the wounds, and also allows you to control the appearance of new bubbles. The lack of funds - green traces on the body, which remain for some time after recovery.

Another popular "color" solution is "Fukortsin". It is also called "raspberry green". It has the same properties, but is washed off much faster. Before you treat chickenpox at home and turn into a "little green man", you need to familiarize yourself with more gentle ways.

Modern means of treating chickenpox rash include:

• Calamine is a solution developed on the basis of zinc oxide. Simultaneously disinfects and relieves itching, providing a cooling effect.
• PoxClean is a hydrogel with a cooling effect. Easily applied to the skin without damaging the bubbles, prevents scarring.
• "Fenistil-gel" allows you to quickly get rid of itching, has an anti-allergic effect.
• Tea tree oil is a natural antiseptic, which, moreover, relieves severe itching in chickenpox rash.

Folk recipes

Adherents of traditional medicine know how to treat chickenpox in adults and young patients. Most of the methods are aimed at suppressing the discomfort from the rash and the speedy healing of sores. You can, for example, dissolve the mummy (0.1 g) in 40 ml of warm water and wipe the pimples with the resulting mixture. Infusions of medicinal herbs should be added to the bath when bathing.

Asking the question of how to treat chickenpox in adults quickly and effectively, it is necessary, first of all, to strengthen the body's defenses. Not only medications will help to increase immunity, but also rosehip broth, tea from currant fruits, a mixture of lemon juice and honey. Well proven infusion of parsley. To prepare it, it is necessary to grind the dried leaves (1 tablespoon) and pour them with a glass of boiling water. Keep warm for at least 15 minutes, then take a quarter every 3-4 hours.

The consequences of chickenpox in adults

Despite the fact that adults rarely suffer from a disease such as chickenpox, complications occur in many. These include not only bacterial infections, but also inflammation of the joints (arthritis), pathologies of the upper respiratory tract (pneumonia, tracheitis), lesions of the meninges (meningitis, encephalitis), and stomatitis. You can avoid serious consequences only if you know how and how chickenpox is treated. You can't do without medical help either! It should be borne in mind that going to the clinic with symptoms of chickenpox is unacceptable.

In severe cases of chickenpox in an adult or a child, hospitalization is necessary. Under the constant supervision of specialists, the patient will recover faster, avoiding serious complications. Droppers will help to significantly alleviate the patient's condition with severe intoxication of the body.

Chickenpox prevention

The best way to prevent chickenpox in adults who did not have the disease in childhood is vaccination. The vaccine is an inactive virus that is harmless to the body but causes it to produce protective cells. In some countries, chickenpox vaccination is mandatory. Particular attention should be paid to vaccination for women who are planning a pregnancy. Children are also vaccinated.

Protecting yourself from a virus will not be easy if the system has not encountered chickenpox before. Contact with an infected person will lead to the development of the disease.

Before treating chickenpox in children at home, you need to call a pediatrician at home so as not to aggravate the condition of a small patient. At high temperatures, you can give an antipyretic. It is advisable to isolate family members who have never had chickenpox. You can turn on the quartz lamp in the room where the patient is. This will help reduce the chance of infection and spread of the virus.

If a child attends a kindergarten or school, it is necessary to warn the educator (teacher) about the disease. Children who have been in contact with the patient in recent days are quarantined.

Chickenpox (chickenpox, varicella) is an acute, highly contagious anthroponotic (only in humans) viral infection transmitted by airborne droplets and contact, accompanied by a vesicular rash and concomitant intoxication.

Chicken pox has been known since ancient times, but only from the end of the 18th century (1800) did it begin to be separated as an independent disease, separate from smallpox, thanks to the work of Vogel. 1911 - Aragao H. described small inclusions in the contents of vesicles - elementary bodies, considering them to be pathogens. The virus itself was isolated in 1940; 1958 and 1972 - proof of the identity of the pathogen in patients with chickenpox and herpes zoster!

Varicella zoster virus, model

The causative agent of chickenpox

Varicella zoster virus (Varictlla-herpes zoster is the 3rd type of herpes virus infection) is a DNA-containing virus, the capsid of which is surrounded by a lipid membrane, which is possible and predetermines its lifelong presence in the body.

Features of the chickenpox virus: quickly spreads through cell cultures (forms intracellular inclusions in epithelial cells) with their subsequent destruction, is able to exist in a latent form by staying in the neurons of the spinal ganglia for life, as well as the facial and trigeminal nerve.

The varicella-zoster virus is not stable in the external environment, it quickly dies at low and high temperatures, UV radiation and disinfectants, and can persist for up to several hours at room temperature.

Susceptibility to the chickenpox virus is high (since it is very volatile - it travels distances of up to 20 m, from floor to floor, through ventilation), especially for those who have not had chickenpox before or have not been vaccinated. Infection with chickenpox occurs even with fleeting contact with the patient. The seasonality of the disease is autumn-winter, and epidemic outbreaks are recorded every 5 years. Children 5-9 years old often get chickenpox, children under 6 months usually do not get sick due to antibodies received from the mother (if the mother had chickenpox in childhood). Adults also rarely get sick.

After an infection, lifelong immunity is formed, but in 3% of cases, re-infection is observed. It should also be mentioned that previously infected people become not only carriers, but also sources during an exacerbation of infection; their disease proceeds in the form of herpes zoster (shingles).

Causes of chickenpox infection

The source is a patient with chickenpox and herpes zoster. Patients are contagious one day before the onset of catarrhal symptoms (i.e. before the prodromal period) and within 5 days from the onset of the rash. Ways of transmission - airborne (when talking, coughing, loud crying, screaming), contact-household (infection with saliva or vesicles) and contact (with direct touch), transplacental (passage of the virus through the placental barrier).

chickenpox symptoms

Incubation period for chickenpox(from the moment of introduction, to the first signs of chickenpox) 11-23 days. During this period, the pathogen penetrates through the mucous membrane of the upper respiratory tract, then the reproduction and accumulation of this virus in the epithelial cells of these mucous membranes.

After the maximum accumulation of the causative agent of chicken pox, it spreads through the lymphatic and blood vessels, causing the occurrence of the following periods - prodromal or rashes.

Prodromal period of chickenpox- (this period may not be) occurs only in a small part of people and lasts 1 day. It is characterized by a scarlet-like rash that persists for several hours and then disappears, the temperature rises to 37-38⁰С and intoxication. More often this period is a reaction to viremia.

Eruption period- with chickenpox, it begins acutely (or immediately after the prodromal period) and lasts for 3-4 days or more. More often, there is no time limit between them at all. As well as the prodromal period, it is a reaction to viremia and is characterized by the following symptoms:

Enlargement of regional lymph nodes (may not be),

A fever of 37-39 ° C persists throughout the entire period of the rash and, each new push of the rash is accompanied by a rise in temperature,

A rash with chickenpox appears on the 1st day of the onset of intoxication, with sprinkling for 5 days - some are already passing, while others are just appearing. Therefore, the impression of false polymorphism is created (a variety of rashes in the same patient: vesicles, spots, and crusts at the same time). There is no favorite localization and staging, like measles (rashes can even be on the scalp - an important differential diagnostic sign, also on the oral mucosa, genital organs in girls, conjunctiva / cornea, larynx, with further ulceration and healing within 5 days). Already in 1 day, the red spot turns into a bubble and after a couple of days the rash looks like “dew drops” on the surface of the body with transparent contents, which becomes cloudy after 1-2 days, and after another 1-2 days the bubble dries up and turns into a crust that falls off after 1-3 weeks.

A patient with chickenpox ceases to be contagious as soon as the infusions have stopped and crusts have formed. The rash is accompanied by itching of varying intensity. With a good antiseptic treatment of rashes, they do not leave scars, but if these hygiene rules are ignored, secondary infection with bacteria from the surface of the skin occurs, followed by damage to the germinative layer and the formation of scars / scars, as with natural smallpox, but not as gross.

The recovery period lasts for 3 weeks from the end of the rash and is characterized by the disappearance of crusts and the formation of lifelong immunity. After the crusts fall off, dark spots remain, but they disappear within a few weeks. Scars do not remain if there was no secondary infection.

This classic picture is typical for chicken pox in children with normal immunity.

There are some groups of people for whom chickenpox is most severe and at high risk of complications, with a malignant variant of the course. This risk group includes: unimmunized pregnant women (danger to the fetus with possible disability), children in the first months of life from unvaccinated mothers, unimmunized adults (not vaccinated and not ill). In these cases, severe forms of chickenpox develop: hemorrhagic, gangrenous, bullous (see complications).

Features of the course of chickenpox in different age groups of children and adults

Chickenpox in pregnancy

Intrauterine infection (possibly in those pregnant women who are not immunized - either did not get sick or were not vaccinated):

Infection at 4 months of pregnancy - pathology of the skin, bones - underdevelopment of the limbs, central nervous system, organ of vision, urinary system, intestines, intrauterine growth retardation, lag in the psychomotor region. And after birth, the mortality rate is 25%.

At 6 months - embryofetopathy, similar to 4 months, does not occur, and after birth only symptoms of herpes zoster.

Infection with chickenpox from the beginning of 9 months of intrauterine stay and during the first 12 days of life leads to a severe course, accompanied by damage to internal organs (lungs, heart, kidneys, intestines) with further addition of hemorrhagic syndrome. In this case, mortality reaches 50%

If reinfection has occurred (i.e., re-infection in a woman who has already been ill or vaccinated), a few days before delivery (as shown above), then the baby's symptoms will develop immediately after birth and chickenpox will proceed easily, because antibodies from the mother to the child still in utero, through the placenta.

Chickenpox infection in infants (first 3 months of life)

It is registered extremely rarely, because maternal antibodies are transmitted to the baby even in utero through the placenta, but if this does not happen, then the following manifestations are observed:

The prodromal period is extended up to 4 days with moderate/severe symptoms of intoxication;
against the background of high temperature, cerebral symptoms may join (visible pulsation of the fontanel will indicate increased intracranial pressure, convulsive readiness, and other manifestations);
rashes are plentiful and stages proceed more slowly (i.e. the formation of spots, then bubbles, after crusts and pigmentation) and the period of rashes becomes protracted - up to 9 days, instead of 5;
bacterial complications often occur.

Features of chickenpox in adults

More pronounced symptoms of intoxication;
The rash does not appear on the 1st day, but on 2-3. The staging and the period of rashes itself becomes protracted.
Secondary bacterial infections, development of pneumonia and other complications are frequent.
Itching is much more pronounced.

Adults with chickenpox are more likely to experience complications (see below)

Chickenpox Diagnosis

1. Virological method - isolation of the causative agent of chickenpox from vesicles and exfoliating skin lesions. But it takes time and is used only in controversial cases.

2. Express method - RIF (immunofluorescence reaction), with the help of which viral antibodies are detected.

3. Serological - ELISA (enzymatic immunoassay) - aimed at the detection of specific IgM and G antibodies to the varicella zoster virus; M- appear even in the incubation period (after 4-7 days from the moment of infection) and persist for 2 months, Their presence indicates an acute period; G - appear at 2-3 weeks and persist for life, they indicate immunization, i.e. protection.

4. Genetic method - the use of PCR (polymerase chain reaction) is aimed at detecting the DNA of the virus.

5. General clinical analyzes: KLA (↓Lc, Lf, normal ESR). Immunological examination: ↓T-lymphocytes, violation of the B-cell link, activity of Hf and macrophages, CEC (circulating immune complexes).

In fact, the listed diagnostic methods are not often used by doctors, often the diagnosis is made on the basis of complaints and examination, in which the nature of the rashes is assessed, which in general is not correct, and tests are prescribed in case of complications.

Chickenpox treatment

Often, according to an old habit, a doctor, having diagnosed chicken pox, does not prescribe any treatment, except for antipyretic drugs and lubricating the rash with brilliant green - at the stage of modern development of medicine, this is not entirely correct. Such a set of drugs can be limited only if the chickenpox is mild, there is little rash, the child eats well and feels satisfactory. In other cases, in children and in the treatment of chickenpox in adults, etiotropic treatment aimed at destroying the virus is a must! Remember that the varicella zoster virus remains in the body for life after an illness and can subsequently manifest itself as herpes zoster, therefore, the more effective the etiotropic treatment is, roughly speaking, the more the virus dies, the less likely it is to get health problems in the future.

1. Etiotropic treatment of chickenpox

Viricidal drugs directed specifically against herpes viruses:
acyclovir = zovirax = virolex (from 2 years old);
valciclovir (from 12 years old),
famciclovir (from 17 years old), isoprinosine; Acyclovir ointment is also used for rashes and conjunctivitis (eye damage).

Immunomodulators: interferon, viferon

Immunostimulants: cycloferon, anaferon

Antibiotics are used for secondary bacterial complications, and 3rd generation cephalosporins are the drug of choice.

In severe cases of chickenpox, intravenous immunoglobulins are used. All of the above drugs should be used in age dosages. If a child of the first year falls ill, treatment is 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!

2. Pathogenetic treatment of chickenpox

Bed rest 3-5 days (longer in complicated cases)

Careful care of the skin and mucous membranes:

Hygienic baths / showers, after that do not rub the skin, but lightly blot with a towel,
treatment of the rash with brilliant green to prevent secondary infection,
treatment of the oral mucosa - rinsing with furacillin and / or sodium sulfacyl, or sodium hydrogen carbonate;
with conjunctivitis, you can use acyclovir ointment to prevent bacterial complications - albucid 20%, chloramphenicol ointment or tetracycline.

Plentiful alkaline drink

In severe cases - stronger immunomodulators (thymolin, thymogen, IRS-19) and cytokine preparations (ronkeilikin),

Multivitamins, probiotics (bifidum-lactobacterin, linex), enterosorbents (smecta), metabolic therapy drugs according to indications (riboxin, cocarboxylase), mucolytics / expectorants (ambroxol, bromhexine, thyme decoction, chest collection No. 1) and anti-inflammatory aerosols for dry cough ( Erespal), antiplatelet agents (actovegil, cavinton, etc.), antihistamines (with severe itching, they are used topically - fenistil gel or gistan, or other antihistamine ointments; and inside, antihistamines suprastin, tavegil, etc. are used); antipyretics (ibuprofen, nurofen, or physical methods of cooling - wrapping).

3. Symptomatic treatment is prescribed from the ranks of pathogenetic groups of drugs or, in case of more serious complications, cardiac glycosides.

Treatment lasts an average of up to 2 weeks (including medication).

Rehabilitation after suffering chickenpox

A month after recovery, the doctor examines the sick person, with an appointment for an immunological examination and the passage of specialists,

Protective mode within 2 weeks after recovery (exemption from physical activity),

Withdrawal from preventive vaccinations for 2 months,

Appointment within a month: multivitamins and / or vitamin-mineral complexes, metabolic therapy and herbal adaptogens.

Complications of chickenpox

Chickenpox complications are often associated with the addition of bacterial microflora, in addition, the immunosuppressive function of the varicella-zoster virus contributes to this, resulting in: gingivitis, stomatitis, purulent parotitis, conjunctivitis, keratitis, otitis media, sepsis, pneumonia, glomerulonephritis, encephalitis, myelitis, nephritis, myocarditis , keratitis, Reye's syndrome, arthritis, laryngitis.

But the most formidable complication is hemorrhagic form of chickenpox, in which the vesicles are filled with hemorrhagic contents (blood) = "bloody dew", multiple hemorrhages in the skin / mucous membranes / bleeding from the nose / hemoptysis / gastrointestinal tract and other organs.

Gangrenous form characterized by the appearance of large flabby blisters, with a zone of necrosis, a scab. After the blisters fall off, ulcers form, which quickly become infected, as a result of which sepsis often develops and a fatal outcome occurs soon. But all severe complications develop against the background of immunodeficiencies, taking glucocorticosteroids (GCS) or hormones.

Reye's syndrome can also result in death. The syndrome is based on fatty infiltration of the liver with the development of hypoglycemia, a significant increase in the level of transaminases, coagulopathy, an increase in the content of ammonia and the level of fatty acids, the formation of toxic metabolites that cause direct damage to neurons, demyelination, and cerebral edema. Symptoms of the syndrome are nausea, vomiting, delirium, epileptic seizures with the development of coma. Because of the danger of Reye's syndrome, aspirin should not be prescribed to children under 11 years of age for any viral infections, including chicken pox, in which the risk of this complication is already increased. Reye's syndrome occurs exclusively before the age of 15 years.

If you have any symptoms of an atypical course of chickenpox, call your doctor immediately.

Chickenpox prevention

In the absence of contraindications (immunodeficiency states (IDS), the recent period of treatment with corticosteroids / immunosuppressants / hormones, acute diseases or exacerbation of chronic ones), vaccination against chickenpox can be done at 2 years - Varilrix, Okavax, Prevenar or Pneumo-23 vaccines (the last 2 also against pneumococcal infection);

Passive immunoprophylaxis is used by the introduction of "Varicella-Zoster-immunoglobulin" - VZIG, it is necessary: ​​for persons with IDS; all newborns whose mothers did not have chickenpox or became infected a few days before birth; all premature infants up to 1 kg, regardless of the infectious history of the mother.

Non-specific prevention of chicken pox - quarantine (isolation of the patient) within 5-7 days from the onset of rashes, with periodic ventilation and wet cleaning of the premises. All non-immunized contacts will be isolated for up to 21 days.

Kindergartens and schools with a mass incidence of chickenpox for quarantine, as a rule, are not closed.

Therapist Shabanova I.E.

Chickenpox is an extremely contagious infectious disease. As they say, it spreads with the speed of the wind. A person becomes a carrier of the disease two days before he discovers the first symptoms. It is because of this feature that 90% of the population has time to get chickenpox in childhood. Having not acquired immunity against this disease at the age of 3-12, there is a risk of experiencing it on yourself in adulthood. Despite similar symptoms, the causative agent of chickenpox in the body of adults behaves much more aggressively: a longer period of the course of the disease, a more abundant rash, increased, temperature up to 40 degrees, painful swallowing, pustular formation, general loss of strength, possible complications.

If you get sick, you will have to quarantine and postpone all personal contacts for at least two weeks. Surely in your environment there are those who have not yet acquired lifelong immunity to chickenpox.

The main irrefutable symptom is rashes that appear all over the body (on the chest and abdomen, arms and legs, face, hair on the head, tongue, palate, nose and even in the perineum). The rash will turn into blisters 2-3 mm in diameter, filled with fluid. The bubbles itch unbearably, but you will be tested for endurance, since it is absolutely impossible to scratch them. This threatens with scars and scars in place of blisters, and if this is the area of ​​\u200b\u200bthe eyebrows, beard and mustache, then an ugly bald patch.

What is a windmill?

Chickenpox is one of the most common acute infectious diseases. It is characterized by rashes on the skin and mucous membranes in the form of small vesicles and fever. It is transmitted by airborne droplets. Most often, chickenpox affects children and adolescents. It is believed that it is better to get chickenpox in childhood, since with age this disease proceeds in a complicated form: with encephalitis, primary varicella pneumonia.

Causes of chickenpox

The disease is caused by a virus of the herpes family. The susceptibility of the population to this virus is very high, so 70-90% of people have time to suffer the disease in childhood or adolescence. As a rule, a child picks up an infection in a kindergarten or school. The source of the disease is an infected person in the last 10 days of the incubation period of the virus and the first 5-7 days from the onset of the rash.

After chickenpox, lifelong immunity is formed, but re-infection also occurs. The virus can “sleep” for years in the body of a person who has had chickenpox and “wake up” at one moment. The cause may be nervous overstrain or. In such cases, an adult may develop. Having no obvious signs of a rash, nevertheless, such a person is a distributor of the disease.

It is also possible infection with the virus through the placenta - from the mother to the unborn baby.

For pregnant women, it is especially dangerous, as it can cause the development of congenital chickenpox in a child, premature birth, or lead to the death of the fetus.

Complications of chickenpox usually occur in connection with a concomitant secondary infection (abscess, pyoderma, sepsis, phlegmon). Sometimes a week after the rash appears, viral-allergic meningoencephalitis develops. There are also cases of focal myocarditis and nephritis.

Chickenpox symptoms

The incubation period lasts from 1 to 3 weeks. Children are characterized by general malaise, irritability, loss of appetite and tearfulness. In adults during this period, fever, malaise, headache, nausea and vomiting are often diagnosed.

The next stage in the development of the disease is associated with the appearance of a rash on the skin and mucous membranes. The body temperature rises, the level of intoxication of the body increases. In children, the rash appears earlier than in adults. In adults, intoxication is more pronounced, and the fever persists much longer.

The next stage of the disease is the formation of blisters filled with fluid. They burst, and ulcers appear in their place. Recovery takes two to five weeks while the sores heal and crust over. The disease reminds of itself for a long time with painful sensations along the course of the affected nerve.

Herpes zoster is dangerous with complications: rheumatism, arthritis, pneumonia, myocarditis, neuralgia. Anti-herpetic drugs are taken to prevent them.

Other forms of chickenpox

Along with the typical forms of chickenpox, there are also erased forms that can occur without clinical manifestations. Such forms of the disease are considered severe. These include:

The bullous form is a concomitant severe disease that develops only in adult patients. It is characterized by the formation of large flabby blisters on the skin, turning into sluggishly healing ulcers.

Hemorrhagic form- observed in patients with hemorrhagic diathesis. Typical for her is the appearance of vesicles with bloody contents, the development of hematuria, nosebleeds. Patients have hemorrhages on the skin.

Gangrenous form- occurs in debilitated patients, occurs against the background of a rapid increase in the size of vesicles and the transformation of their contents into a hemorrhagic form. After the sores dry up, black crusts form, which have an inflammatory rim.

Chickenpox can lead to severe complications associated with exposure to the virus and the body's response to it, for example, chickenpox laryngitis, tracheitis, encephalitis,. Deep lesions of the epidermis of the skin with the formation of noticeable scars are also possible. With the spread of chickenpox flora, such complications of the disease as nephritis, myocarditis, arthritis can be observed. Secondary attachment of bacterial flora and purulent inflammation are also possible.

Chickenpox in pregnant women

Chickenpox in pregnant women deserves a separate discussion. In addition to the risk for the expectant mother, there is a danger for the fetus. As a result of chicken pox, the course of pregnancy can be disrupted and even spontaneously interrupted. That is why the treatment of chickenpox for pregnant women should be carried out under the strict supervision of a doctor. Do not worry too much, because anomalies in such a newborn are diagnosed in only one case out of a hundred. With chickenpox without complications, premature birth and spontaneous abortions in women were not observed.

However, deviations are sometimes possible, since the virus can enter the fetus from the mother through the placenta. Cases of congenital malformations, pathologies of the visual apparatus, mental and physical retardation, and paralysis are described.

It has been noticed that the disease of chickenpox in a future mother in the early stages (up to 3.5 months) is practically not dangerous for the fetus. With the development of chickenpox for up to 5 months, the risk for the unborn baby increases slightly, and from 5 to 9 months it is almost reduced to zero. The last days of gestation are an exception. They are the main danger. If a pregnant woman fell ill a few days before giving birth, then in 15% of cases the virus affects the internal organs of the baby. To prevent such a situation, serum with antibodies is administered as soon as possible to the mother and the newborn. The baby is isolated from the mother until the danger of infection passes.

Chickenpox treatment

Chickenpox is treated at home and only in severe cases - in the hospital. The decision on hospitalization is made by the attending physician.

As a rule, no special therapy is required. Until the rash stops, the patient should be isolated. Bed rest for up to 8 days is recommended for a child and adult with chickenpox. It is advisable to change bed linen as often as possible, and underwear - every day. Clothing made from soft natural fabrics is suitable.

The patient needs to drink more fluids and follow a diet of a milk-vegetable nature (mashed fruits and vegetables, milk porridge). Juices are best diluted with water in a ratio of 1:1. Sour, spicy and salty foods should be excluded from the patient's diet.

At home, red spots and blisters are treated with green paint or a 1-2% solution of potassium permanganate. If rashes appear in the oral cavity, mouth rinses should be carried out with antimicrobial agents (for example, furacilin solution).

Throughout the entire period of illness, the patient is worried about constant itching (). However, scratching can introduce infection into the wound. If this happens, the spots on the skin take longer to heal and may even remain as scars. It is best to cut your nails short, and the baby should wear cotton mittens on the handles. In addition, itching increases with the appearance of sweat, so doctors do not advise wrapping the patient in warm blankets. It is worth noting that warm indoor air also exacerbates itching. It is best to give the patient a damp cold cloth - let him apply it to those places that you want to scratch.

Medicines containing ibuprofen or paracetamol are used to reduce fever. With chickenpox, aspirin is contraindicated, which increases the susceptibility to the development of Reye's syndrome.

To reduce the severity of the disease, antiviral drugs are sometimes used, which are prescribed by a doctor. It can be antibiotics or immunoglobulin.

Chickenpox vaccine for adults

The disease transferred in childhood usually gives stable lifelong immunity. But for people who did not get sick in childhood, and for those who are at risk for developing severe forms of the disease, there is the possibility of vaccination. On the territory of Russia, the vaccines Varilrix and Okavax are officially registered.

The chickenpox vaccine forms a stable and long-lasting immunity in the human body. Suitable for both routine and emergency vaccinations. If the vaccine is administered within the first 72 hours after the first contact with the patient, then protection against infection is almost 100% guaranteed.

No side effects or serious complications have been reported with vaccination, so these drugs can be used in people with a weakened immune system or with severe chronic diseases.

Expert editor: Mochalov Pavel Alexandrovich| MD general practitioner

Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Chickenpox- one of the most common infectious diseases, occurring with a characteristic bubble rash. Children 2-6 years old who attend kindergarten or school (places with a large number of people) get sick more often.

The causative agent of chickenpox is one of the herpes viruses, which is called Varicella Zoster and has a very high volatility (it can spread with air over distances of up to 20 meters). Outside the human body, the virus persists for only 10-15 minutes, quickly dies in direct sunlight and heating, so the highest incidence occurs in the autumn-winter, early spring period.

How can you get chickenpox

The infection is transmitted by airborne droplets (when talking, staying in one small unventilated room); with air flow, the virus can spread over long distances, such as neighboring rooms. The causative agent of chickenpox is unstable in the external environment and enters the body through the mucous membranes of the upper respiratory tract - through the mucous membranes of the nose, mouth and pharynx. Then the virus spreads throughout the body by lymph and blood, penetrates the skin and mucous membranes, where it multiplies. The virus is not transmitted through things, objects and third parties.

The source of infection is a sick child who becomes contagious 1-2 days before the onset of the rash and remains contagious for the first 5-7 days after the last rash appears. Infection can also occur from a patient with shingles.

It is believed that a child up to 4-5 months of age is protected from the disease (if the mother had chickenpox and the woman has antibodies to the chickenpox virus). However, children of all ages can get chickenpox, including newborns. More than 90% of cases are children under the age of 10 years.

The transferred disease leaves strong immunity, repeated cases of chickenpox are possible, but very rarely recorded.

chickenpox incubation period

The incubation period is the period of time from the moment the virus enters the human body until the first symptoms of the disease appear. The infection penetrates into the tissues, organs, where they accumulate, the virus multiplies. The duration of the incubation period is important to know in order to understand when to expect the first manifestations of chickenpox, as well as for quarantine measures.

As a rule, during the incubation period, a sick person is not contagious to others, but not with chickenpox. The release of microbes with saliva when coughing and sneezing begins 1-3 days before the first signs of chickenpox appear.

Chickenpox usually appears between the 10th and 19th day from the date of infection (the incubation period is 11-21 days, usually 14-16 days). Patients with chickenpox become contagious at the end of the incubation period (48 hours before the rash appears) and continue to pose a danger to others until the 5th day after the last element of the rash appears.

As a disease, chickenpox is diagnosed very easily.

Diagnosis of chickenpox

The diagnosis of chickenpox is made by a doctor if there is information about contact with a patient with chickenpox, a characteristic rash. When the doctor makes a diagnosis, he looks for a fresh pimple among the crusts with a bubble that has not yet burst.

Chickenpox symptoms

Chickenpox begins with an increase in temperature to 38-39 ° C (although in some children the temperature is much lower), the child’s weakness, small single red spots appear against this background, then in the next few hours bubbles 3-5 mm in diameter form on their base, filled with a clear liquid with a pink rim (they can be compared to a dew drop).

Chickenpox stages:
1 - visicle vesicle, 2 - formation of crusts.

On the second day, the contents of the bubbles become cloudy, the surface of the bubble becomes wrinkled, the center begins to sink. In the following days, crusts form, which gradually dry out and fall off over 7-14 days, leaving red spots that do not fade for many weeks. The rash usually does not occur simultaneously, but as if in jolts within 2-5 days. Due to the rapid change of each bubble in one part of the body, you can see a rash in a different stage: a spot - a bubble - a crust. When peeling off the crusts and introducing an infection, scars may remain on the skin. The rash is accompanied by severe itching, a cough may appear (due to blisters that affect the mucous membrane).

Usually, a rash with chickenpox occurs first on the face, scalp, torso, then spreads to the limbs; sometimes the mucous membrane of the mouth, external genitalia, conjunctiva of the eye are affected. There is no rash on the palms and soles. The rash is accompanied by intense itching. The child becomes lethargic, naughty, his appetite worsens. As a rule, each wave of a new rash coincides with a deterioration in the general condition of a child with chickenpox.

Chickenpox on the neck of a child

windmill shapes

Chicken pox is manifested by typical, atypical and erased clinical forms. Typical chickenpox is divided into mild, moderate and severe according to the severity of the course.

Lightweight windmill. The disease proceeds without a rise in temperature or the body temperature does not exceed 38 ° C and is of a short-term nature. General well-being, as a rule, is not disturbed, rashes are not plentiful, lasting 2-3 days.

Moderate form of chickenpox- accompanied by an increase in temperature to 38-39 ° C, the temperature lasts for 3-4 days. Symptoms of intoxication appear: headache, vomiting may occur, sleep and appetite are disturbed. Rashes are plentiful, especially on the trunk and extremities, and not only on the skin, but also on the mucous membranes of the mouth, external genitalia, last 5-7 days and are accompanied by skin itching. Many children with moderate varicella have swollen cervical lymph nodes.

Severe form of chicken pox. The temperature rises to 39-40°C, which lasts for 6-9 days. The child's health deteriorates significantly, he has a headache, lethargy, vomiting, sometimes delirium, refusal to eat. Rashes on the skin and mucous membranes are abundant, large, accompanied by severe skin itching lasting 7-8 days. Very often, not only cervical, but also axillary and inguinal lymph nodes increase.

Complications with chickenpox

Complications of chickenpox are rare: this is the development of croup, pneumonia, nephritis, encephalitis (inflammation of the brain), serous meningitis. Swollen lymph nodes may be a reaction to an infection in the area of ​​the rash. More often, complications are caused by combing the rashes and peeling off the crusts, and this contributes to the attachment of a pustular infection (staphylococcus, streptococcus, pneumococcus), which leads to the formation of pustules; children of the first years of life develop otitis media and pneumonia. Complications are quite rare and are most often associated with inaccurate treatment of rashes, which subsequently leads to scarring.

If the mother had chickenpox during the first trimester of pregnancy, severe malformations may occur in the fetus.

Chickenpox is a "childhood" disease, but non-experienced adults can also be infected, and with age, this disease is more difficult to tolerate.

Treatment and prevention of chickenpox

Prevention of chickenpox consists in isolating sick children until the fifth day after the last elements of the rash appear. After isolating the patient, the room is carefully, repeatedly ventilated - the virus is afraid of drafts. Wet cleaning is required. Children who have been in contact with the sick person are subject to quarantine from the 11th to the 21st day of contact.

Treatment chickenpox is carried out at home and consists mainly in the prevention of bacterial complications. To avoid the spread of infection, all personal hygiene rules should be strictly observed:

• from the first day of illness, it is necessary to bathe the child, adding a weak solution of potassium permanganate to the bath. Itching can be relieved by taking two to three baths a day with a warm solution of cornstarch, baking soda, or oatmeal. A full glass is dissolved in a small bath, 2 glasses of the product in a large bath. Dry starch is poured into a container with a capacity of 2-4 cups, then cold water is slowly added with constant stirring until the starch is completely dissolved (thus no lumps form). Then pour the resulting solution into the bath.
• change linen daily. T-shirts and shirts should be made only from natural materials.
• trim your nails to prevent blisters from scratching. If the child is very small, put on cotton mittens for him.
• wash your child's hands with soap and water at least three times a day and wear cotton mittens at night so that he does not scratch himself in his sleep.

Don't let your child scratch the blisters (scabs) caused by chickenpox, as this can lead to a secondary bacterial infection or scarring.

Your doctor may prescribe a mild antihistamine to relieve itching.

Lubricate the blisters with your choice of weak potassium permanganate solution (1-2%), aqueous, alcoholic solution of brilliant green (1-2%), fucarcin solution, rivanol solution (0.05%) or methylene blue aqueous solution (1%). This will help dry out the blisters.

If the baby has rashes on the oral mucosa, rinse regularly with a weak solution of furacilin or miramistin or treat with a 2% solution of methylene blue.

When the temperature rises above 38 ° C, the child should be given antipyretics based on paracetamol or ibuprofen, never give aspirin!

Try to follow a dairy-vegetarian diet (do not give your child sweets, soda, fried foods) and give your child plenty of fluids - juices (preferably diluted in half with water), rosehip broth, cranberry juice, dried fruit compote.

Try to have a comfortable temperature at home, do not wrap the baby up, sweat increases itching.