Should I worry if a child or an adult has inflamed lymph nodes with chickenpox, they hurt and are red?

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Herpesvirus infections are a group of diseases caused by viruses of the Herpesviride family, which are characterized by a wide epidemic spread and a variety of clinical manifestations.

Eight types of viruses cause disease in humans:

• herpes simplex virus types 1 and 2;
• Varicella Zoster virus (VZV or herpes type 3);
• Epstein Barr virus (EBV, herpes type 4);
• cytomegalovirus (CMV, herpes type 5);
• human herpes viruses types 6, 7 and 8.

Antibodies to herpes viruses are found in 70-90% of adults.

The main risk groups for herpesvirus infections are children:

• born from mothers with a burdened obstetric history and a pathological course of pregnancy;
• recipients of blood transfusions, organs and tissues;
• children with immunodeficiency conditions.

Herpes simplex infection is characterized by a long latent course with periods of exacerbation, accompanied by blistering rashes on the skin and mucous membranes, as well as damage to the central nervous system, eyes, and internal organs.

Herpes type 1 is a disease that affects the skin of the face, mucous membranes of the mouth, and lips.

Herpes type 2 is genital herpes.

Chickenpox - definition

Chickenpox (also known as varicella) is an infectious disease of Chickenpox (Varicella).
It is caused by the varicella zoster virus. By the way, a close relative of the herpes familiar to many. All herpes are contagious, but varicella is the coolest. Chickenpox spreads through airborne droplets, and does so very actively. To catch an infection, sometimes it’s enough to look into the patient’s room for a second.

It always seemed to people that the disease was literally carried through the air, by the wind. Hence the first part of the name - wind. It was named smallpox because of the numerous rashes in the form of fluid-filled vesicles (papules), similar to those that form in smallpox.

Fortunately, chickenpox is not as deadly.

Chickenpox symptoms

Chickenpox usually lasts about ten days. The main symptom of chickenpox is a typical rash. One to two days before the rash appears, the following nonspecific symptoms may occur:

• Fever
• Decreased appetite
• Headache
• Fatigue and general malaise

The chickenpox rash goes through three stages of development:

• Pink or red spots and bumps (papules), which appear in spurts, with each new wave of fever, 2-6 shocks per day, for 3-6 days.
• After a few hours, these papules turn into blisters filled with clear liquid (vesicles), they last for a day, after which they burst and the liquid flows out
• After the blisters burst, after a few hours weeping appears - in their place crusts form, which last from several days to several weeks until new tender skin forms under them, after which they fall off.

CHICKENPOX IN CHILDREN: SYMPTOMS, COURSE, TREATMENT

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CHICKENPOX IS A DISEASE THAT IS NOT LOSSING ITS POPULARITY. WHOLE KINDERGARTENS AND FAMILIES HAVE IT: CHILDREN, ADULTS, FUTURE MOMS. BUT DESPITE THE FELLOWSHIP, THE SYMPTOMS AND TREATMENT OF CHICKENPOX IN CHILDREN AND ADULTS CONTINUE TO CAUSE MANY QUESTIONS. TODAY OUR EXPERTS WILL ANSWER THE MOST COMMON OF THEM.

WHAT IS CHICKENPOX

Varicella zoster virus is a type of herpes. More precisely: the herpetic virus varicella zoster (Varicella zoster), the 3rd type of herpes viral infection. The signature sign of chickenpox is a blistering rash that often covers the entire body (although there are also cases of localized rashes). In the past, each such pimple was supposed to be smeared with brilliant green, so in our country chickenpox is firmly associated with children with green spots. Dr. Komarovsky even has a joke about this: “A spotted green rash is a characteristic symptom of chickenpox.” When the blisters burst, they cause itching, which can lead to scratching and secondary infection of the wounds. The “favorite” season of the disease is considered to be autumn-winter, and epidemic outbreaks are recorded once every 5 years.

Chickenpox predominantly affects children aged 1 to 10-12 years, and the majority of cases are among children 3-4 years old.

HOW INFECTION WITH CHICKENPOX OCCURS

Susceptibility to the chickenpox virus is very high because it is very volatile - it covers distances of up to 20 m, from floor to floor, through ventilation. Chickenpox is transmitted through the mucous membranes of the eyes and upper respiratory tract. But the virus has several ways of entering someone else’s body from a patient. The virus literally travels with the wind: through airborne droplets - when talking, coughing, crying loudly, or screaming. It spreads through contact and household contact - infection with saliva or fluid from a pimple. Transmitted by direct touch. A pregnant woman with chickenpox can infect her child, since the virus passes transplacentally, that is, through the placental barrier from mother to fetus.

To become infected with chickenpox, it is enough to communicate with someone who has chickenpox or someone who has shingles (herpes zoster), and chickenpox infection will occur even with fleeting contact with him. The period of contagiousness of chickenpox in patients begins at the end of the incubation period (48 hours before the appearance of the rash) and continues until the 5th day from the moment the last pimple appears. Moreover, the incubation period of chickenpox in children and adults is not typical at all and does not manifest itself in any way for 1-3 weeks (at least 7 days), so it is impossible to say exactly when those same 48 hours before the appearance of acne will occur.

INCUBATION PERIOD OF CHICKENPOX

The incubation period, that is, the time from the moment of introduction to the first signs of chickenpox, is 11-23 days. During this period, the pathogen penetrates through the mucous membrane of the upper respiratory tract, then multiplies and accumulates in the epithelial cells of these mucous membranes.

After the maximum accumulation of the chickenpox pathogen, it spreads through the lymphatic and blood vessels.

In some patients (there are very few of them), the end of the incubation period is marked by scarlet-like rashes. This may be the first sign of chickenpox in children and adults. This condition lasts literally one day, several hours, then the rash disappears, the temperature rises to 37-38⁰C.

WHEN DOES THE RASCH APPEAR DURING CHICKENPOX?

After the incubation period, the period of rash begins. These are the most obvious and first signs of chickenpox in children and adults. The period of rash lasts for 3-5 days, while the lymph nodes enlarge, the temperature rises to 37-39°C, persisting throughout the entire period of the rash. Also, each new outbreak of rashes is usually accompanied by a rise in temperature.

WHAT DOES THE RASHE (ACNE) LOOK LIKE WITH CHICKENPOX

A rash with chickenpox appears on the 1st day of the onset of intoxication, with breakouts (the appearance of new pimples) within 5 days - some pimples are already going away, while others are just appearing. Therefore, it seems that the patient has pimples of different types: blisters, spots, and crusts at the same time.

The rash does not have a favorite localization; rashes can even be on the scalp, on the mucous membrane of the mouth, genital organs in girls and women, conjunctiva/cornea, and larynx. All these pimples mature and heal within 5 days, and the rash is accompanied by itching of varying intensity. Against itching, various doctors recommend using antihistamines, wet wraps or even baths. During the first day, the red spot turns into a blister and after a couple of days the rash looks on the surface of the body like “dew drops” with transparent contents, which becomes cloudy after 1-2 days, and after another 1-2 days the blister dries out and turns into a crust that falls off after 1-3 weeks.

WHY ARE PIMLES LUBRICATED WITH ZELENKA

As Dr. Komarovsky wittily noted, speaking about chickenpox: “Painting a child with brilliant green is a personal matter for his parents, determined by their love of painting and has nothing to do with treatment.” In fact, brilliant green does not treat chickenpox rash, but is a medical marker with which the appearance of new pimples on the patient’s body is noted. As soon as new objects for staining with brilliant green stop appearing on the skin of a child with chickenpox, and old pimples have crusted over, that’s it, the child is no longer contagious. Nowadays, pimples are smeared with brilliant green only by those who firmly believe that it is one of the mandatory means of treating chickenpox. But this is a misconception. You can't cure pimples, you can only wait until they go away on their own. To avoid secondary infection of the skin, it is necessary to prevent scratching in the area of ​​acne. To do this, you need to purchase other drugs from pharmacies that are specially created to eliminate symptoms of such diseases. They relieve itching, dry, have a cooling effect and, by the way, are also not completely colorless.

WHEN DOES A PATIENT WITH CHICKENPOX STOP BEING INFECTIOUS?

A patient with chickenpox ceases to be contagious as soon as the appearance of new pimples has stopped, and crusts have already formed on all existing ones. The recovery period lasts for 3 weeks from the end of the rash and is characterized not only by the falling off of the crusts, but also by the formation of lifelong immunity. After the crusts fall off, dark spots remain, which disappear within a few weeks. There are no scars left unless there is a secondary infection.

CHICKENPOX IN INFANTS

Breastfed newborns up to 6 months usually do not get sick due to antibodies received from the mother, but only if the mother herself has previously had chickenpox or has been vaccinated. If the mother has not passed on these antibodies to the baby (not having them herself), then the baby may get chickenpox. Please note that we are talking specifically about breastfed babies. Formula-fed babies do not have such antibody protection.

In a sick infant, the disease is severe. Against the background of high temperature, intracranial pressure may increase, which will be indicated by visible pulsation of the fontanel and convulsions. The rashes in such babies are profuse and the maturation of the rash proceeds more slowly, becoming protracted - up to 9 days, instead of 5. Bacterial complications often occur.

For this reason, all newborns whose mothers have not had chickenpox or were infected a few days before birth, as well as all premature babies under 1 kg, regardless of the mother’s infectious history, must be administered a special immunoglobulin. This is not a vaccination against chickenpox, but temporary protection against it until the child is strong enough to cope with this virus on his own, unless, of course, the mother chooses vaccination over the disease.

It is worth noting that children who are not in a group, children under 3 years of age, as a rule, very rarely have the opportunity to become infected with chickenpox. Adults also rarely get this disease.

IS IT DIFFICULT TO IDENTIFY CHICKENPOX?

In typical cases (and this is the majority of cases of chickenpox), the diagnosis of the disease is established on the basis of characteristic clinical data of the disease. The clinical picture of chickenpox is so typical that there is simply no need for additional diagnostics.

However, in some cases, when the disease does not proceed in a completely typical manner, it may be necessary to carry out a differential diagnosis of chickenpox with other viral infectious diseases, mainly those that are accompanied by similar symptoms. We are talking, first of all, about influenza, parainfluenza, measles; in some cases, differential diagnosis with rubella may be required. For this, a blood test is done.

IS IT POSSIBLE TO CONFUSE CHICKEN POX AND RUBELLA?

The doctor, of course, will not confuse these diseases. For doubting patients, you need to keep in mind their obvious differences. With chickenpox, a polymorphic rash is most often observed, that is, spots, crusts, and blisters are simultaneously present on the skin. With rubella, only a pinkish rash can be observed. With chickenpox, the temperature can rise to 40°C; with rubella, it occasionally reaches 39°C. The rubella virus is dangerous for the fetus; the chickenpox virus does not pose such an acute danger to pregnant women. Chickenpox can be complicated by inflammatory phenomena on the skin, but this does not happen with rubella. Chickenpox rarely goes away with catarrhal symptoms; with rubella, redness of the pharynx and catarrh of the upper respiratory tract almost always occur.

HOW TO TREAT CHICKENPOX IN CHILDREN?

If a child of the first year gets sick with chickenpox, treatment is carried out only under the supervision of a doctor with possible hospitalization

, because the course of infectious processes in young children is prone to generalization, frequent and severe complications and high mortality!

In children aged 2 to 10-12 years after diagnosis (with primary chickenpox), specific treatment for uncomplicated chickenpox is not carried out (and patients are not painted with brilliant green). All manipulations with a patient with chickenpox are associated with the relief of symptoms, namely: reducing the temperature with antipyretics (except aspirin) and relieving skin itching, if any. If the child does not look lethargic, if his temperature is not too high, then you should not convince him that he is very sick and needs bed rest. Children under 10-12 years of age suffer from chickenpox quite easily. And the only thing that usually torments them is the itching of the chickenpox rash. This problem is solved by using antihistamines.

To prevent the child from scratching the skin in areas of chickenpox rash, parents will have to monitor him and distract him. It is also necessary to monitor the child’s nails, and very young children can wear special mittens - “scratchies”. There is also a “grandmother’s” way to help a child with severe itching, even if antihistamines do not help - this is a feather. In the past, children were relieved of itching with a goose feather - with its help, mothers “scratched” especially disturbing places on the skin, without creating scratches.

A month after recovery from chickenpox, the doctor examines the patient, with an appointment for an immunological examination and specialist examination. Preventive vaccinations cannot be given within 1 month.

IS QUARANTINE FOR CHICKENPOX REQUIRED?

In the not-too-distant past, quarantine due to chickenpox was as commonplace as wearing war paint with brilliant green on children affected by this virus. But now, when there is a mass incidence of chickenpox, kindergartens and schools are usually not closed for quarantine. Groups and classes in which children with chickenpox have been identified continue to function, but they may be subject to temporary (up to three weeks) bans on outings, on contacts with children from other groups (classes), as well as on the admission of new children to them .

Chickenpox: course of the disease

Chickenpox is characterized by stages, which allows you to assess the course of the disease and navigate the quarantine period.

The incubation period of chickenpox is the time that elapses between the virus entering the body and the appearance of the first symptoms of the disease. It usually lasts 2 weeks, but can range from 10 to 21 days. The incubation period for chickenpox in adults and children is usually the same length.

The prodromal period is the initial stage of chickenpox. It is short (1-2 days), and may be absent altogether. Its characteristic symptoms are poor health, fever, muscle and headaches, and catarrhal phenomena in the nasopharynx. The first symptoms of chickenpox in adults are usually more pronounced than in children.

The rash period lasts 3-10 days. Elements of the rash appear in waves, this is accompanied by an increase in body temperature and poor health. 1-2 days pass between “waves” of rashes. There are usually 2-5 of these “waves”, then new elements stop appearing and gradually heal. The next stage begins - healing.

The recovery period begins from the moment when new elements cease to form, and all that appear become covered with crusts.

The period of convalescence (recovery) after chickenpox can last up to 1 year. The varicella-zoster virus causes a serious blow to the human immune system, and the process of its recovery is usually quite long. During this period, the body's resistance to other viral infections, such as ARVI, decreases.

How many days chickenpox lasts depends on the individual characteristics of the disease, the patient’s age, and the state of his immunity. On average, from the moment the first signs of chickenpox appear in a child until the elements of the rash completely heal, 3 weeks pass; in adults it may be longer.

Symptoms of inflammation of the lymph nodes

Do lymph nodes become inflamed in adults? The complication occurs, but much less frequently when compared with young patients. This phenomenon is based on the fact that the immunity of people over 15 years of age is more resistant to negative effects.

It is not difficult to detect an increase; the complication is evidenced by uncomfortable sensations, less often by pain.

Important: swollen lymph nodes are not a direct sign of chickenpox. Many other pathologies lead to this complication.

Typically, with chickenpox, inflammation is observed in the following places:

Symptoms of herpes zoster during pregnancy and its treatment

• On the neck;
• On the back of the head;
• Behind the ears.

Those lymph nodes that are closest to the internal organs affected by the herpes virus become enlarged. This condition is observed throughout the acute period of the disease. They decrease when the number of rashes decreases and peeling of the skin is revealed.

However, there are clinical pictures when the increase remains even after the patient has recovered. Then the nodes become hard and flexible, discomfort occurs when palpating the affected areas, but there is no pain.

Types of chickenpox (classification of chickenpox).

Chicken pox occurs in typical and atypical forms and in terms of severity is mild, moderate and severe. 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 characterized by development in patients with immunodeficiency. It is very difficult, the symptoms are more pronounced and often ends in death for the sick person.
• The rudimentary form is found 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 occur 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.

What causes chickenpox and how can you get infected?

Varicella zoster virus (VZV) is a virus that causes chickenpox and belongs to the herpesvirus family. Like other viruses in this group, it has the ability to persist in the body after the initial infection.

After a person has had chickenpox, VZV does not leave the body but remains in the sensory nerve ganglia.

Thus, primary VZV infection leads to chickenpox, and herpes zoster is the result of reactivation of a latent infection of this virus, which is caused by decreased immunity due to various circumstances (hypothermia, stress, etc.) or concomitant diseases that are accompanied by immunodeficiency (malignant blood diseases, HIV etc.). Due to the presence of this property, the chickenpox virus belongs to the group of pathogens of slow infections. It is worth noting that the chickenpox virus itself has an immunosuppressive property.

VZV is thought to have a short survival time in the environment. All herpes viruses are sensitive to chemical and physical effects, including high temperature.

The source of infection is a person with chickenpox or herpes zoster. The virus is contained on the mucous membranes and in the elements of the rash. A patient is considered contagious from the moment the rash appears until crusts form (usually up to 5 days after the last rash).

The chickenpox virus is highly contagious, meaning it is very likely to be transmitted through respiratory droplets or direct contact with characteristic skin lesions of an infected person. This is due to the fact that most of the population becomes ill in childhood.

80-90% of cases occur under the age of 14 years. Chickenpox is also characterized by high susceptibility (90-95%).

Most countries tend to have higher incidence rates in urban areas (700-900 per 100,000 population) and significantly lower rates in rural areas. The epidemiology of the disease differs in different climatic zones, for example, a significant difference is observed in temperate and tropical climates. The reasons for these differences are poorly understood and may relate to properties of the virus (which are known to be heat sensitive), climate, population density, and exposure risk (eg, daycare or school attendance, or number of siblings in the household).

Why is chickenpox so relevant in the modern world?

The relatively mild course and low mortality rate have long been the reason for an extremely calm attitude towards this infection.

However, at the moment, as a result of numerous studies, it has been established that the pathogen can affect not only the nervous system, skin and mucous membranes, but also the lungs, digestive tract, and genitourinary system.

The virus has an adverse effect on the fetus when the disease occurs in pregnant women. It is worth remembering that the mother can transmit the infection to the fetus if she is sick with chickenpox or herpes zoster (the virus can penetrate the placenta throughout pregnancy).

Diagnosis of chickenpox

The basis for detecting herpes is a virological study - examination of media to detect the pathogen. In case of chickenpox, for diagnosis, liquid from vesicles is used, in which, when stained, accumulations of the pathogen, the Argan corpuscle, are isolated.

Chickenpox is usually distinguished from insect bites. The main difference is the lack of development of elements and bedding, as well as normal body temperature.

Also, the disease should be differentiated from:

• streptoderma - occurs without fever, the rash is different - cloudy, purulent contents, after involution leaving a yellow crust, in its place a red spot forms. The rash is located mainly behind the ears and on the extremities, never on the scalp (a hallmark of chickenpox).
• herpes zoster - the blisters are located strictly along the nerve trunk; they practically never occur on the legs and arms.
• vesicular rickettsiosis - a small scab forms at the site of the tick bite, followed by the formation of an ulcer (a scar forms in its place after healing). Enlargement of regional lymph nodes is typical.

Diagnostics

It is not difficult to determine the development of chickenpox, because its main symptom is a characteristic skin rash. If, against the background of this disease, an enlargement of the lymph nodes is observed, then the diagnosis is somewhat complicated, because the cause of lymphadenitis may be some hidden pathological process occurring in the body.

Testing is necessary to identify the cause of inflammation of the lymph nodes

Identifying the root cause of the disease involves the use of laboratory and hardware diagnostic techniques. The first includes the following procedures:

1. Clinical blood test.
2. Analysis of urine.
3. Analysis of cerebrospinal fluid for suspected development of an oncological process.

Hardware diagnostics involves the use of the following techniques:

1. Radiography. Used to identify pathologically altered tissues.
2. Ultrasound. Designed to determine the degree of development of the pathological process in tissues.
3. CT and MRI. The most effective techniques that allow you to visualize changes not only in bone structures, but also in soft tissues.

When to see a doctor?

If you suspect that you or your child has chickenpox, consult your doctor. The doctor will be able to make a diagnosis simply by examining you, studying the elements of the rash and accompanying symptoms. Your doctor may also prescribe medications to reduce the severity of chickenpox and reduce the risk of complications, if necessary. Call the pediatrician in advance and warn that you suspect chickenpox - the doctor will see you in a separate room, without waiting in line, to avoid the risk of infecting other patients.

Also, be sure to tell your doctor if you have any of these complications:

• The rash has spread to one or both eyes.
• The skin around some parts of the rash becomes very red, hot, or painful, indicating a secondary bacterial skin infection.
• The rash is accompanied by dizziness, disorientation, rapid heartbeat, shortness of breath, tremors (shaking hands), loss of muscle coordination, increasing cough, vomiting, difficulty bending the head forward, or a fever above 39.4 C.
• a history of any immunodeficiency, or age younger than 6 months.

How to treat chickenpox

Chickenpox is a virus. And, like most viruses, there is no specific treatment for it. Helping a sick person comes down to alleviating the main symptoms.

Fever and headache

Remember: paracetamol and nothing else! Popular painkillers and antipyretics based on ibuprofen should not be taken. The use of nonsteroidal anti-inflammatory drugs and the risk of serious skin and soft tissue complications in patients with chickenpox or herpes zoster have been reported to indicate that ibuprofen for chickenpox increases the incidence of complications such as skin infections.

Aspirin is completely contraindicated. In conjunction with the varicella-zoster virus, it has a powerful toxic effect on the liver and brain (the so-called Reye's syndrome).

Itching

To relieve itching, your doctor may recommend an antihistamine. Considering the insidiousness of the virus, under no circumstances prescribe it to yourself!

You can also treat your skin with calamine lotion according to the instructions.

Scratches and wounds

To avoid scratching the skin and causing infection in the wounds:

• Trim your nails as short as possible. If your baby is sick, put on thin protective gloves.
• Wear clean, loose clothing.
• Change your underwear and bed linen more often.

It is not necessary to smear the rashes with brilliant green: brilliant green will not speed up the maturation of the blisters. The color only helps to mark pimples in order to track the moment when new ones stop appearing.

Soreness in the mouth

If there are rashes on the oral mucosa, doctors recommend eating sugar-free popsicles. The cold will help relieve discomfort. Also try not to eat salty and spicy foods.

Treatment

If during the diagnosis it was revealed that enlarged lymph nodes occurred against the background of chickenpox, then therapy should be aimed at eliminating this disease. In this case, symptomatic treatment is used, which involves taking the following drugs:

• immunostimulants;
• antipyretics;
• antiviral medications;
• headache tablets (if necessary).

To eliminate pain and inflammation in the lymph nodes, drug treatment is necessary

To get rid of skin itching, the patient is prescribed antihistamines. The patient may also be prescribed skin care medications. Most often, the rash is smeared with brilliant green, due to which the wounds dry out quickly.

If the lymph nodes continue to grow in size, and a bacterial infection is associated with chickenpox, then the child is prescribed a course of antibiotic therapy. If the lymph nodes are suppurated, surgical intervention may be required.

What complications can occur with chickenpox?

The disease is usually mild, but complications may occur, including bacterial infections (eg, bacterial skin lesions, pneumonia) and neurological infections (eg, encephalitis, meningitis, myelitis), which can be fatal.

Secondary bacterial skin infections, which are caused by streptococcus or staphylococcus, are the most common cause of hospitalization and outpatient medical visits. Secondary infection with invasive group A streptococci can cause abscesses and cellulitis.

Pneumonia after chickenpox is usually viral, but can also be bacterial. Secondary bacterial pneumonia is more common in children under 1 year of age. It is characterized by an increase in temperature up to 40⁰C, an increase in pallor and cyanosis of the skin, the appearance of a substernal dry cough and shortness of breath. Patients can take a forced position in bed.

Damage to the central nervous system in chickenpox ranges from aseptic meningitis to encephalitis. Cerebellar involvement followed by cerebellar ataxia is the most common presentation of central nervous system disorders but usually has a positive outcome.

Encephalitis is one of the most dangerous complications of chickenpox (10-20% of cases are fatal). This complication manifests itself as headache, nausea, vomiting, convulsions and often leads to coma. Diffuse brain involvement is more common in adults than in children. Chickenpox meningitis may occur together with encephalitis or independently.

Rare complications of chickenpox include Guillain-Barré syndrome, thrombocytopenia, hemorrhagic and bullous chickenpox, glomerulonephritis, myocarditis, arthritis, orchitis, uveitis, iritis and hepatitis.

Once infected, the virus remains hidden in nerve cells and can be reactivated, causing a secondary infection, herpes zoster. It usually occurs in adults over the age of 50 or with a weakened immune system and is associated with a painful rash that can cause permanent nerve damage.

How to prevent chickenpox?

Chickenpox can be prevented through vaccination. Specific prevention is carried out with live vaccines from a weakened varicella zoster virus (for example, the Belgian vaccine Varilrix). Vaccination is especially recommended for young children, and in the United States for the elderly, to prevent herpes zoster and postherpetic neuralgia.

In clinical trials, it was found that individuals who were vaccinated were either not susceptible to chickenpox or experienced it in a very mild form.

Chickenpox vaccines

Vaccination is necessary for those categories of people who have reduced immunity and, as a result, a high risk of severe and complicated course of the disease. These include the following categories:

• persons with malignant diseases,
• HIV-infected,
• those groups of people who have severe chronic pathology,
• patients taking glucocorticosteroids.

Vaccination indicated:

• for preventive purposes, especially recommended for high-risk categories: - routine vaccination at the age of 12-15 months, - routine second dose at the age of 4-6 years.
• for emergency prevention of those who have not had chickenpox and have not been vaccinated, but are in contact with patients.

The minimum interval between doses of varicella vaccine is 3 months for children under 13 years of age.

Although single-dose programs are effective in preventing severe varicella disease, as demonstrated by a study in Australia (one of the few countries to include varicella vaccination as part of its national immunization program), evidence suggests that it is not necessary to interrupt transmission of the virus. two doses are required. Emerging school outbreaks and high rates of chickenpox, although usually not severe, have prompted some countries to implement a two-dose vaccination schedule.

Vaccination is the most effective medical intervention ever invented by man.

Used materials

• https://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html - etiology, pathogenesis, clinical features, prevention of chickenpox
• https://www.who.int/immunization/sage/meetings/2014/april/5_The_potential_impact_Varicella_vaccination_Low_Middle_Income_Countries_feasibility_modeling.pdf?ua=1&ua=1 – vaccination for chickenpox
• https://www.who.int/immunization/diseases/varicella/en/ - about the epidemiology of chickenpox and herpes zoster
• https://www.who.int/bulletin/volumes/92/8/13-132142/en/ - research on the effectiveness of vaccination against chickenpox and herpes zoster in Australia.
• https://www.who.int/immunization/position_papers/varicella_grad_effectiveness_2_doses.pdf?ua=1 - about the effectiveness of vaccination against chickenpox.
• https://www.who.int/wer/2014/wer8925.pdf?ua=1&ua=1 – epidemiology, diagnosis, treatment, some positions on vaccination for chickenpox and herpes zoster.
• Vozianova Zh. I. Infectious and parasitic diseases: In 3 volumes - K.: Health, 2000. - T. 1. - 904 p.
• Golubovskaya O. A. Infectious diseases. - M.: VSV "Medicine", 2012. - 728 p. + 12 s. color. on

Author: Anastasia Lishnevskaya, infectious disease doctor Source: MMK Formed

Chickenpox and pregnancy

A special type of complications from chickenpox can occur in pregnant women. Chickenpox in early pregnancy can lead to a variety of problems in the newborn, including low birth weight and birth defects such as limb abnormalities. A particularly great threat to the child occurs when the mother gets chickenpox a week before giving birth. In this situation, there is a high risk of infection that is life-threatening to the newborn (congenital chickenpox syndrome).

If you are pregnant and have been in contact with someone who has chickenpox, be sure to talk to your doctor about the risks to you and your unborn baby.

Causes

Enlarged lymph node.

When palpated, such a lump is soft, does not move with the skin, and is painless. Typically, lymph nodes enlarge symmetrically, so lumps appear on both sides. Causes of enlarged postauricular lymph nodes:

• Past infections.
• Otitis media Then a unilateral enlargement of the lymph node is possible.
• Lymphadenitis.

The lump behind the child's ear gradually increases in size. In a newborn it may not be noticeable at all.

Parotitis

The disease is popularly called mumps.

The process affects the postauricular salivary glands, which increase in size, become denser and look like lumps. Characterized by pronounced swelling of the soft tissues in the area behind the ear, which extends to the cheek and earlobe. The disease is accompanied by the following symptoms:

• Intoxication and fever. The child is lethargic and complains of headache and muscle pain. Appetite is reduced, sleep is disturbed.
• Pain in the ear area. It gets worse when talking and chewing.
• In complicated forms of the disease, other organs are involved in the inflammatory process - the testicles in boys, the pancreas, joints, kidneys, and nervous system.
• With mumps, the lump behind the ear is painful when palpated. When examining the oral cavity, the mucous membrane is swollen and hyperemic in the area of ​​the exit of the excretory duct of the salivary gland (Mursu's symptom).

Tumor process

Unlike lymph nodes, the tumor lump behind the ear is mobile and moves along with the skin. At the first stages of the process, the child does not make any complaints. But the slightest suspicion of a tumor requires immediate contact with an oncologist.

Parotid fistula

Occurs when there is an intrauterine disorder in the formation of the hearing organ. A fistula is a canal that opens behind the ear in the area of ​​the cartilaginous part of the auricle, and the other end goes into the oral cavity, middle ear or neck area. A lump at the site of the fistula outlet is formed only when the tissues of the canal become inflamed.

Treatment methods

A lump behind a child's ear does not always require treatment.
It is better not to touch enlarged lymph nodes during the recovery period after infectious diseases. They themselves will gradually decrease to normal size. Lymphadenitis may require antibiotics, but only if a complete blood count shows signs of active bacterial inflammation. If a child is diagnosed with mumps, treatment is aimed at preventing complications. Since the causative agent of mumps is a virus, there is no specific treatment. Antibiotics are also ineffective. bed rest for 10 days is mandatory (prevention of orchitis) and a dairy-vegetable diet (prevention of pancreatic inflammation).

Tumors and parotid fistulas are most often removed surgically.

Any lump behind the ear in a child requires consultation with a pediatrician. Only he can distinguish a harmless symptom from a severe infectious disease and prescribe adequate treatment.

Is it possible to wash yourself if you have chickenpox?

“Is it possible to swim if you have chickenpox?” is an age-old question parents ask their pediatrician. The answer depends on the patient’s well-being. In general, bathing with chickenpox is not only safe, but even beneficial - keeping the skin clean reduces the risk of secondary infection and promotes faster healing. However, at high body temperatures, it is better to refrain from water treatments and limit yourself to treating the rash elements with antiseptics.

If you have chickenpox, you can bathe in a weak solution of potassium permanganate or with herbal decoctions, but it is better to refrain from using cosmetics (shower gels and even soap). It is also undesirable to use washcloths and towels, as they can injure the skin.