The disease is very contagious. All children are susceptible to chickenpox. In newborn infants is extremely rare, but rely on reliable transplacental immunity is not necessary. Infection occurs by airborne droplets on contact with a sick child.
It is enough for a patient to stay for a short time in a hospital room or in a classroom, as all children who have not previously contracted chickenpox and are very susceptible to it, become infected and can not be prevented from doing so. The patient becomes infectious already on the last day of the incubation period of the disease. Infectious discharge from the nose of a sick child, the contents of the pharynx. When the bubbles dry up and the crusts form, the contagiosity ceases. After the transferred disease, there is a persistent immunity.
Symptoms:
The incubation period is 2-3 weeks. At the patient within the first 24 hours there is a special rash, the body temperature rises, a headache, a bad general state of health
Eruptions begin to appear on the face, scalp, trunk and for a few days the rash covers the whole body. The individual elements of the rash first look like a roseola the size of a pinhead, then turn red and become the size of a lentil, then quickly turn into transparent, watery bubbles that quickly cloud, swell, then burst and dry, covered with brown crusts. The latter after 1-2 weeks fall off, usually without leaving scars.
It is characteristic and very important for the diagnosis that the rash does not occur immediately, but undulating, for several days. On the skin all the time, there are fresh elements of the rash. On the other hand, only a part of the papular elements of the rash turns into vesicles. On the skin at the same time, all the stages of development of the rash are observed: roseola, transparent, watery vesicles, bubbles with cloudy contents, drying bubbles covered with crusts.
From the point of view of diagnostics it is important that the elements of the rash are found on the skin of the scalp and on the mucous membranes. Vesicles on the oral mucosa, vulva of the mucous conjunctiva often ulcerate, causing pain when swallowing, urination. Fortunately, the appearance of sores on the cornea of the eye is rare. The appearance of ulcers on the mucous membrane of the larynx, although rare, causes symptoms similar to croup (hoarseness of the voice barking cough).
The rash is accompanied by itching. Children scratch their skin, restless. They do not find their place. Small sores on the oral mucosa cause a lack of appetite. The temperature is usually not very high. Each new rash is accompanied by an increase in temperature. Fever and rash of vesicles, and the loss of crusts occur even for 2-3 weeks. The picture of blood is not characteristic, sometimes there is a moderate decrease in leukocytes.
There are very mild forms of the disease with a mildly expressed rash and mild symptoms of general malaise. Heavy forms, which especially often affect adults. Characterized by an abundant discharge of vesicles, completely covering the entire face, head, body, and high fever. In some cases, the contents of the bubbles become bloody. The severe course of chickenpox occurs in young children, weakened, depleted, and also in children receiving corticosteroid treatment. In these cases, the elements of the rash form deep sores, the size of a three-kopeck coin, which are easily infected and subjected to a gangrenous process. Quite often, due to itching and scratching, secondary infection occurs. A very rare complication is encephalitis. It manifests itself in two forms. The mild form of encephalitis, in which the cerebellum is mainly affected, is accompanied by ataxia, tremor; its course is benign, recovery without consequences. Diffuse encephalitis is much more severe.
Rare complications are bronchopneumonia and glomerulonephritis caused by secondary streptococcal infection.
Prevention:
Prevention requires sick children, weakened and debilitated, children of the first months of life, especially those whose mothers did not suffer from chicken pox. As a rule, a sick child should be isolated from brothers and sisters or children living with him in the same room. The disease is contagious until the crusts dry out, which, having dried up, fall away. Immediate registration of the disease is not required.
Treatment:
During the first week, while the patient has a fever, or rather when the rash occurs, the baby is assigned a bed rest. When itching, which causes anxiety, and for drying out the elements of a rash, talc powder is recommended. Nails should be cut short and clean. When purulent infection should take antibiotics. If varicella develops in patients undergoing steroid treatment, the dose of the latter should be reduced, but treatment can not be interrupted.
The prognosis of the disease is usually good. Lethal outcome can occur in weakened children, in children receiving treatment with steroid drugs, and in case of complication with encephalitis.