To know what herpes zoster is, whether it is contagious for children, how it manifests itself and how it is treated, is worth every modern parent. This disease is quite common, also known under the name "shingles", belongs to the category of sporadic. Symptoms are manifested in a person in whose body the Varicella-Zoster virus becomes active. This life form lives in the ganglia between the vertebrae. Consider the features of the pathology.
General information
For the first time, doctors noticed signs of herpes zoster in a child in 1888. It was then that a specialist from Hungary, Bokai, noticed that chickenpox is often observed in those families where one of the members is sick with this type of herpes. Modern experts know that pathology develops if a person is infected, and the activity of the immune system is reduced due to any factors. Only with a combination of these phenomena is the manifestation of the disease possible.
Herpes zoster in a child may appear if he received the virus from a carrier. Infection is possible through contact witholder children or adults suffering from either this form of herpes or chickenpox. It is known from statistical studies that in children under ten years of age, signs of the disease are observed very rarely.
Features
A person with the type of herpes in question can infect someone who has smallpox. The reverse process is possible. Both of these situations are rare in practice. The infection is transmitted by airborne droplets, through contacts and in the household. The frequency of occurrence is higher in cold seasons. Cases are predominantly sporadic.
Most often, shingles in a child occurs due to contact with the patient. First, primary infection is observed, after which the pathological form of life continues to exist in the human body in secret. The localization area is the nerve ganglia. It is possible to detect particles in the spinal system, trigeminal or sacral nerve. Reactivation occurs endogenously.
Mechanisms and protection
The main factor that prevents the pathological microscopic form of life from reactivating is T-lymphocytes. The weakening of the protective function associated with these cells is possible with severe somatic pathologies, oncological diseases, and HIV infection. Lymphocytes become weaker if a person is forced to use immunosuppressive medications. Similar processes are observed in those who are older than 55 years of age. If the deterrent weakens, disease develops. Between initial infection and re-infectionactivation usually takes a fairly long time period, but there are exceptions. Brief pauses are characteristic of children suffering from chronic foci of infection, T-cell deficiency. There is a possibility of congenital chickenpox.
If a child's herpes zoster reactivates, pathological life forms travel axonally to the skin, attacking and multiplying in cellular structures. Activation is possible if the nerve endings become inflamed, the integrity and structure of the ganglia between the ribs or the cranial nervous system are disturbed, if the posterior spinal roots are affected.
Diseases: similarities and differences
Doctors compared the characteristics of herpes and chickenpox. In the first case, the most characteristic symptoms are due to the influence of the virus on the nervous system, while skin lesions are secondary.
In modern medicine, chickenpox is regarded as a hematogenous infection, which is inherent in people who have not received appropriate immunity. Herpes zoster is the result of neurogenic infection, which is characterized by activation even in the case of humoral immunity.
How to notice?
Already at the initial stage of herpes zoster in children, you can see the specific symptoms of the disease. Manifestations appear in the coming hours after infection or secondary activation. First, the general temperature rises, the patient feels weak, complains of pain in the head. Many feel sick, rarely vomit. Affected skin attracts attentionitching, soreness, the strength of which varies from case to case. A typical symptom is paresthesia.
After a few days (from three to five), erythema forms on the affected area, the area swells. Papules, vesicles filled with a specific liquid gradually appear. Such formations can merge. After a week or a half, the filling dries up, crusts appear. Their upper part may burst. This results in the formation of a bright red erosion. The site is disturbed by soreness.
Usually, the symptoms of herpes zoster in children are one-sided. There is one zone of skin lesions, beyond which the pathology does not go. More rarely, several such sites (up to three) are formed. There is a possibility of damage to the mucous membranes of the oral and nasal cavities. The conjunctiva, reproductive system, intestinal tract, and bladder may be affected. In the affected area, the temperature balance of the skin is disturbed, sensitivity to touch and pain changes. Possible muscle paresis. There are cases when the disease was accompanied by a violation of the he alth of internal systems: respiratory, cardiac, gastrointestinal tract.
Classics and more
Herpes zoster in a child can form in the variant described above, but there is a possibility of an atypical course. From medical observations, cases of bullous rash, hemorrhagic form are known. There is a possibility of abortive, gangrenous types. There is widespread deprivation. The nuances of symptoms, features of skin lesions, a tendency to an atypical course depend onprimary focus.
If the virus has infected the trigeminal nerve, the lesions are visible on the conjunctiva. Many develop stomatitis. There is a possibility of keratitis, iridocyclitis, neuritis of the elements responsible for ensuring the efficiency of the visual system. The probability of forming an atypical form is estimated at 30-90%. If the virus has infected the cervical or thoracic element, the activation of the disease is accompanied by paresis of the upper limbs, acute myopathy. The probability of an atypical case is about 40-50%. The thoracic segments, as can be seen from the statistics, are rarely affected.
Localizations and types
Interesting materials can be found in specialized medical reference books about herpes zoster in children. Photos in such publications quite clearly demonstrate the features of the development of the process. You can learn that a viral lesion of the brain can initiate encephalitis. The probability of an atypical course does not exceed one percent. If there is a spinal lesion, the peripheral nervous system suffers. Infection leads to myelitis. The probability of an atypical flow also does not exceed one percent.
Possible localization of the virus in the lumbosacral region. Manifestations of this option are paresis of the lower extremities, violations of the process of emptying the bladder. Some develop intestinal obstruction. The probability of an atypical course reaches 15%. You can learn from reference books that tell and demonstrate the development of pathology with a photo: herpes zoster in children is sometimes formed when the virus invades the meninges. Suchoption is associated with the risk of serous meningitis. The probability of this flow reaches 80%.
What to expect?
Usually, the period of regression of bright manifestations takes a couple of weeks. In the presence of serious disorders of the immune system, manifestations are characterized by a long duration. With some types of flow, a rash is observed for a month, two, and sometimes even a longer period of time. This is possible when entering a bacterial infection and gangrenous, hemorrhagic types of rashes.
What does it lead to?
If, as the signs of herpes zoster appear in children, the treatment was adequate, suitable for the case, there would probably be no consequences. Without the correct therapeutic course, there is a possibility of secondary neuralgia. Such a pathological condition, on average, in 60% of those who have been ill lasts at least a month after the complete disappearance of the rashes. Approximately one in four notes secondary neuralgia within a quarter to half a year after the disappearance of the rash. About 15% suffer from neuralgia even longer. From the moment of self-removal of crusts and until the appearance of primary soreness, it takes from one to six months.
Sometimes even the treatment of herpes zoster (shingles) in children and adults does not avoid a serious complication - myelitis or encephalitis. The probability of such a development of the situation reaches one case per thousand patients. This happens more often if herpes manifests itself in a child younger than one year of age, as well as in the case of widespreadrash format.
Complications: what and how?
If the treatment of herpes zoster in children has not helped to avoid worsening the case, it is usually possible to notice this a week or two after the first skin rashes. The patient's consciousness is disturbed, convulsions are observed, the ability to empty the bladder, control the urge to defecate is impaired. There are sensitivity problems and focal symptoms.
About four out of a dozen patients with severe complications have isolated lesions of the integrity of the meninges, studies show serous meningitis. Cases of encephalitis, psychosis, paresis are known. The risk of death reaches 25%. Possible damage to the nerves of the skull. From practice, cases are known when patients developed Gijsna-Barre disease. There is a danger of myositis, a granulomatous vascular cerebral inflammation leading to a stroke.
With a weak immune system, there is a risk of dissemination of the infectious process. It spreads to the respiratory system or the heart, brain or liver. The risk of a progressive course in lymphogranulomatosis is higher. Approximately 40% of patients with this disease suffer from a common form of herpes.
How to fight?
As can be seen from clinical guidelines, herpes zoster in children should be treated as early as possible. It is advisable to take the first measures within 72 hours after the onset of the disease. Therapy should be continuous for at least seven days. Treat the sickit is necessary from the very beginning of the formation of foci of rash, during the entire period of formation of new ones and at least two more days after the appearance of the final zone.
The classic approach involves the use of "Acyclovir". For babies under one year of age, 30 mg / kg is indicated. The daily dose is divided into three portions. If necessary, give the patient medicines intravenously shown 1.5 g / ml, also divided into three injections. In the event of a relapse, the earliest possible use of such a pharmaceutical product allows to reduce the duration of the acute episode. The patient's pain disappears earlier, crusts form faster, and the risk of complications decreases. The use of "Acyclovir" from the very beginning of an exacerbation reduces the likelihood of dissemination of pathology.
Nuances of therapy
With symptoms of herpes zoster in children, treatment with Acyclovir can be practiced with a weak immune system, if the disease develops in a mild form, it is not severe. In this embodiment, the agent is indicated in the form for oral administration up to five times daily. A single dose is 0.8 g. If the pathology is severe, has spread, is accompanied by a complication, it is better to inject preparations containing ribamrin into a vein. Long term infusion recommended. The duration of the procedure is 12 hours. Dose - 15 mg/kg.
Immunoglobulin can be used as the main antiviral agent. With symptoms of herpes zoster in children, treatment involves a single injection of 0.2 ml / kg. If the pathology isdifficult, it is allowed to increase the volumes several times (no more than four).
What else?
Antiviral drugs with a systemic effect are not the only component of the treatment of the disease in question. It is recommended to use ointments that affect locally the affected areas. Topical formulations containing acyclovir, interferon should be used. To ease the pain, the doctor will prescribe analgesics. Non-hormonal anti-inflammatory drugs will come to the rescue. Sometimes a course of tranquilizers is recommended to the patient. To speed up the recovery process, diseased skin is treated with ultraviolet light. Of the additional methods of treatment, blockade with novocaine and electrophoresis have proven themselves best.
When choosing a program to help a child recover, elders caring for a child should be aware of the contagiousness of this disease. In order to minimize the risks for yourself, as well as to minimize the risk of the baby getting infected from other people, you need to instill hygiene skills from an early age, take care of cleanliness and maintain immunity at the proper level.
Important to remember
Shingles is a disease initiated by the third type of herpes viruses. The causative agent, having penetrated into the human body, remains there for life. Getting rid of it is not possible. The risk of getting sick is increased if a person has undergone an internal organ transplant. There are cases when a child's shingles was disguised as SARS, differing onlymanifestation of skin rashes. To identify the DNA of the virus, it is necessary to take blood samples for analysis using the PCR method. If specific antibodies are detected in the laboratory, the diagnosis is considered confirmed.
