Chickenpox, or, more correctly, chicken pox, is familiar to almost every inhabitant of the Earth. It is awarded to us by viruses with the melodic name of varicella-zoster, discovered in 1911. More than a century has passed since that distant time. Varicella has already been studied far and wide, but so far a person is not able to defeat it. The diseases caused by this virus do not seem particularly serious, because the death rate from them is 1 per 100 thousand cases, and even then not from them, but from the complications they cause. It is in these complications that his cunning lies. The varicella-zoster virus is able to penetrate into the blood, into the lymph, into many body systems. It is impossible to expel him from there. Once in our body, the parasite stays with us forever.
Portrait of the virus
Varicella zoster belongs to the genus Varicellovirus, with 17 species. Among them there are those that affect only certain animals or birds, and there are purely human ones. These include the type of "zoster" we are considering. This word meanstranslated from the Greek "belt", which reflects the pattern of rashes that is observed most often.
It is impossible to get infected from pigs, chickens, dogs and other living creatures. In the international taxonomy of infectious pathogens, it is called Human alphaherpesvirus type 3. All viruses are microscopically small, but each has its own unique "face". The microscope shows us that varicella-zoster is round or slightly oval in shape, has a core consisting of DNA, and a shell strewn with spines made of complex proteins. Initially entering the victim's body, the virus causes chickenpox disease.
Routes of infection
The varicella-zoster virus infects only humans, predominantly preschool children and younger schoolchildren. Especially high number of infections in schools, kindergartens, in any large number of groups. Ways of distribution - airborne (sneezing, coughing) and contact. Bubbles always form on the body of a sick child, in which thousands of thousands of viruses can be counted. When these bubbles burst, pathogens are released into the environment with exudate and can enter the body of a he althy person through dirty hands, objects, or through bodily contact, such as a handshake. Viruses can exist gracefully only in the cells of their victim, therefore, once outside, they become defenseless. They can be easily killed with disinfectants, boiling, any detergents.
Symptoms
Varicella-zoster enters our body through the mouth, where it settles on the mucous membranes. Having wonitself the first "bridgehead", viruses are introduced into the lymphatic vessels, blood, lungs, nervous and autonomic systems, cells of the spinal cord. Having penetrated into these organs, they begin to reproduce, and having already settled in the body, they cause disease. From the moment of infection to the first symptoms, it can take 14 or more days. The main symptom of chickenpox is the appearance of blisters in the form of a rash all over the body. At first, they look like reddish nodules, but quickly increase to the size of a match head or slightly less. In them, under the thin skin is a transparent exudate. When the bubbles burst, the exudate flows out, and sores remain on the skin, which turn into crusts when dried.
The temperature in sick preschoolers rarely rises to high values, and usually stays around 37.5 ° C, signs of intoxication are most often not observed, but the child may be capricious, refuse to eat, be lethargic. Older children (7-12 years old) suffer from chickenpox somewhat more difficult, although their disease can also occur in a fairly mild form with a low temperature and satisfactory he alth.
Chickenpox is a problem with a rash that is very itchy in patients of any age. Children itch and peel off the scabs, leaving lifelong pockmarks on their skin.
Adults with primary chickenpox tend to have a more severe disease. They have:
- weakness;
- headache;
- high temperatures;
- body aches;
- sleep disorder;
- sometimesnausea to vomiting and stool disturbance.
Chickenpox in pregnant women and newborns
Chickenpox is rarely diagnosed among pregnant women (no more than 5%), since most expectant mothers had it in childhood, and the body is able to develop antibodies to varicella-zoster. In a newborn, they also provide protection against this virus up to 6 months. Therefore, babies practically do not get chickenpox.
Unfortunately, if the primary infection with the smallpox virus occurred during pregnancy, there is a risk of infecting the fetus with it (8%). If the disease happened in the first trimester, 5% of babies may have various congenital malformations (convulsive syndrome, paralysis, rudimentary fingers, anomalies in appearance and organs). With a disease in the second trimester, 2% of children are born with deviations, and with a disease in the third trimester, there are isolated cases.
But if a mother gets chickenpox five days before childbirth or within two days after them, chickenpox is very difficult in newborns, even deaths are possible.
Diagnosis of varicella-zoster, IgG, IgM and other antibodies
Previously, the diagnosis of chickenpox was made visually. Now doctors are conducting a series of tests to find out which virus caused the disease and which antibodies are produced in the body. Modern diagnostics include:
- Oral swab.
- A blood test to determine the type of virus.
- Analysis of exudate from vesicles.
- Test for antibodies of the IgM group, which are formed almostimmediately after the onset of the disease in pre-B-lymphocytes, and in the blood they are detected on the 4th day of the disease. In the future, antibodies of other groups are also found in patients. IgG antibody values rise slowly, but just as slowly and decline after visible symptoms disappear and the disease subsides. This property is used to diagnose chronic forms of certain ailments.
Treatment
As a rule, patients with chickenpox are not hospitalized. At home, they are given a course of antiviral drugs ("Acyclovir", "Brivudin", "Gerpevir"), according to indications, antipyretic, antihistamines are prescribed, and all rashes are smeared with brilliant green or fucorcin. Doctors also attribute vitamins and diet to boost immunity.
In the body of those who have been ill, antibodies to the varicella-zoster virus remain for life, which are protection against repeated infections. These are mainly antibodies of the IgG group, although IgA, IgM groups may also be present. The level of AT IgA drops significantly already by the 4th month after the disease. Basically, they protect the mucous membranes of internal organs and make up 20% of all antibodies. IgM of the total number of immunoglobulins is 10%, and IgG 75%. They are the only ones able to pass through the placenta (due to their compact size), and give immunity to the fetus in the womb.
Complications
Because people have antibodies to the varicella-zoster virus IgG after chickenpox, they get lifelong immunity. Complications of the disease in ordinary children can be infections brought into papules. Have a veryFor weak children, the following complications are possible:
- pneumonia (symptoms: cough, fever, skin cyanosis, shortness of breath);
- encephalitis (symptoms: headache, fever, convulsions, incoordination, nausea);
- bursitis;
- arthritis;
- thrombophlebitis.
Adults against the background of chickenpox may develop:
- laryngitis;
- tracheitis;
- meningitis;
- encephalitis;
- hepatitis;
- arthritis;
- mug;
- abscesses, phlegmon, streptoderma.
Shingles, causes of appearance
This disease is also called "herpes zoster". Varicella-zoster, once ingested, remain to live in a latent (inactive) state in the nerve cells in the spinal cord, in the cranial nerves, in the ganglia (clusters of neurons) of the nervous system. As long as a person’s immunity is strong, they sit quietly and do not cause trouble. But as soon as the body weakens, the viruses are instantly activated. As a result, there is no new chickenpox, but a person begins another ailment - shingles, which belongs to the category of infectious diseases, and manifests itself with characteristic rashes on the body.
Reasons:
- transferring operations, injuries, other diseases, including acute respiratory infections, influenza;
- nervous stress;
- bad food;
- hard work exhausting the body;
- poor living conditions;
- chronic diseases with relapses;
- pregnancy;
- hypothermia;
- organ transplant;
- certain immunosuppressive drugs;
- old age.
Symptoms
Shingles is more common in adults, but it can also be diagnosed in debilitated children who have had chickenpox. Its main visual sign is rashes on the body, mainly located where the nerve trunks pass. This ailment has nothing to do with herpes near the nose and on the lips, as it is caused by another virus, which is shown by the analysis. The varicella-zoster virus, having gained freedom from the immunity that kept them in check, leaves the nerve cells and rushes along their axons to the tips of the nerves. Upon reaching its target, it causes a skin infection. Harbinger Symptoms:
- temperature;
- unexplained fatigue and malaise;
- failure;
- loss of appetite;
- pain and itching (sometimes incomprehensible tingling) in places of future rashes.
Symptoms at the peak of the disease:
- blister rash with clear exudate;
- enlarged lymph nodes;
- neuralgic pain (may be moderate or severe);
- temperature above subfebrile;
- signs of intoxication.
The disease lasts from a week to a month.
Classification by type of rash
Varicella-zoster can affect different parts of the body, and therefore there are such types of herpes zoster:
- Ophthalmic (the ophthalmic branch of the trigeminal nerve is affected, which can lead tocorneal injury). Manifested by pain in the eyes, loss of vision, rash on the temples and under the eyes.
- Ramsey-Hunt syndrome (mimic muscles are affected, rashes are noted in the oral cavity and ear canal).
- Motor (myotomes and dermatomes are affected, patients complain of severe pain in the muscles of the limbs, forearms).
The following types are distinguished according to the course of the disease:
- abortive (without pain and rashes);
- blistering (rashes are very large);
- hemorrhagic (blood is present in the exudate of the vesicles);
- necrotic (necrosis of the skin occurs at the site of the papules);
- generalized (rash all over the body).
Diagnosis
Clinically and visually, shingles before a rash appears is often mistaken for appendicitis, angina pectoris, pleurisy, and other ailments. If necessary, laboratory analysis is carried out. Varicella-zoster is detected by express diagnostics, which consists in examining samples under a microscope. Immunofluorescent and serological methods are also used. Complicated laboratory tests are carried out in cases of:
- baby patients;
- immune-deficient children;
- atypical herpes;
- complex course of the disease.
Varicella-zoster IgG antibodies and IgM antibodies are found in large quantities in babies infected in the womb. Differentiation is performed using PCR. This reaction also helps detect viruses in the absence ofrashes on the skin and its presence on the internal organs.
Treatment of shingles
If the analysis turned out to be positive, varicella-zoster is diagnosed with 100% certainty. After that, the doctor determines the treatment algorithm. I must say that in young people, shingles goes away without medication, but with a sparing diet and bed rest. Medicines can speed up recovery and prevent complications, as well as relieve pain and fever, if any.
Antiviral drugs are prescribed for patients older than 50 years old, severely weakened, who have undergone injuries and operations, suffering from chronic ailments, and children. The prevailing drugs are Acyclovir, Famciclovir, Valaciclovir, and among painkillers Ibuprofen, Ketoprofen, Naproxen and analogues. Also, according to indications, anticonvulsants, antidepressants, corticosteroids are prescribed. When infected with varicella-zoster of the eye and / or brain, the patient is hospitalized.
Complications
Are noted in 28% of those who have been ill with herpes zoster. Patients complain about:
- vision deterioration;
- hearing loss;
- frequent and causeless headaches;
- spontaneously occurring dizziness;
- soreness of the body after the disappearance of the rash.
In some patients, the development of heart and / or kidney failure, complications of the course of oncological diseases, blindness or deafness, damage to the tissues of the brain and / or spinal cord.
As a preventive measure, the Zostavax vaccine has been developed. Its effectiveness, established empirically, is equal to50%.
