Chickenpox (popularly, chickenpox) is an acute infectious disease caused by the virus of the family Herpesviridae and characterized by the presence of a particular maculopapular-vesicular rash. The bulk of the sick are children, but cases of morbidity are not uncommon in adults. Chickenpox is usually benign – complications occur only in 2% of those who have been ill.
Causes, epidemiology and the development of chickenpox
The causative agent of the disease is the virus of the family Herpesviridae – Varicella Zoster. Getting into the human body for the first time, it causes chickenpox, and if the virus is unnoticed for a long time in the body (persists in it), under the influence of some adverse factors it activates and causes another unpleasant disease – herpes zoster.
The virus that causes chickenpox is unstable to environmental influences – its survival outside the body is no more than 10 minutes.
The source of infection is a sick person. It becomes contagious 2–3 days before the appearance of the elements of the rash and remains until 5 days after the appearance of the last element of the rash.
The mechanism of transmission is airborne (the virus spreads easily when talking, sneezing, and coughing). It should be noted that chickenpox – highly contagious (contagious) infection – susceptibility to it tends to 100%.
The entrance gate of the infection is the mucous membranes of the upper respiratory tract. Being introduced into the epithelium of the mucous membranes, the virus penetrates the bloodstream and spreads through the body, settling in the skin cells. As a result, in its surface layers, replacing each other, the following changes occur:
- capillaries expand – a stain forms;
- part of the fluid leaks from the vessels into the skin, that is, serous edema occurs — a papule forms;
- the epidermis in the affected areas exfoliates, forming a vesicle, or vesicle.
The waste products of the virus, getting into the bloodstream, cause symptoms of intoxication.
The result of the infection is persistent (often life-long) immunity.
Clinical manifestations of chickenpox
The incubation period of the disease is 13–17 days, in some cases, 11–21 days.
A few days before the appearance of rash, the patient notes an increase in weakness, the appearance of a headache, fever – this is the so-called prodromal period. It should be noted that this period may be asymptomatic in children, but a brighter clinic is characteristic of people of mature age.
The period of rash in children often proceeds easily, without a pronounced violation of their general condition. Simultaneously with the onset of fever or a couple of hours after its occurrence, the first rash appears on the skin of the abdomen, thighs, chest, shoulders, and later on the face and head:
- at first they look like round spots 5–10 mm in diameter;
- in the center of the spot appears bump, or papule;
- after some time, the top of the papule exfoliates, and the papule becomes a vesicle (vesicle) 8–12 mm in diameter with colorless contents inside;
- the vesicle dries out after 1–2 days, forming a crust, which disappears, leaving no scars or pigmentation behind.
Since the new lesions appear jerky, all the above elements of the rash are present on the patient’s skin at the same time – in medicine this phenomenon is called “false polymorphism”.
The appearance of rash is accompanied by intense itching.
In parallel with the skin rash appear rashes and mucous membranes. They have the appearance of bubbles, which after some time turn into ulcers surrounded by a red rim. In most cases, no more than 3 such elements are noted for each patient. They heal within 2 days.
The febrile period of the disease is 2–5 days, in some cases up to 10 days. The period of rash is from 2 to 9 days.
In most cases, chickenpox is benign, but its individual forms (bullous, gangrenous, hemorrhagic) threaten with possible complications such as pyoderma, encephalitis, myocarditis, lymphadenitis.
A serious complication is sepsis, which developed as a result of the addition of a secondary infection. It is also dangerous and chickenpox pneumonia – very difficult and often does not respond to treatment with antibiotics.
If the future mom picks up the chickenpox 4–5 days before giving birth, the probability of getting sick from her child rises to 17%, and 30% of the sick newborns, alas, die.
Diagnosis of the disease
Currently, when smallpox is completely eradicated, it is not a problem for the doctor to suspect chickenpox. The preliminary diagnosis is made on the basis of the patient’s complaints, the history of the disease and the initial examination (the presence of special rashes on the skin).
In general, the blood test for chickenpox may increase the ESR. In conducting specific laboratory diagnostic methods is usually not necessary.
People with chickenpox usually receive outpatient treatment.
The first mandatory component of the treatment of varicella is bed rest for the period of fever.
A special diet is not prescribed for chickenpox, but copious drinking is an integral part of the treatment, since it performs a very important function – detoxification (it eliminates the body of toxins).
Drug treatment is carried out both general and local. The total may include medications of several groups:
- antiviral drugs (Acyclovir is considered to be the most effective in this regard, but it is not prescribed for non-severe forms of the disease);
- antihistamines – are prescribed if the rash is accompanied by intense itching;
- NSAIDs are prescribed to lower the temperature (Ibuprofen and Paracetamol are commonly used, aspirin is contraindicated in this case because of the risk of a serious complication – Ray’s syndrome);
- in the case of purulent complications of the disease – antibacterial drugs.
Topical treatment includes careful care of the affected skin, aimed at preventing secondary infection of the rash elements. Usually for the treatment of lesions using a solution of brilliant green, potassium permanganate or Fucorcin.
To avoid residual marks at the site of rash, it is strongly recommended not to break the crust.
Since the virus is unstable in the external environment, it is necessary to regularly carry out wet cleaning and often ventilate the room.
Currently, there is a vaccine against chickenpox, but it is not included in the schedule of scheduled vaccinations.
Which doctor to contact
Chickenpox is treated by a pediatrician. If the disease is severe, especially in adults, help from an infectious disease specialist is needed.