Chickenpox in HIV-infected adults. Chickenpox (chickenpox): symptoms in children and adults, treatment, prevention. What is chickenpox

Chickenpox, or chickenpox, is an acute anthroponous (only in humans) infectious disease with an airborne (aerosol) transmission mechanism of the virus, characterized by the appearance of a vesicular rash, the presence of fever and general intoxication syndrome.

Cause of chickenpox (chickenpox)

The causative agent ("vector") of chickenpox (chickenpox virus) is a human herpes virus of type 3 - "Varicella Zoster". In the environment, the virus is absolutely unstable, highly sensitive to disinfectants and ultraviolet light; dies when exposed to high temperatures. It multiplies in the nuclei of the affected cells and has a pronounced cytopathic (affects the cell) effect.

The source is patients with all forms of chickenpox, as well as patients with herpes zoster (herpes zoster). The route of transmission of the virus is airborne (aerosol), that is, the virus is released as a result of sneezing, kissing, coughing and banally - during a conversation, being released along with microscopic droplets of saliva. The virus has a very high volatility, which makes it highly infectious even when located at a distance of 15-20 meters from a sick person. As a result of infection of a pregnant woman, the virus, entering the bloodstream and causing viremia, can cross the placenta and enter the fetus with further consequences (described below). The infectiousness of chickenpox is quite high - patients are contagious 24 hours before the first elements of the rash appear and up to 5-6 days from the moment the last rash appears. The sensitivity to chickenpox is quite high, but newborns have innate immunity, which was passed on to it from the mother, therefore, chickenpox in children under 6 months, as a rule, does not occur.
The largest number of cases occurs at the age of up to 7 years, and mortality occurs in cases of illness in old and senile age. The peak of all the incidence of chickenpox falls on 2 periods: the autumn period and the transition from autumn to winter (October - December). After the transferred chickenpox, a person develops non-sterile immunity of chickenpox, which remains for life, therefore, repeated cases and relapses of chickenpox are extremely rare.

The incubation period is long and ranges from 9 to 22 days. Chickenpox in adults often occurs with the presence of a prodromal period (without clinical manifestations). In children, the disease most often begins with the appearance of elements of a vesicular rash, and only after a few days general manifestations join.

Types of chickenpox (classification of chickenpox).

Chickenpox occurs in typical and atypical forms and is mild, moderate and severe in severity. Chickenpox is also classified according to ICD-10 (with meningitis, encephalitis, pneumonia).
Atypical forms of chickenpox are divided into:

Hemorrhagic form - a common consequence of this form is bleeding, and this form occurs in people with thrombocytopenia.

Pustular form - develops when a bacterial agent is attached.

Gangrenous form - can lead to the development of sepsis and occurs most often in patients with weakened immunity.

The generalized (visceral) form of chickenpox is characteristic of the development in patients with immunodeficiency. It is very difficult, the symptoms are more pronounced and often ends in death for the sick person.

Rudimentary form - occurs in children who received immunoglobulin during the incubation period. It flows quite easily.

The severity of chickenpox is directly determined by the degree of intoxication syndrome and its criteria, as well as the presence of specific vesicular rashes on the skin and mucous membranes. It should be noted that there are also so-called abortive (very mild) cases of the disease, which proceed without the appearance of fever and are characterized by the appearance of single rashes on the skin of the abdomen and back. Such chickenpox is detected in kindergarten during examinations during outbreaks.

To the question "how long does chickenpox last?" It is difficult to answer unequivocally, since the duration of the disease directly depends on the form and course of chickenpox. On average, in the classical (typical) course, the duration of the disease is from 12 to 16 days.

Chickenpox (chickenpox) of newborns.

The manifestation and clinical picture of chickenpox directly depends on the time when the pregnant woman was infected with the virus. Fetal syndrome (usually manifested by underdevelopment of the upper and lower extremities, the appearance of cicatricial changes on the skin, atrophy of the cortical structures of the brain, microcephaly - a decrease in the size of the brain and the volume of the cranium) occurs very rarely, especially if the pregnant woman was infected in the first trimester of pregnancy ... Chickenpox during pregnancy can have consequences for the fetus according to two more criteria:

In the case when a pregnant woman becomes infected with a virus 4 days or less before delivery or within 2-3 days after delivery, a generalized (so-called visceral) form of chickenpox may develop in a newborn.

In the case when a pregnant woman becomes infected with a virus more than 4 days before delivery (5 days, a week, a month), then she develops antibodies to chickenpox, which, penetrating into the child's body, can prevent the development of the generalized form.

The consequences of chickenpox (chickenpox).

Both secondary associated infections and chickenpox itself can lead to similar consequences. Complications after chickenpox (typical form) are rare.

• Bullous impetigo. As a result of the attachment of a secondary (bacterial) infection (in particular, Staphylococcus aureus), a disease such as bullous impetigo, characterized by massive lesions of the skin, can develop.
• Cutaneous gangrene. It develops when staphylococcus penetrates into the subcutaneous fat and multiplies in the deep layers. Very often this leads to the development of a septic process.
• Wound scarlet fever. The development of such a complication is possible with the penetration of streptococcus (hemolytic) into some of the elements of the chicken rash, which leads to the appearance of a small rash all over the body, characteristic of scarlet fever.
• Pneumonia. Pneumonia is a rather severe complication of chickenpox, and in the first few days, pneumonia (chickenpox) can lead to respiratory failure and death, especially in people with immunodeficiency and pregnant women. In the future, abscesses and their breakouts may form with the formation of fistulas.

Other complications can be phlegmon, lymphadenitis, can occur erysipelas, myocarditis, but the most serious complication is post-windmill encephalitis, the mortality rate of which is 10-15%.

Swimming with chickenpox.

There is an opinion that it is generally impossible to wet the rash with chickenpox, because this can lead to a generalization of the process. This issue can be viewed from two angles: when to wet and how to wet. The state of the current plumbing system and the quality of the water indicate that it is undesirable to wet the elements of the rash and swim with chickenpox, especially before the crust appears. This is due not only to the addition of bacterial flora, but also to the fact that the appearance of a virus in water can lead to contamination of unaffected skin areas, which in the future can lead to severe intoxication. At the same time, in some foreign sources, on the contrary, it is recommended to bathe with chickenpox with the addition of a small amount of potassium permanganate to the water, which will contribute to better healing and elimination of itching. Based on this, it is possible to unequivocally answer the question "is it possible to wash with chickenpox?" it is forbidden. One has only to remember that, even if you still decide to wash during the illness, you should not rub the elements of the rash with a washcloth. It is advisable to take a shower without steaming the skin.

Which doctor should i contact for chickenpox (chickenpox)?

Chickenpox is infectious disease, therefore, it is best to immediately consult an infectious disease doctor. However, symptoms such as the appearance of a rash are usually delayed. Therefore, a person who does not suspect that they have chickenpox goes to a therapist or pediatrician with general complaints. After a thorough examination, the therapist in any case sends the patient to the infectious disease specialist for further hospitalization in the hospital. In some cases (in case of refusal of treatment in a hospital, lack of beds), outpatient treatment may also be indicated.

Symptoms

Chickenpox: the incubation period and the first symptoms in children and adults

The symptoms of chickenpox are divided into two groups: general symptoms characteristic of many infectious diseases, and specific characteristics of how this pathology manifests itself. The first group includes

malaise, weakness;

headache;

Body aches;

• increased body temperature with chickenpox (specifically up to 37-38 ° C);

  sleep disturbance;

  lack of appetite;

  side disorders gastrointestinal tract(nausea, vomiting, diarrhea with chickenpox).

The incubation period of the disease is 6 to 20 days. Therefore, the first symptoms of chickenpox, belonging to the second group, appear, as a rule, two weeks after the moment of infection. But since it is difficult to accurately determine the moment at which the pathogen virus entered the body, it is more expedient to count from the onset of the disease. The onset of the disease is considered to be an increase in body temperature. By the end of the first day, specific signs of chickenpox appear, namely, a papular rash. The number of elements varies from several dozen to several hundred. Localization of rashes can be different:

scalp;

mucous membranes;

• upper and lower limbs;

  buttocks and hips.

Chickenpox is more difficult in adults than in children. The disease can be of two types. The most common form of the disease is the traditional form. But recently, there have been cases of registration of an atypical course of chickenpox.

• Typical shape. Another name is traditional. There are three possible stages: mild (a slight increase in body temperature, barely noticeable rash), moderate (an increase in body temperature to 38 - 39 ° C, general malaise, elements of the rash are localized on the skin, but also affects chickenpox and mucous membranes) and severe (body temperature above 39 ° C, profuse large eruptions, weakness, headache, lack of appetite).
• Atypical form. This form is also called rudimentary. In most cases, it occurs in children, mainly newborns. Among possible options of how the atypical course of the disease manifests itself, there are three types: a generalized form with a predominant lesion internal organs(liver, kidney, lungs, etc.); hemorrhagic form with the appearance of hemorrhages in the epidermis, intestinal bleeding, bloody vomiting and gangrenous form, when the bubbles turn into ulcers, often leading to the development of sepsis.

All types of atypical forms are characterized by a severe course, the addition of secondary infections, and the development of complications. This can be observed in both children and adults. The patient requires prompt hospitalization.

Specific signs of chickenpox

As mentioned above, a specific sign of chickenpox is the spread of the rash. What the rash looks like should be examined in more detail. At first, a faint spot can be seen on the body. Gradually, a lump forms in the center of the redness, referred to as a nodule or papule. The nodule has clear contours and rises above the level of the skin, the area around the formation has a bright red tint. After a few hours, the papule fills with serous contents, turning into a bubble with liquid. By the end of the first day, a light brown crust forms in place of the bubble. After one to two weeks, the crusts fall off without leaving any traces. But this is only if the elements of the rash were not damaged. A rash with chickenpox is accompanied by severe itching, and patients often scratch the blisters. In such cases, a pigment spot may remain in place of the crust that has fallen off. If suddenly, when combing, microbes get into the wound, then infection can occur. Then the bubbles will fester, which will lead to scarring. After chickenpox, scars can be observed.

The rash can also affect the mucous membranes in the mouth. This is manifested by the formation of whitish-yellow spots in the area of ​​large molars. Such symptoms are especially difficult for children, mainly infants. Babies are restless, naughty and refuse to eat.

A rare symptom is the formation of a rash on the genitals. These will be acne, quickly turning into a state of ulcers, which heal within 3 to 5 days.

It should be noted that the interval of rashes is 1-2 days. Therefore, on the patient's body, elements of rashes are observed in various stages, from redness to crusts. Each wave of rashes is accompanied by a febrile syndrome.

Chickenpox: symptoms of complications

In most cases, the course of chickenpox is favorable. The condition of the patients is satisfactory. But there are certain groups of people at risk of developing complications:

immunocompromised adults;

children born to unvaccinated mothers;

pregnant women;

aged people.

The complications are:

pneumonia (pneumonia);

encephalitis (inflammation of the brain);

meningitis (inflammation of the membranes of the head and spinal cord);

gastritis (inflammation of the stomach lining);

pancreatitis (inflammation of the pancreas);

pyelonephritis (inflammation of the kidneys);

hepatitis (inflammation of the liver).

The above diseases are caused by the varicella-zoster virus itself. Among the complications, there are also those that are provoked by other microorganisms. In such cases, we should talk about the accession of a secondary infection. This happens because the chickenpox virus significantly weakens the immune system, as a result of which pathogens of various diseases easily enter the body. The following infections are most common:

stomatitis (damage to the oral mucosa);

gingivitis (inflammation of the gums);

mumps (infection of the salivary glands);

conjunctivitis (inflammation of the mucous membrane of the eye);

otitis media (collective concept inflammatory diseases ear).

Atypical forms of chickenpox involve other complications:

myocarditis (damage to the heart muscle);

pyoderma (purulent skin lesions);

lymphadenitis (a condition in which the lymph nodes become inflamed and enlarged with chickenpox).

Diagnostics

How to understand whether a person has contracted chickenpox? To determine this, there is laboratory diagnostics where the analysis for chickenpox is carried out. Laboratory doctors take blood from you for antibodies to chickenpox (both in children and adults).

This blood test is a comprehensive diagnosis aimed at detecting the Zoster virus in the body. In addition, the current state of immunity is assessed. Depending on the reaction to chickenpox, doctors can conclude whether further vaccinations and treatment are needed, or whether the body already has permanent immunity to chickenpox.

When will a blood test for chickenpox be done?

Such a diagnosis, first of all, is prescribed when the clinical picture for a given disease is atypical, namely: there is severe intoxication and uncharacteristic rashes on the skin. If doctors cannot accurately diagnose or confirm the disease, and the person does not remember whether he suffered the disease as a child, a blood test for chickenpox is also carried out. In women during pregnancy planning, this analysis is mandatory.

What is the essence of the method?

Blood is taken in the usual way, and it considers two indicators: IgG immunoglobulins, which are formed in the blood when a person begins to recover, and IgM immunoglobulins, which appear after infection with the disease.

How exactly does analysis stand for?

If the concentration of antibodies exceeds normal value, which means that a person is sick with chickenpox, but if the concentration is lower, the person is considered healthy. The following indicators are distinguished:

• IgG negative, IgM positive. Primary acute infection.
• IgG positive, IgM negative... The virus is reactivated.
• IgG negative, IgM negative. The man has never had chickenpox.
• IgG positive, IgM positive. The man had had chickenpox earlier.

How do I prepare for the analysis?

No special training is required. The only thing that is desirable to do is to refuse spicy and fatty foods at the time of the test.

Signs of chickenpox

What chickenpox looks like, everyone knows very well. The first sign of chickenpox is a specific red rash all over the body. But relying on such signs without appropriate knowledge and trying to independently diagnose such a disease is still not worth it. For doctors, such a symptom can speak of many other diseases, including dermatological

In addition to red rashes on the body, it is worth paying attention to a general deterioration in well-being paired with an increased body temperature. The patient's temperature can go up to thirty-nine degrees Celsius. The rash is mainly localized on the surface of the face, hairy parts head, body, arms and legs. It is extremely rare on the palms and feet of the feet. Over time, the foci of the rash grow in size, acquiring a clearly round or oval shape. Individual vesicles can be up to five millimeters in size. The contents of the rashes are predominantly transparent, sometimes cloudy. After two or three days, the vesicles dry out, leaving behind a hard crust that falls off after two to three weeks. In children, after falling off, scars do not remain. In the case of adults who have been ill, at a fairly decent age for such a disease, scars are quite frequent problem... Sometimes a rash can be found on the mucous membrane of the mouth, larynx, and the surface of the genitals. A characteristic feature chickenpox is a strong increase in size lymph nodes... After the first week, the temperature returns to normal against the background of the parallel drying of the rash, and the patient's well-being improves. Some by this time are still worried about severe scabies.

In chickenpox, several degrees of manifestation are distinguished, and they usually proceed in the following three forms:

• Lightweight form. This form is characterized by an increased temperature of up to 37 degrees, general weakness and fatigue. The rashes on the body are quite small, and their duration on the body ranges from one to two days.
• Medium form. The average severity of chickenpox is characterized by an increase in temperature up to 39 degrees, patients often complain of migraines, vomiting, bad dream and complete loss of appetite. The skin rash is quite large. The rash begins to appear on the mucous membrane, and the duration of the period is about five to six days.
• Severe form. The temperature rises to 40 degrees, and the patient feels much worse compared to the two previous stages. A person suffers from severe headache and dizziness, vomits, he does not eat anything, delirium is noted. The rash on the body is profuse and itchy, and lasts from seven to eight days.

Treatment

To date, there are no drugs that are aimed directly at the treatment of chickenpox. Basically, drugs are used to combat the external manifestations of the disease - rash, skin inflammation, temperature. Reception scheme medications depends on the condition of the person and on the severity of the disease. Most often, chickenpox is treated at home with readily available drugs that do not have a negative effect on the body.

Chickenpox has an incubation period, during which a person may not even be aware of the need for treatment. Only after the first signs of the disease appear, you can begin symptomatic treatment: both in children and in adults. During this period, you need to isolate the patient in order to prevent infection of other people.

After the transfer of the disease in the body of a child or an adult, antibodies to chickenpox are produced. They persist throughout a person's life, protecting him from re-infection after contact with the virus.

In most cases, chickenpox does not cause complications, especially in young children. If you start treatment on time, follow the doctor's instructions, apply the recommended remedies, the disease goes away quickly enough. With a severe course of chickenpox, a person can be hospitalized in order to use more serious drugs and constantly monitor his condition.

How is chickenpox treated in children?

When the first rashes appear, which are characteristic of this disease, it is imperative to call a doctor at home. You cannot go to the clinic, since the child is the carrier of the virus. It can easily infect other babies who are not yet immune to the disease.

An ordinary pediatrician deals with the treatment of chickenpox in children. He examines the baby and prescribes drugs that will be most effective in each individual case of the disease.

You cannot self-medicate. It is imperative to consult with experienced doctor, who will be able to adequately assess the condition of the crumbs. Hospitalization may be necessary if complications develop.

Treatment of chickenpox in children is aimed at eliminating characteristic symptoms disease. Mainly used:

• antiseptics;
• immunostimulants;
• antihistamines;
• antiviral agents;
• antibiotics.

To quickly get rid of rashes and prevent infection in open sores, you need to know how to smear the skin in order to alleviate the child's condition. It is best to use modern antiseptics, which will kill all bacteria, relieve inflammation, and accelerate wound healing.

Smearing the skin with chickenpox should be as often as possible: every 1-2 hours, which will contribute to a quick recovery.

With a high risk of complications, the child needs to take drugs that increase the protective functions of the body. Immunostimulants are prescribed only by a doctor. It is categorically impossible to use these funds on their own for treatment, since they have a large number of contraindications.

When the disease is difficult for the child's body, antiviral agents are prescribed. If the child feels well, there is no temperature or it decreases after 2-3 days, taking this group of drugs is undesirable.

Antihistamines are indicated for severe itching that does not relieve after the application of antiseptics. Taking such drugs can prevent the formation of wounds from the constant scratching of small pimples. If a child touches a rash on the skin, he can introduce an infection into the body with dirty hands.

Antibiotics are rarely prescribed for chickenpox. They must be taken if there is a bacterial infection. In other cases, these drugs are useless.

If the baby has a fever, it is worth taking an antipyretic agent. When high readings on the thermometer appear for several days in a row, it is imperative to inform the doctor who must adjust the treatment regimen.

Features of caring for a sick child

If you do not know how to relieve itching with chickenpox, use the following guidelines:

• ventilate the nursery constantly;
• dress your baby in light clothes made from natural fabrics so that he does not get hot;
• play with your child to distract him from severe itching;
• try to change your bedding often.

Washing with chickenpox is a must. It helps relieve itching and inflammation. You need to take a cool bath every day with the addition of decoctions of medicinal herbs.

Dear mothers, do not hesitate whether it is possible to wash a child with chickenpox. Water procedures will only benefit your baby and accelerate recovery.

When treating chickenpox, you need to be careful about nutrition. Exclude from the child's diet:

• hot seasonings;
• hot dishes;
• solid food;
• allergic foods.

Sick children in the early days may refuse to eat. Don't force him to eat. Better offer warm herbal tea, sugar-free compote, or milk. Feed your child light meals - soups, vegetable and fruit purees, fermented milk products.

Do not doubt whether it is possible to go outside with chickenpox. This virus is not able to persist for a long time in open space. If your baby does not have a fever, walk with him for 30-45 minutes in the park, avoiding crowds or playgrounds. But still, in the midst of an illness, when new rashes appear, sit at home. This will reduce the risk of infection of other people, and will have a positive effect on the well-being of the baby.

Also remember that a child is highly contagious, so do not allow him to communicate with healthy people. It will be possible to attend school or kindergarten only after the issuance of the corresponding certificate by the pediatrician. It notes that the baby is completely healthy and is no longer contagious.

Treatment for chickenpox in adults

This virus is difficult to carry by a person if he got into his body at an older age. Treatment of chickenpox in adults at home should be supervised by a therapist.

In some cases, hospitalization may be required:

• with severe symptoms;
• if complications appear;
• to isolate the patient when it is not possible to do it in another way.

For the treatment of adults, the same drugs are used as for children. It is imperative to treat the rash with antiseptic solutions or ointments, if necessary, use antihistamines. If the body temperature is above 38 ° C, use antipyretic drugs.

With a high likelihood of complications, you need to take immunomodulators, antiviral drugs.

Chickenpox vaccine

The most effective method chickenpox prevention is vaccination.

Chickenpox vaccination is shown:

• children over 2 years old;
• in the presence of chronic diseases that can suppress the immune system;
• before organ transplant;
• if the person is taking immunosuppressants;
• before radiation therapy.

Children need to be vaccinated against chickenpox once, and adults - twice with an interval of several weeks. It is contraindicated in people with severe immunodeficiency and in pregnant women.

The chickenpox vaccine will help protect your baby from the virus for life. The components of the medicine can sometimes provoke the development of the disease, but it will go away in a mild form and without complications.

Chickenpox vaccine is indicated for adults if they have small children. The older a person is, the worse he tolerates the disease. The risk of complications increases significantly. They can be avoided by using the chickenpox vaccine.

Prevention of chickenpox - sanitary rules

In order to prevent infection of healthy people by contact with sick people, you need to carefully clean the room where the person with chickenpox is. Do wet cleaning every day after 4-5 hours. There is no need to use disinfectants. Clean the floor with plain water.

You also need to often ventilate the room, while leaving the room for 10-15 minutes.

In hospitals, ultraviolet irradiation of wards is carried out.

For the prevention of chickenpox in children, it is imperative to introduce quarantine at school or kindergarten if a sick child appears in the team.

Medicines

Medicines against chickenpox used in medical practice are used for the following purposes:

• Destruction of the virus (antiviral drugs).
• Elimination of itching (so-called antipruritic drugs).
• Getting rid of the general intoxication of the body (temperature, weakness, headache).
• Bactericidal drugs (it is immediately necessary to make a reservation that antibiotics for chickenpox are indicated only for the prevention of an infectious process, but not for treatment). These drugs include baneocin, which is used for chickenpox in the form of a powder applied to the affected skin.

Antiviral drugs for the treatment of chickenpox (chickenpox).

The only remedy that adequately affects the destruction of the Varicella Zoster virus is acyclovir.

For chickenpox, it is the most effective, safe and affordable substance, which is one of the best antiviral drugs for herpes infection.

Acyclovir is a prodrug, a synthetic analogue of the deoxythymidine nucleoside. For acyclovir to become active, a viral enzyme, kinase, is required, and therefore it is selectively activated only in those cells of the body that are directly damaged by the virus. Then there is a blockade of viral DNA polymerase, which leads to the impossibility of reproduction (replication) of the virus. It should be noted that topical acyclovir is the least effective, especially in recurrent forms of herpes infection. Therefore, it is better to use oral forms. There are very few side effects of acyclovir, which is associated with the low toxicity of the drug. Very rarely, there may be nausea, vomiting, diarrhea, and headache. With intravenous (slow!) Administration of acyclovir, it is necessary to saturate the body with fluid in order to avoid nephrotoxicity and neurotoxicity.

Interferons for chickenpox (chickenpox).

These include viferon, anaferon and cycloferon, which are used in the treatment of chickenpox. In this case, Viferon is applied per rectum (rectally) 1 suppository 2 times a day, however, in generalized forms, the use of the drug is not recommended.

Anaferon for chickenpox is rarely used and is more often used in patients with acute respiratory viral infections and herpes. Available in tablets.

As for cycloferon, it can be prescribed from 4 years old in the complex treatment of chickenpox, 1 tablet (150 mg) per 1 dose.

Medicines for the itching of chickenpox (chickenpox).

Antipruritic drugs are one of the important ingredients in the treatment of chickenpox. These medications are antihistamines, as well as poxclin, calamine, and calamine lotion.

Calamine for chickenpox is one of the best Israeli drugs used in dermatological practice: perfectly eliminates itching, eliminates scratching for various skin diseases. In addition to a good therapeutic effect, there is one more plus - the drug has no side effects, except for individual and very rare reactions to the components of the drug (either to 15% calamine, or to zinc oxide).

For children under one year old, it is better to use calamine with chickenpox in the form of a lotion, as it quickly eliminates itching and prevents the baby from combing itchy bubbles. Like calamine, this lotion is applied topically (per bottle) and is quite effective in relieving itching.

Another remedy for chickenpox is PoxClean, a medical hydrogel with a cooling effect that not only soothes the skin and alleviates the symptoms of chickenpox, but also effectively relieves itching. PoxClean contains only natural ingredients and does not include toxic products. The drug has been used since the age of two. Use PoxClean every time the itching sensation recurs, but no more than 25-30 days in a row. The gel is gently and carefully applied to the affected areas of the skin, without rubbing into the affected area. In addition to the antipruritic effect, PoxClin also has an antibacterial effect, which prevents the development of an infectious process in the formed vesicles. All these advantages of the drug directly answer the question: "how to smear chickenpox?"

Due to the fact that chickenpox is most often found in medical practice in children, in this case, brilliant green is a fairly effective and cheap remedy, which:

• Possesses bactericidal (antibacterial) action - prevents the spread of infection and destroys bacteria.
• Slightly dries the rash (in this regard, potassium permanganate is better for chickenpox).
• Reduces local itching.
• Low cost and effective effect
• In addition, the doctor is able to visually track the appearance of new lesions.

Tsindol with chickenpox can be used at any age (even in pregnant women) due to the fact that it is not absorbed into the bloodstream and does not cause side effects. Tsindol is a common zinc oxide that has an antiseptic effect, dries out the elements of the rash and has an anti-inflammatory effect. It is applied as follows: a thin layer of tsindol suspension is applied to clean, dry skin in the affected area. Then it is left for 1-1.5 hours and washed off with water. This procedure is repeated after 5 hours.

Fukortsin with chickenpox is ineffective due to the fact that it has a weak antiseptic and pronounced antifungal action, therefore, its use for chickenpox is not justified.

Antihistamines for chickenpox are used for severe and severe itching. These means include fenistil, suprastin, zirtek and zodak.

All these drugs have no direct differences and are used as a means to relieve itching and combat allergic reactions. Fenistil for chickenpox should not be taken by children under 1-2 months of age, as a rule, it is added to a bottle with a nutritional formula just before feeding. Suprastin for chickenpox is prescribed 1 tablet 3 times a day for adults and a quarter of a tablet for children under one year old (6.5 mg). Zyrtec (like Zortec) has a large number of contraindications and can be used in the form of tablets and drops. Drops are prescribed to patients under the age of 6, tablets - from 6 years of age and older.

It should be noted that the application of any of drugs it is necessary to discuss with the treating doctor and do not self-medicate.

Folk remedies

With the course of the disease, a gradually appearing rash develops into a more serious form - bubbles appear in place of red spots. And it is during this period that a number of tips and recipes for the treatment of traditional medicine come to the rescue.

Folk remedies for chickenpox

• The most popular recipe for chamomile broth. In order for the irritation to pass as quickly and less noticeably, it is necessary to take a daily bath with a decoction of chamomile: while the mixture of herbs and plant flowers is poured with boiling water and infused for several hours. As soon as the broth has cooled, it can be filtered into a separate container. For greater efficiency, you can brew a bag of sage along with chamomile, because this plant, like chamomile, helps reduce irritation.
• To reduce itching ethnoscience recommends taking baths with bergamot oil. After all, it is an ideal natural antiseptic and antipyretic in one bottle. However, you should not abuse its amount.
• No less effective will be the old grandfather's method, when vodka, water and vinegar are combined in certain proportions. Mixing these three ingredients will not only reduce fever, but also temporarily relieve irritation and dry the blisters of chickenpox. Thus, the disease will proceed with less serious consequences.
• Cool water, in which a small amount of baking soda has been previously dissolved, will allow the patient to feel less itching. After all, “itching” with such a disease is strictly prohibited: not only will the burst bubbles remain forever on the body as a small reminder in the form of scars, it is also possible to infect an infection. But even without that, the body is experiencing malaise caused by herpesvirus type 3.
• No less useful advice one more recipe of our grandmothers should be considered - a decoction of yarrow and chamomile flowers. As mentioned earlier, chamomile broth helps relieve irritation and itching, and together, chamomile and yarrow will cope with this task much faster, while providing a more lasting effect. When making a decoction, a mixture of chamomile and yarrow is brewed, then allowed to cool and filtered. One portion of the broth goes for one bath, while you should not prepare it in advance, because it gradually loses its healing properties, and literally the next day, the value of such a drug will be minimal.

Thus, following the provided simple tips, you can avoid unpleasant consequences diseases and significantly save on medications, however, the use of such prescriptions must be agreed with the attending physician.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, see your doctor.

Chickenpox, or chickenpox, is a highly contagious disease caused by primary infection with the varicella-zoster virus (varicella-zoster virus, VZV). The disease is associated with a characteristic skin rash that forms small, itchy blisters that eventually heal. The rash usually starts on the chest, back, and face and then spreads to the rest of the body. Other symptoms may include fever, fatigue, and headaches. Symptoms usually last five to ten days. Complications can sometimes include pneumonia, inflammation of the brain, or bacterial skin infections, among others. The disease is often more severe in adults than in children. Symptoms begin ten to twenty-one days after exposure to the virus.

Chickenpox is a transmissible disease by airborne droplets that spreads easily by coughing and sneezing an infected person... It can begin to spread as early as 1–2 days before the rash appears and remains infectious until all lesions are crusted. Chickenpox can also spread through contact with the blisters. People with shingles can spread chickenpox to non-immune people through contact with the blisters. The disease can usually be diagnosed based on symptoms; however, in exceptional cases, the diagnosis can be confirmed by polymerase chain reaction (PCR) blister fluid or scabs. Antibody testing may be done to determine if a person is immune. People usually get chickenpox only once in a lifetime. The chickenpox vaccine has led to fewer cases and complications from the disease. The vaccine protects approximately 70 to 90 percent of people from illness, especially severe illness. Routine childhood immunization is recommended in many countries. Immunization within three days of exposure may improve outcomes in children. Treatment for infected patients may include the use of Calamine Lotion to combat itching. It is recommended that you trim your nails to reduce scratch injuries, and use paracetamol (acetaminophen) to fight fever. For those at high risk of complications, antiviral drugs such as acyclovir are recommended. Chickenpox is found in all parts of the world. As of 2013, there were 140 million reported cases of chickenpox and herpes zoster. Before routine immunization, the number of cases per year was close to the number of people born. Since the beginning of immunization, the number of infections in the United States has decreased by almost 90%. In 2013, chickenpox caused 7,000 deaths worldwide, up from 8,900 in 1990. Death occurs in about 1 in 60,000 cases. Chickenpox was not separated from smallpox until the late 19th century. In 1888, her association with shingles was determined. The first recorded use of the term "chickenpox" dates back to 1658.

Signs and symptoms

Early (prodromal) symptoms in adolescents and adults are nausea, loss of appetite, muscle pain, and headache. This is accompanied by a characteristic rash or sores in the mouth, malaise, and a slight fever, signaling the presence of the disease. Oral manifestations of the disease (enanthema) often precede an unusual external rash (exanthema). In children, the disease is usually not preceded by prodromal symptoms, and the first sign is a rash or spots in oral cavity... The rash begins as small red dots on the face, scalp, torso, upper arms and legs; progresses over 10-12 hours to small bumps, blisters and pustules; with subsequent retraction in the form of a navel and the formation of scabs. In the blister stage, severe itching is usually present. Blisters can also be seen on the palms, soles and genitals. Typically, visible evidence of disease develops in the mouth and tonsils in the form of small ulcers that may be painful and / or itchy; this enanthema (internal rash) may precede the exanthema (external rash) and develop 1-3 days earlier or may be at the same time. These symptoms of chickenpox appear 10 to 21 days after contact with an infectious person. Adults may have a more extensive rash and longer fever and are more likely to experience complications such as chickenpox pneumonia. Because a watery nasal discharge containing a live virus usually precedes the ecanthema (external rash) and enanthema (mouth ulcers) by 1 to 2 days, the infected person actually becomes infectious 1 to 2 days before the disease is recognized. The infection persists until all the vesicles become dry crusts (scabs), which usually lasts four or five days, during which time the secretion of live virus from the nose stops. The illness usually goes away on its own within a few weeks. The rash, however, can last up to one month, although the infectious stage does not last longer than a week or two. Chickenpox is rarely fatal, although it tends to be more severe in adult men than in women or children. Non-immune pregnant women and those with suppressed immune systems are at the highest risk of serious complications. Arterial ischemic stroke (AIS) associated with chickenpox in the previous year is associated with nearly a third of AIS in childhood... The most common late complication of chickenpox is shingles (herpes zoster), caused by the reactivation of the varicella-zoster virus decades after the onset of the initial chickenpox, often during childhood.

Pregnancy and newborns

During pregnancy, the risk to the fetus associated with primary infection with varicella zoster virus is higher in the first six months. In the third trimester, the mother is more likely to develop severe symptoms. In pregnant women, antibodies produced by immunization or previous infection are passed through the placenta to the fetus. Women who are immune to chickenpox cannot become infected and do not need to worry about it, either for themselves or their baby during pregnancy. Varicella-zoster infection in pregnant women can spread across the placenta and infect the fetus. If infection occurs during the first 28 weeks of pregnancy, it can lead to fetal chickenpox syndrome (also known as congenital varicella syndrome). Exposure to the fetus can range in severity from underdeveloped fingers and toes to severe malformations of the anus and Bladder. Possible problems include:

Diagnosis

The diagnosis of chickenpox is based primarily on signs and symptoms, with typical early symptoms a characteristic rash follows. Confirmation of the diagnosis is made by examining the fluid in the blisters of the rash, or by testing the blood for an acute immune response. Vesicular fluid can be examined using the Tsank test, or a direct immunofluorescence test. The fluid can also be “cultured,” that is, an attempt can be made to grow a virus from a sample of the fluid. Blood tests can be used to identify the response to acute infection(IgM) or previous infection and subsequent immunity (IgG). Prenatal diagnosis of intrauterine varicella-zoster infection can be done by ultrasound, although a delay of 5 weeks after the primary maternal infection is recommended. A PCR (DNA) test of the mother's amniotic fluid can also be performed, although the risk of miscarriage due to the amniocentesis procedure is higher than the risk of a baby developing chickenpox syndrome.

Pathophysiology

Effects of varicella-zoster virus on healthy child initiates the production of antibodies immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin A (IgA); IgG antibodies persist throughout life and provide immunity. Immune reactions cell-mediated also play an important role in limiting the extent and duration of primary varicella infection. After primary infection, the varicella zoster virus is hypothesized to spread from mucous and epidermal lesions to local sensory nerves. The varicella-zoster virus (VZV) in this case remains hidden in the dorsal spinal root ganglia of the sensory nerves. Reactivation of VZV leads to clinically defined herpes zoster syndrome (eg, herpes zoster), postherpetic neuralgia, and sometimes Ramsey Hunt type II syndrome. Varicella zoster can affect the arteries in the neck and head, causing a stroke, either during childhood or after many years of latency.

Herpes zoster

After a chickenpox infection, the virus remains latent in the body's nerve tissues. The immune system keeps the virus at a distance, but later in life, usually in an adult, the virus can reactivate and cause another form viral infection called herpes zoster (also known as herpes zoster). The United States Advisory Committee on Immunization Practices (ACIP) invites every adult over the age of 60 to receive a shingles vaccine. Herpes zoster affects one in five adults infected with chickenpox during childhood, especially people with suppressed immune systems, particularly as a result of cancer, HIV, or other illnesses. Stress can also cause shingles, however, scientists are still investigating this connection. Shingles is most common in adults over the age of 60 who were diagnosed with chickenpox before the age of one.

Prophylaxis

Hygiene

The spread of chickenpox can be prevented by isolating affected individuals. Infection occurs through airborne droplets or through direct contact with lesions, for a period ranging from three days before the onset of the rash, up to four days after the onset of the rash. The varicella-zoster virus is sensitive to disinfectants, in particular chlorine bleach (i.e. sodium hypochlorite). Like all enveloped viruses, it is sensitive to drying out, heat and detergents.

Vaccine

The chickenpox vaccine is recommended in many countries. Some countries require chickenpox vaccination prior to entering primary school... A second dose is recommended five years after the initial immunization. If infected, the vaccinated person is more likely to suffer a milder case of chickenpox. Immunization within three days of exposure may improve outcomes in children. Chickenpox immunization is part of routine vaccination in the United States. Some European countries include varicella vaccination as part of universal childhood vaccination, but not all countries provide the vaccine due to the cost. In the UK, as of 2014, the vaccine is only recommended for people who are particularly vulnerable to chickenpox. It is important to maintain good hygiene and cleanse your skin daily with warm water to avoid secondary bacterial infection. Scratching can also increase the risk of a secondary infection. Paracetamol (acetaminophen), but not aspirin, can be used to lower fever. Using aspirin for chickenpox can lead to serious, sometimes fatal, liver and brain disease, Reye's syndrome. Varicella-zoster intramuscular immunoglobulin (VZIG), a drug that contains high titers of antibodies to varicella-zoster virus, may be given to people at risk of severe complications who have experienced significant exposure to the virus. Antiviral drugs are sometimes used.

Children

Taking acyclovir within 24 hours of the onset of the rash reduces symptoms by one day, but has no effect on the incidence of complications. The use of acyclovir is therefore not currently recommended for people with normal immune function. Children under 12 years of age and over one month of age should not take antiviral drugs unless they have another medical condition that puts them at risk for complications. Treatment for chickenpox in children focuses on symptoms, while the immune system deals with a virus. With children under the age of 12, cutting their nails and keeping them clean is an important part of treatment as they are more likely to scratch their blisters more deeply than adults. Aspirin is contraindicated in children under the age of 16, as it has been associated with Reye's syndrome.

Adults

In healthy adults, the infection is usually more severe. Treatment antiviral drugs(eg, acyclovir or valacyclovir) is generally recommended if started within 24 to 48 hours of the onset of the rash. The remedies for relieving the symptoms of chickenpox in adults are basically the same as for children. Antiviral drugs are more often prescribed for adults because they are effective in reducing the severity of the disease and the likelihood of complications. Antiviral drugs do not kill the virus, but they stop it from multiplying. Adults are advised to increase their water intake to reduce dehydration and headaches. Pain relievers such as paracetamol (acetaminophen) are recommended as they are effective in relieving itching and other symptoms such as fever or pain. Antihistamines relieve itching and can be used when itching is interfering with sleep because they also act as sedatives. Like children, antiviral treatment considered more beneficial for those adults who are more prone to developing complications. These include pregnant women or people who have a weakened immune system. Sorivudine, a nucleoside analog, has been reported to be effective in treating primary varicella in healthy adults (only known from case histories), but large clinical trials are needed to demonstrate its effectiveness. After recovering from chickenpox, doctors recommend that adults give one injection of VZV immunoglobulin and one injection of chickenpox vaccine or herpes zoster vaccine.

Forecast

The duration of the visible blisters caused by the varicella-zoster virus varies in children, usually from 4 to 7 days, and the appearance of new blisters begins to subside after the fifth day. The infection is milder in younger children, and symptomatic treatment with a sodium bicarbonate bath or antihistamine can relieve itching. It is recommended to keep infants from birth to 6 months of age away from an infected person for 10 to 21 days because their immune systems are not sufficiently developed to cope with stress. Paracetamol (acetaminophen) is widely used to reduce fever. Aspirin, or foods containing aspirin, should not be given to children with chickenpox, as this can cause Reye's syndrome. In adults, the disease is more severe, although the incidence is much less common. Infection in adults is associated with greater morbidity and mortality due to pneumonia (either direct viral pneumonia or secondary bacterial pneumonia), bronchitis (viral bronchitis or secondary bacterial bronchitis), hepatitis, and encephalitis. In particular, up to 10% of pregnant women with chickenpox develop pneumonia, the severity of which increases at the end of pregnancy. In England and Wales, 75% of chickenpox deaths occur in adulthood. Brain inflammation, or encephalitis, can occur in weakened individuals, although the risk is higher with herpes zoster. Necrotizing fasciitis is another rare complication. Chickenpox can be fatal for immunocompromised adults. The number of people in this high-risk group has increased due to the HIV epidemic and the increase in the use of immunosuppressive therapy. Chickenpox is a particular problem in hospitals when patients' immune systems are weakened by the use of drugs (such as high doses of steroids) or HIV infection. Secondary bacterial infection of skin lesions, manifested as impetigo, cellulitis and erysipelas, is the most frequent complication in healthy children. Disseminated primary varicella-zoster infection, commonly seen with immunodeficiency, can have a high mortality rate. Ninety percent of chickenpox pneumonia cases occur in the adult population. Rare complications of disseminated chickenpox include myocarditis, hepatitis, and glomerulonephritis. Hemorrhagic complications are more common in immunocompromised or immunocompromised individuals, although they can also affect healthy children and adults. The five main clinical syndromes are febrile purpura, malignant chickenpox with purpura, post-infectious purpura, fulminant purpura, and anaphylactoid purpura. These syndromes vary in duration, with febrile purpura being the most favorable of the syndromes and having an uncomplicated outcome. In contrast, malignant chickenpox with purpura is a serious clinical condition that has a mortality rate of over 70%. The cause of these hemorrhagic chickenpox syndromes is not known.

Epidemiology

Primary chickenpox is found in all countries of the world. In 2013, the disease caused 7,000 deaths, up from 8,900 in 1990. In temperate countries, chickenpox is primarily a disease of childhood, and most of the cases occur in winter and spring, most likely due to the spread of the disease in schools. Chickenpox is one of the classic childhood illnesses, with the highest prevalence in the 4-10 age group. Like rubella, it is rare in preschool children. Chickenpox is a highly contagious disease, with an incidence rate of 90% in close contact. In temperate countries, most people become infected before adulthood, and 10% of young people remain susceptible. In the tropics, chickenpox is common in older people and can lead to more serious illness. In adults, pockmarks are darker and more visible than in children. In the United States, the Centers for Disease Control and Prevention (CDC) does not require health departments to report chickenpox infection, and only 31 states currently voluntarily report this information. However, in a 2013 study done with a social media disease surveillance tool called Sickweather, individual posts about chickenpox on Facebook and Twitter were used to measure and rank the states with the most infections per capita, with Maryland, Tennessee and Illinois were in the top three.

Society and culture

That is why it is so easily transmitted by airborne droplets.

Chickenpox symptoms

Chickenpox is one of the few diseases for which diagnosis does not require medical education... The main symptom that allows you to accurately determine the infection of chickenpox is the appearance of a rash, usually accompanied by an increase in body temperature. Chickenpox rashes are small pink spots with a well-defined outline. Within a few hours, the spots spread throughout the body, after which vesicles are formed on them - bubbles with a transparent liquid inside, resembling water droplets in appearance.

Chickenpox in children

Chickenpox is traditionally considered a childhood disease, as more than 90 percent of those affected by the virus are children under the age of 17. At the same time, secondary infection with chickenpox is extremely rare due to the development of immunity after an already suffered illness.

The course of the disease

Within 7-23 days from the moment of infection, chickenpox is asymptomatic. The first rashes are noted, as a rule, in the scalp and on the face, with subsequent spread. In this case, both a uniform distribution of vesicles throughout the body and concentration in its individual areas are possible. Damage to the mucous membranes of the mouth, eyes and genitals is not excluded.

The acute stage of the disease lasts about 3-7 days. During this period, the rash continues, the healed vesicles are replaced by new ones. In children, chickenpox rarely occurs with complications, an increased body temperature is usually observed only in the first days of the disease and most often does not exceed 38 degrees.

Treatment of chickenpox in children

Chickenpox disease involves outpatient treatment in compliance with bed rest and quarantine. Actually, chickenpox itself does not lend itself to any treatment, any effects are aimed only at relieving its symptoms.

So, to relieve itching and fix the number of vesicles, they are usually cauterized with solutions of brilliant green, which is commonly called brilliant green or methylene blue. Alternatively, you can use a weak solution of potassium permanganate. Alcohol for these purposes is categorically contraindicated. Since chickenpox is often accompanied by manifestations in the patient of signs of intoxication, a certain diet should be adhered to, which includes, first of all, abundant drinking and the use of dairy and herbal products that have a detoxifying effect. It is recommended to exclude from the diet salty, spicy and acidic foods, as well as foods that can cause an allergic reaction.

Antibiotic therapy is used exclusively in cases of development of a bacterial infection, which occurs, as a rule, due to scratching of the vesicles. Therefore, in order to avoid complications, constant monitoring of the child's behavior is necessary; it is best for babies to wear light mittens. Overheating should be avoided as sweating increases itching. Antihistamines may be prescribed if necessary and on the recommendation of a doctor.

If the body temperature exceeds 38 degrees, drugs containing paracetomol are used as antipyretic drugs.

Attention! Aspirin is contraindicated for chickenpox, since it can contribute to the development of complications of varying severity.

Attention! Ibuprofen (nurofen) for chickenpox - highly discouraged

It is highly undesirable to take ibuprofen with chickenpox. Despite the fact that most Russian-language sites will tell you that you can take both paracetamol and ibuprofen, it is highly undesirable to take it. According to the US National Library of Medicine (MedlinePlus.Gov), it increases the likelihood of reinfection.

Similar data can be found on reputable medical resources in the UK (for example, NHS.uk). The same data are used by doctors when prescribing antipyretics in most European countries.

Chickenpox in adults

The incidence of chickenpox among adults is about 10 percent of all reported cases. As a rule, these are primary infections of people over 17 years old who have not had chickenpox for more early age... However, there are also known cases of secondary infection, which occur mainly in patients suffering from pathologies of the immune system or undergoing chemotherapy or radiation therapy.

The course of the disease

Unlike a child's, the adult's immune system reacts much more actively to a virus entering the body. That's why outward signs diseases such as chickenpox tend to appear later in adults, making diagnosis much more difficult.

Most often, after incubation period, the duration of which is the same in both children and adults, chickenpox in the latter manifests itself in the form of an increased body temperature, often reaching a critical level of 40 or more degrees. In this case, the appearance of a characteristic rash can be delayed for several days. Prolonged hyperthermia can be accompanied by nausea, vomiting, which does not bring relief, as well as photo and sound phobia.

With the appearance of rashes, an elevated temperature, as a rule, persists, or there is a slight decrease in it. There is also an acute reaction of the lymph nodes, expressed in their enlargement. The duration of the acute stage of chickenpox in adults is about 10 days. During this time, skin rashes continue, while the healing of vesicles, which in most cases occurs without a trace in children, is often accompanied by the formation of scars in adults.

Chickenpox treatment in adults

In addition to measures taken to treat chickenpox in children, active prophylaxis is needed in the event of an adult illness. possible complications... Therefore, treatment is carried out with the use of antiviral and immunomodulatory drugs. If indicated, antibiotic therapy is used.

Regardless of the patient's age, strict adherence to personal hygiene standards is necessary. Water treatments that can significantly relieve itching are possible immediately after the body temperature has returned to normal. Frequent bed linen changes are also recommended.

Despite the widespread prevalence of chickenpox, this disease is not harmless and requires an immediate response. Timely appeal for medical help and adequate treatment will help to avoid the development of complications and significantly reduce the duration of the course of the disease. The use of any medications, as well as alternative methods of treatment, must be agreed with the doctor without fail.

Chickenpox Videos

"Live healthy!". Release of a program about chickenpox.

Dr. Komarovsky on the dangers of childhood chickenpox.

Among the measures for the prevention of chickenpox, doctors consider the most correct decision to be vaccinated against such a childhood infection. Thanks to vaccination, a child or an adult who has not been previously ill receives stable long-term protection against the pathogen of chickenpox. The injection will help prevent both the disease itself and its consequences.

Especially often people think about the chickenpox vaccine before pregnancy and in adulthood, when small children appear in the family who can "bring" chickenpox from kindergarten or school. The reason is that in adults, the course of such a disease is quite severe and often leads to serious complications.

But, before you buy the vaccine and go to the vaccination room, you should make sure that the person has not had chickenpox before. But how can you tell if a particular person had chickenpox in childhood? This will help the stories of relatives, entries in the medical record or special tests.

Interviewing parents

Having decided to find out if you had chickenpox as a child, first of all you need to turn to the older generation. This is the easiest way to test for chickenpox immunity. The time when the baby had a high fever, itchy bubbles appeared all over the body, due to which the child was painted with a green dot, it is difficult to forget.

However, such information may be inaccurate or missing for the following reasons:

• There are no parents or other close relatives or they do not remember about your childhood illnesses.
• You've had chickenpox in a very mild form with a few blisters that your mom might mistake for insect bites without paying much attention to them.
• You are from a large family and your parents do not remember exactly which of the children had chickenpox and which did not get infected.
• You may have had another childhood infection with similar symptoms, which my mother mistook for chickenpox.

We study the medical card

If there is no confidence in the information about the transferred chickenpox from relatives or the information itself is absent, you can try to find out everything about childhood diseases in your medical record. Many people keep it at home, so flipping through its pages and finding a record of past infections is a good way to learn about chickenpox that was in childhood.

However, records from the map will not help you figure out anything if:

• The card was lost, for example, during a move.
• The card is kept in the clinic, but they refuse to give it to you.
• The doctor's handwriting that filled your card is unreadable.

We donate blood

Advances in medicine today make it possible to find out exactly whether the body has encountered a particular pathogen before. Therefore, if you need the most reliable way to test immunity to chickenpox, then a blood test can be called just that.

What is the name of the analysis

The examination, due to which antibodies to the varicella-zoster virus are detected, is called an enzyme-linked immunosorbent assay (ELISA). It determines two types of immunoglobulins in the patient's blood - M and G. Based on their presence or absence, it is judged about the presence of an active infectious process or a past illness.

Also, the chickenpox virus can be detected using PCR analysis (it is deciphered as "polymerase chain reaction"). Such a study determines the DNA of the virus and allows you to answer whether this pathogen is in the body. It is often prescribed in the presence of an infectious process, when there are doubts or you need to make sure that the chickenpox virus was the cause of the disease.

Where and how to get tested

The determination of antibodies to chickenpox is carried out in many private laboratories, for example, in such well-known laboratories as Gemotest and Invitro. The method is called convenient, highly accurate and very fast, since the result is obtained within a day. Such an analysis costs 760-880 rubles (determination of one type of immunoglobulin without the cost of manipulating blood sampling).

No special preparation for the analysis is required. It is often taken in the morning on an empty stomach, and on the eve of the test it is advised to avoid fatty and sweet dishes, as well as significant physical activity... Blood for examination is taken from a vein.

Decoding the result

When a person falls ill with chickenpox, antibodies presented by IgM begin to form in his blood from 4-7 days of illness. Over time, in the body of a patient who has suffered chickenpox appears IgG antibodies that remain in the blood until the end of life.

Taking into account such data, the analysis can be deciphered as follows:

Chickenpox (chickenpox) is a highly contagious disease caused by the herpes simplex virus type 3, also known as Varicella-Zoster or Herpes Zoster. Distributed throughout the world, according to some reports, each person is 100% susceptible to primary infection.

The name "chickenpox" is associated with the erroneous assumption, widespread in the Middle Ages and modern times, that this disease is a kind of smallpox - and for its relatively fast and easy course it was nicknamed "chickenpox".

Not required differential diagnosis with smallpox, since, firstly, the latter disease practically does not occur in developed countries, secondly, the symptoms inherent in chickenpox have been identified, and thirdly, in isolated doubtful cases lab tests blood and vesicle contents give an accurate answer.

How does it begin

Varicella Zoster virus belongs to herpes viruses, and its effect on the body is quite similar to the development of other forms of herpes. The behavior of Varicella-Zoster is due to two of its properties: dermatotropy and neurotropicity, that is, "love" for skin cells and nerve cells, respectively.

Chickenpox has several stages, and between some of them the time interval can be tens of years.

Both a child and an adult who has never had chickenpox can catch a primary infection, and in adults, the course of the disease is usually more severe.

The most common age of the disease is 4-7 years.

Babies are also seriously ill and only in very rare cases:

• with intrauterine infection (mother gets sick in the last week of pregnancy);
• in the absence of breastfeeding and, accordingly, the mother's protective antibodies;
• with strong immunodeficiency conditions (including cancer and AIDS).

The risk of infecting a healthy child on breastfeeding yes, if the mother does not have specific immunity (she did not have chickenpox at all and was not vaccinated).

Incubation period

• Infection
  The virus enters the body by airborne droplets and is fixed on the mucous membrane of the upper respiratory tract, where it accumulates and multiplies - while there are no symptoms of chickenpox. On average, this stage lasts about 2 weeks, the patient is not contagious.
• First symptoms
  Gradually, the chickenpox virus begins to penetrate the bloodstream and, when its amount becomes sufficient, the body's immune system reacts to the foreign presence. The patient may have a fever, weakness, headache, lower back pain, but there is no rash yet. This period lasts 1-2 days, and the patient can infect others.
• Primary acute stage
  With the flow of blood, the virus reaches its targets - skin and nerve cells. There is still no nerve damage, Varicella Zoster is only fixed in the roots of the spinal cord, but specific symptoms appear on the skin - a rash that occurs in fits and starts over the next 4-7 days. A rash is the body's response to the activity of the chickenpox virus concentrated in the skin, in rare cases it is almost invisible, which complicates the diagnosis. The patient remains contagious.
• How many days does it last
  If the patient has a healthy immune system, then after 4-7 days the rash stops, the general condition improves, the acute stage ends. The patient ceases to be contagious, but the virus is firmly fixed in the nerve cells and remains there for life.
• Secondary acute stage
  With weakened immunity or stimulation nervous system(including as a result of frequent stress) the chickenpox virus reveals itself again. This time, the places of the rashes depend on which nerve is most affected - most often it is the axillary region or abdomen, which is why the secondary manifestation of Varicella Zoster was called shingles (zoster (lat.) - to girdle). Skin manifestations at this stage may not be present - symptoms are limited to pain along the nerve, which is especially common in the elderly. During periods of skin rashes, the patient, as well as with chickenpox, remains infectious, including for children.

Today there is no way to completely destroy the type 3 herpes virus in the body. Having fixed in the nerve endings, Varicella Zoster becomes very little susceptible to antiviral drugs and immune agents - their action is mainly aimed at treating exacerbations, effectively when the virus is localized in skin cells during these periods. Therefore, chickenpox can only be described as the first stage chronic illness- herpes virus type 3.

Nevertheless, after the first infection, a person develops a strong immunity against Varicella Zoster - therefore, they do not get sick with chickenpox again (that is, the first acute stage), all subsequent manifestations are the result of the activity of the virus already present in the body.

Given this nature of the immune response, in many countries, including, in part, in Russia, it is considered expedient to vaccinate, and not specifically expose children in preschool age, which is also very common in our time.

How can you get chickenpox?

As we have already noted, the virus is transmitted by airborne droplets from an infected person between the first and last day of the rash, as well as 1-2 days before the appearance of pustules. This is one of the reasons for the high prevalence of chickenpox in the world - the prodromal period is almost impossible to recognize. In addition, there is a very high susceptibility of people to the herpes simplex virus type 3 - everyone who comes into contact is infected with it.

Chickenpox is transmitted only from person to person; it does not survive in the external environment or, for example, in the body of domestic animals. The source of the primary infection can also be a patient with shingles in the acute stage. In rare cases, infection can occur through contact with the contents of the pustules.

Diagnosis and symptoms of chickenpox

A specific symptom of chickenpox is a rash that appears only 2 to 3 weeks after infection and 2 to 3 days after a person becomes contagious.

Firstly, a distinctive feature is the ubiquitous localization of the rash - it is found even on the scalp, mucous membranes, conjunctiva. Moderate to severe itching is characteristic of the rash.

Secondly, the rash with chickenpox is quite heterogeneous in appearance, as it appears in fits and starts within 1-7 days. There are also fresh formations on the patient's body - small pink spots; and papules, and vesicles with purulent contents, and scarring crusts.

Diagnosis of chickenpox, with the exception of rare complicated cases, is not difficult and is carried out on the basis of examination, but there are also laboratory tests that detect the Herpes Zoster virus in the blood and rashes during an exacerbation.

Photo of chickenpox

What does chickenpox look like in children in the initial stage?

Chickenpox drying out and crusting

Chickenpox treatment in children and adults

Chickenpox in children and adults requires the prescription of special drugs to alleviate the course of the disease. In our country, the standard therapy is the appointment of antihistamines to get rid of itching, antipyretic drugs and antiseptics (usually aniline dyes).

A solution of brilliant green (brilliant green) is used for chickenpox as a standard antiseptic for disinfection. However, in world practice, this approach has long been abandoned, since antihistamines and antiallergic drugs have a strong systemic effect on the body of a child or an adult and have a number of side effects, and brilliant green or iodine are not always acceptable from an aesthetic point of view.

Since chickenpox is caused by a virus, antibiotic therapy is ineffective for it, including with complications of chickenpox pneumonia. In addition, during the normal course of specific treatment, no specific treatment is required - the body's immune system recognizes and destroys the virus in the blood and skin cells within a few days. But with the Herpes Zoster virus, which has invaded nerve cells, as a rule, neither our immunity nor medications can cope.

Therapeutic treatment of chickenpox in children has several directions:

• Relief of symptoms, including itching. For this, antihistamines of systemic action are used, which, however, are becoming less popular today, since inhibition of the immune response, according to assumptions, can lead to complications. With general symptoms of inflammation, they also seek to alleviate the patient's condition - relieve pain and temperature, for which paracetamol or ibuprofen is recommended.
• Reduction acute period especially in cases of high risk of complications. For this, antiviral drugs are used, primarily acyclovir and interferon, which suppress the multiplication of the virus, stimulate the immune system.
• Prevention of complications, including secondary infection. For this, the elements of the rash are treated with antiseptics, and bed rest is prescribed.

For the period of the appearance of the rash, it is necessary to limit contact with the patient, in addition, persons who have not had chickenpox who have communicated with the patient 1-2 days before the onset of the rash are subject to quarantine.

Prevention of chickenpox

The issue of chickenpox prevention remains highly controversial. A number of specialists still do not consider it necessary, despite the possible side effects, including those delayed in time. Due to the fact that preschoolers, as a rule, tolerate chickenpox more easily than other age groups, sometimes parents and doctors even deliberately try to infect a child so that he suffers the disease earlier.

Meanwhile, since the 70s of the last century, a very effective vaccine against chickenpox has been successfully used in civilized countries, which gives persistent immunity for tens of years, according to blood studies of adults who were vaccinated in childhood. This vaccine, including its modified versions, is also available in Russia, it is especially recommended for people at high risk of complications - women planning pregnancy, cancer patients, HIV-infected and so on.

Remember that it is impossible to predict the course of the disease even in a healthy child, so when deciding on the prevention of chickenpox, consult with several specialists!

Complications of chickenpox

Approximately 5% of chickenpox cases go away with various complications. Traditionally, the disease is more severe in people with weakened immunity, in patients over 12 years of age (with primary infection), as well as in infants.

During pregnancy, chickenpox can harm the fetus, the greatest risk (about 2%) is observed with infection from 12 to 20 weeks. In this case, treatment with immunoglobulin specific to Herpes Zoster is effective - it significantly reduces the risk of congenital malformations. Infection of a pregnant woman in the last week before childbirth is also quite dangerous, since the immune system does not have time to work and the newborn has congenital chickenpox, which is very difficult.

In total, there are about 200 complications of Varicella-Zoster only from the nervous system, the skin, lungs and other internal organs can also be affected. Consider some cases of severe chickenpox.

1. Secondary infection
   Most often, a secondary infection enters the skin when papules and vesicles are scratched. That is why young children with chickenpox are recommended to cut their nails short. Interestingly, a secondary infection can both complicate the course of chickenpox and alleviate - for example, Herpes Zoster behaves very ambiguously with scarlet fever. According to observations, if the infection with scarlet fever occurred at the beginning of the rash of chickenpox, then both diseases can proceed more easily. But in most cases, the secondary infection makes the course of chickenpox heavier, lengthens the recovery period, worsens the general condition. The most severe secondary infection scenario is sepsis of the blood, an emergency, life-threatening condition. In addition, skin abscesses and other inflammatory processes can be very unpleasant.
2. Chickenpox pneumonia
   It is a common complication in adults who develop chickenpox for the first time. In children, it is in second place after secondary infection. It is rather difficult to diagnose - symptoms may be absent for a long time, the pathological process is detected during X-ray examination. Symptoms are shortness of breath, chest pain, deterioration of the general condition, in advanced cases - sputum with blood. Treatment with antiviral drugs only after confirmation of the diagnosis - bacterial pneumonia should be distinguished, which can occur in parallel with chickenpox and require antibiotic therapy.
3. Visceral chickenpox
   It is a lesion of the mucous membrane of internal organs, similar to a skin rash. It occurs in infants, as well as in persons with severely weakened immunity, the mortality rate is very high, the prognosis depends on timely diagnosis and the extent of the lesions.
4. Chickenpox encephalitis
   Brain damage by the Herpes Zoster virus. The manifestations are very diverse and depend on the localization of the affected tissues - the disease can be asymptomatic for many years, it can be accompanied by disturbances in movement, behavior, and nervous pain. In some cases, chickenpox encephalitis occurs in the acute period against the background of a severe course of the disease due to intoxication of the body. The prognosis is usually good, but the patient needs urgent medical attention.
5. Hemorrhagic chickenpox
   It occurs in persons with bleeding disorders, and is also considered normal if the picture is observed only on certain rare papules. If, during the entire acute period, the rash contains ichor, bruises appear on the skin, they speak of a severe form of hemorrhagic chickenpox. Such cases require urgent medical care, since there is a risk of internal bleeding and death.
6. Chickenpox gangrenous
   A very severe complication of chickenpox, accompanied by necrosis of tissue areas under the inflamed papules and vesicles. It is rare, in individuals with a very weakened immune system or, conversely, a pathologically strong immune response (incl. allergic reaction or some skin diseases).

Doctor Komarovsky about chickenpox