Chickenpox in children
The content of the article:
- Causes and risk factors
- Symptoms of chickenpox in children
- Diagnostics
- Treatment of chickenpox in children
- Diet for chickenpox in children
- Alternative treatment of chickenpox in children
- Potential consequences and complications
- Forecast
- Prevention
Chickenpox in children (chickenpox) is an acute infectious highly contagious disease of viral origin, which occurs with the appearance of a characteristic polymorphic rash on the skin and mucous membranes and a moderately pronounced intoxication syndrome.
Chickenpox rash in children has the character of bullous dermatitis
The susceptibility to infection is very high. After contact with a patient, almost 100% of people who do not have immunity to this infection fall ill. The highest morbidity rate among children of preschool and primary school age attending organized children's groups. According to statistics, about 80% of the population is ill with chickenpox before the age of 16. The peak incidence occurs during the cold season. In rural areas, the disease is recorded half as often as in cities.
After the transferred chickenpox in children, stable immunity is formed, which lasts for life.
Children of the first year of life who are breastfed rarely develop chickenpox, since they receive the necessary antibodies from the mother's body.
Causes and risk factors
The causative agent of chickenpox in children is the DNA virus Varicella Zoster, which belongs to the Herpetoviridae family, and is also the causative agent of another disease - shingles.
The virus is capable of replication exclusively in the human body; in the external environment, it quickly loses its virulence. The source of infection is a patient with chickenpox or shingles. It poses an epidemiological danger to others, starting from the last 10 days of the incubation period and until the 7th day after the end of the rash.
The causative agent of chickenpox in children is the Zoster virus, which belongs to the Herpetoviridae family.
Chickenpox in children is transmitted by airborne droplets, contact-household transmission is extremely rare, which is explained by the weak resistance of the virus in the external environment. When talking, sneezing, coughing, a sick person releases a fine aerosol containing the Varicella Zoster virus. Its particles are carried over long distances by air currents and can even get into adjacent rooms. Possible perinatal infection of a child with chickenpox disease of a pregnant woman 5 days before delivery.
The gateway for chickenpox virus is the mucous membrane of the upper respiratory tract. The pathogen enters the epithelial cells, where it begins to actively multiply. From here it spreads to the lymph nodes and bloodstream, spreading throughout the body. Viremia leads to the development of general intoxication.
The virus has an affinity for the epithelial cells of the skin and mucous membranes. After its replication (multiplication), epithelial cells die, and in their place cavities filled with exudate, i.e., vesicles, are formed. After opening them, erosion forms, which then becomes covered with a crust. After the crust falls off, a skin area with a new epidermis is exposed under it. Chickenpox in children with weakened immunity occurs with severe general intoxication, often accompanied by the development of complications.
The varicella-zoster virus is able to accumulate in the cells of the nerve ganglia. In this case, the patient develops a latent virus carrier. The activation of the virus leads to the development of the clinical picture of herpes zoster. Currently, the reasons provoking viral activation have not been established.
Symptoms of chickenpox in children
The incubation period for chickenpox in children lasts 11-21 days. The disease begins with a short prodromal period, which is usually mild. The child may complain of general weakness, headache and / or muscle pain. He may have a fever, nausea, vomiting.
Symptoms of chickenpox in children
The prodromal period is replaced by a period of extensive clinical manifestations (a period of rashes). There are daily peaks in temperature, coinciding with the appearance of new rashes. Often in children, especially those of preschool age, vesicular rashes on the skin and mucous membranes appear suddenly, without any signs of general intoxication.
The rash with chickenpox in children has the character of bullous dermatitis. Its elements spread throughout the body without any regularity, do not merge with each other. Each element goes through several successive stages of development: spot, papule, vesicle, crust. Elements of different ages are present on the skin, which is associated with daily dripping. Usually, the first spots appear 1-2 days after the onset of the disease, and the last ones - 3-6 days.
The main diagnostic element of a skin rash with chickenpox in children is a vesicle - a small vesicle filled with a transparent liquid content and surrounded by a corolla of hyperemia. The rash is accompanied by severe itching. When combing it, an infection of the vesicle can occur, as a result of which a pustule (a bubble filled with purulent contents) forms in its place. After the pustules heal, pockmarks (small scars) remain. If suppuration does not occur, the healing of the vesicles is not accompanied by the formation of scars.
The nature of the rash with chickenpox
The rash can occur anywhere on the body except the soles and palms. The greatest number of elements is localized on the neck, face and scalp, they can be observed on the mucous membrane of the genitals, oral cavity and on the conjunctiva. After opening the vesicles, erosions and ulcers form on the mucous membranes.
In rare cases, chickenpox in children is accompanied by inflammation of the lymph nodes (lymphadenopathy).
Children with weakened immunity can develop severe chickenpox:
- bullous - elements of the rash are represented by bullae (large blisters filled with transparent contents);
- pustular - suppuration of vesicles, with their transformation into pustules;
- hemorrhagic - impregnation of vesicles with hemorrhagic (with blood) content;
- gangrenous - the rash is represented by necrotic elements that penetrate into the deep layers of the skin.
The disease can take on an erased form. In this case, the symptoms of chickenpox in children are poorly expressed, there are no manifestations of intoxication, the rashes are single and disappear within a short time.
Diagnostics
The diagnosis of chickenpox in children is carried out on the basis of the characteristic clinical symptoms of the disease, data from the epidemiological history (indication of contact with a patient with chickenpox or shingles 11-21 days before the onset of the disease).
With an atypical course of chickenpox in children, as well as disseminated lesions of internal organs, it may be necessary to conduct laboratory diagnostics:
- isolation of the Varicella Zoster virus from the elements of the rash by classical virological methods on cultures of embryonic cells;
- microscopy of scraping from the base of the elements of the rash (detection of multinucleated giant cells);
- microscopy of smears of vesicular fluid (detection of Aragao bodies);
- detection of antibodies to the antigens of the virus (setting the reactions of ELISA, RSK, test of the fluorescence of antibodies to membrane Ag).
Chickenpox in children is differentiated with insect bites, contact dermatitis, drug allergies, secondary syphilis, impetigo, herpes simplex.
Treatment of chickenpox in children
Treatment of chickenpox in children in most cases is carried out at home. Hospitalization in an infectious diseases hospital is indicated only in severe cases of the disease, accompanied by severe intoxication.
Careful care of the elements of the rash is necessary in order to prevent the addition of a secondary purulent infection. Each element is treated 1-2 times a day with an antiseptic solution (potassium permanganate solution, Castellani solution). Erosion and ulcers on the mucous membranes are treated with a solution of ethacridine lactate or hydrogen peroxide. To reduce the severity of itching, the skin in the area of the rash is wiped with alcohol, a weak solution of acetic acid, lubricated with glycerin. If necessary, the child may be prescribed antihistamines.
A rash with chickenpox is treated with an antiseptic solution
In order to normalize body temperature, non-steroidal anti-inflammatory drugs based on ibuprofen or paracetamol are used. Acetylsalicylic acid (Aspirin) should not be prescribed to children with chickenpox, as its use may be associated with the development of Reye's syndrome.
In severe forms of the disease, the development of disseminated forms, immunodeficiency states, children are treated with antiviral drugs (acyclovir, interferon alfa, vidarabine). In addition, a specific anti-veterinary immunoglobulin may be used.
Antibiotic therapy is prescribed only when a secondary bacterial infection is attached.
Diet for chickenpox in children
Properly organized nutrition helps to accelerate the recovery of children, reduces the risk of complications.
In the first days of the illness, against the background of intoxication syndrome, children may refuse to eat. In this case, one should neither insist on eating, much less force-feed them. It is important to provide an abundant drink (weak tea, rosehip broth, still mineral water, compote). As the general condition of the child improves, appetite returns, but after that, an increased drinking regime should be maintained.
Diet helps speed up recovery from chickenpox in children
Foods that contribute to the allergy of the body, and thereby intensify itching, are excluded from the diet. These products include:
- fatty meat, sausages, smoked meats;
- seafood;
- mushrooms;
- berries, citrus fruits;
- confectionery;
- spices;
- pickles and marinades;
- sweet carbonated drinks.
A sample menu for one day for children with chickenpox:
- breakfast: oatmeal or buckwheat porridge with butter, soft-boiled egg;
- second breakfast: low-fat cottage cheese with sour cream or a glass of kefir;
- lunch: vegetable puree soup, steamed cutlet or boiled lean fish;
- afternoon snack: freshly squeezed vegetable juice diluted with warm water in a ratio of 1: 3;
- dinner: baked zucchini, croutons and unsweetened tea or cottage cheese casserole with grated green apple.
Alternative treatment of chickenpox in children
To reduce itching and prevent vesicle suppuration, traditional medicine can be used. In particular, warm baths:
- with calendula infusion. Brew 60 g of medicinal raw material with 1 liter of boiling water, leave for 40 minutes, strain and pour into the bath. Take a bath 2 times a day for 8-10 minutes;
- with oat flour. Pour 500 g of oatmeal into a linen bag (if it is absent, you can take oatmeal) and tie it tightly, lower the bag into a bath with warm water. The duration of the procedure is 5–8 minutes, after which gently pat the child's body with a soft towel;
- with yarrow infusion. Pour 200 g of yarrow herb into 5 liters of boiling water, leave for 4 hours, strain and pour into the bath. Take a bath for 15–20 minutes.
Treatment of vesicles with calendula tincture helps to reduce itching and prevent suppuration.
To dry the crusts and reduce itching, the skin can be wiped with a mixture of olive and bergamot oils taken in equal proportions. It helps to eliminate itching and rubbing the skin with a decoction of barley: pour 1 kg of barley with 5 liters of cold water, bring to a boil and simmer for 1 hour, then cool and strain.
Potential consequences and complications
In most cases, chickenpox in children is benign, and only 5% of patients have complications:
- stomatitis;
- keratitis;
- lymphadenitis;
- pyoderma;
- bullous impetigo;
- abscesses and phlegmon;
- sepsis;
- erysipelas;
- pneumonia;
- hemorrhagic nephritis;
- myocarditis;
- viral encephalitis.
Scientists from the London School of Tropical Medicine and Hygiene conducted medical examinations of 49 children who were being treated for a stroke. When taking the anamnesis, it was found that many of them had had chickenpox a few months earlier. This fact aroused the interest of specialists. In an effort to wait for a logical explanation, they retrospectively analyzed the medical histories of children with strokes over the past few years. It turned out that in 31% of cases, children had chickenpox in the last 6 months before the development of an acute disorder of cerebral circulation.
Doctors cannot yet explain the relationship between chickenpox and stroke in children, especially since such a relationship has not been identified in adults. It has been suggested that the Varicella Zoster virus damages the inner lining of the arteries, contributing to the development of an inflammatory process in it, which, in turn, causes stenosis of the damaged vessels.
Forecast
In most cases, the prognosis is favorable, the disease ends with a complete recovery. Scars remain only when the vesicles fester and transform into pustules. In children with severe immunodeficiency, the prognosis is worse, since the infection is much more severe, often causing the development of life-threatening complications.
Prevention
Prevention of chickenpox in children is to prevent the entry and spread of infection in children's groups. It includes the following activities:
- isolation of patients with chickenpox until the 5th day after the appearance of the last rashes;
- in nursery groups of preschool children's institutions, children who have been in contact with a sick person are quarantined for 21 days from the moment the patient is isolated;
- among children with immunodeficiency, preventive measures are taken in the first three days from the moment of contact with the patient using passive immunoprophylaxis (a single injection of immunoglobulin).
If a pregnant woman becomes ill with chickenpox, in order to prevent intrauterine infection of the fetus, she is prescribed specific immunoglobulins.
A vaccination against chickenpox in children has been developed. Vaccination is indicated for immunocompromised children suffering from chronic somatic diseases. For its implementation, vaccines Okavax (Japan) or Varilrix (Belgium) are used.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
