Chickenpox quarantine in kindergarten: rules of conduct

Chickenpox in adults - incubation period, first signs and main symptoms (photo)

Chicken pox or “chickenpox” is an acute viral disease that is transmitted by airborne droplets and has pronounced external manifestations. This disease is suffered only once, usually in childhood, however, many avoid this fate.

Even though this fact seems pleasant, you will most likely still get chickenpox. And it is worth saying that in adulthood this disease is more difficult to bear and brings more inconvenience both because of its appearance and because you have to get sick at home, since the disease is contagious.

All these factors knock an adult out of his usual working rhythm for some time, which is undoubtedly very unpleasant.

How can you get infected?

Chickenpox is caused by infection with the Varicella Zoster virus (HSV-3, or herpes simplex virus type 3). During the incubation period, which lasts 2 weeks, an adult may not experience chickenpox symptoms.

Doctors have noticed that the older the patient, the more time passes before pronounced signs of pathology appear. For example, the body temperature of an infected person may rise after 3 weeks of contact with a carrier of the virus.

How is the chickenpox virus Varicella Zoster transmitted? Doctors identify three routes of transmission:

1. Airborne (through saliva, during sneezing).
2. Tactile (close communication, kissing).
3. Close contact with a person with herpes zoster.

The pathogen enters a healthy body through the epithelial tissues of the respiratory tract, then moves to regional lymph nodes. The virus enters the bloodstream along with lymph and causes intoxication syndrome. Externally, the disease manifests itself on the skin and mucous membranes in the form of blistering rashes.

Re-infection with chickenpox is possible with HIV, after chemotherapy and organ transplantation. The state of the immune system in such patients is unsatisfactory, which is why relapses of many diseases occur.

A little about chickenpox

Chickenpox (varicella) is a viral disease transmitted from a sick person by airborne droplets. It has distinctive features, which greatly facilitates diagnosis. Chickenpox is characterized by the appearance of skin rashes that go through several stages in their development, after which the disease gradually subsides.

Chickenpox is predominantly a childhood disease, since 90% of those who have been ill are children under 14 years of age. But adults can also get chickenpox if they avoided it in childhood.

Properties of the chickenpox virus

Varicella Zoster is a virus that, when it enters the human body, provokes the development of chickenpox. It belongs to the group of herpes viruses, due to which it has a certain property. This pathogen no longer leaves the body into which it entered, being located in the nerve ganglia. Moreover, he may not remind of himself for a long time. But if this virus is reactivated (with decreased immunity, stress and exhaustion), then it causes another disease - shingles.

The virus cannot exist in our environment, so it dies quickly. But it is known that you can become infected with it due to its spread.

When a person suffers chickenpox, a strong immunity is formed in his body, which lasts for life. This is why it is very unlikely that you will get chickenpox again.

Chickenpox incubation period in adults

This period of time is characterized by the absence of any symptoms and lasts from the moment of infection until the first signs of intoxication appear.

The classic development of the clinical picture suggests that the incubation period lasts approximately 2 weeks, however, the older a person becomes, the longer it takes from infection to the first symptoms. In an adult, it is considered normal if the temperature rises three weeks after contact with an infected person.

Symptoms and first signs

According to statistics, in adults over 18 years of age, the severity of the disease and the frequency of complications after chickenpox are the same as in a 20-year-old person as in a 50-year-old person. However, in the older population, due to possible immunity disorders and existing chronic diseases, a greater number of cases of complications of this disease are recorded.

What are the symptoms and first signs of chickenpox in adults? Chickenpox begins (see photo) like a cold, flu, with general intoxication:

1. Pain in muscles, joints
2. A slight increase in temperature to subfebrile levels of 37.3-37.5C
3. General weakness
4. Headache

As soon as pink spots appear on the scalp and face, the period of rashes begins:

1. Signs of intoxication of the body increase, high temperature up to 40C, chills, weakness, etc.
2. A profuse rash throughout the body creates severe itching of the skin, even on the mucous membranes of the upper respiratory tract and in the mouth enanthems form. People after 20 years old always develop rashes on the genitals, which is accompanied by severe pain when urinating. First a spot appears, then a bubble with liquid and a depressed center. If the crust is burned with alcohol dye or torn off, a scar will remain. The bubbles then burst, releasing liquid and subsequently forming a dried crust, which, with regular processing, leaves no trace in the future. When a secondary infection penetrates the wound, the course of the disease becomes more complicated, weeping pustules appear, which after healing leave scars on the body.
3. The patient's lymph nodes are enlarged - behind the ear, inguinal, submandibular and axillary, they become painful on palpation.
4. An undulating course of rashes that lasts about 10 days.
5. If the patient has a very weakened immune system, the rash can provoke the development of fasciitis, abscesses and even sepsis.

Sometimes in adults, chickenpox begins with signs of cerebral edema, nervous system disorders, and also as primary chickenpox pneumonia or encephalitis, with the following symptoms added:

1. Nausea, vomiting
2. Irritation from sharp sounds and bright lights - sound sensitivity, photophobia
3. Coordination of movement, convulsions, and general muscle weakness are impaired.

Possible complications

Fortunately, most children recover well from chickenpox. However, in some categories of patients the disease may have unfavorable outcomes, such as:

1. Hepatitis;
2. Pathology of the structures of the eyeball (keratitis);
3. Encephalitis. This pathology is manifested by severe damage to the central nervous system, manifested by seizures. This is due to the high tropism of the virus to nervous tissue. In most cases, this complication is detected in patients on days 7-12 of the disease. A persistent disorder of higher nervous activity in the form of idiocy occurs relatively rarely;
4. Pustular skin lesions: phlegmon, abscesses or boils. They are the result of penetration of pathological microorganisms into the liquid inside the vesicle, which, upon contact with neutrophils, can form pus;
5. Pneumonia. Most often diagnosed in adults. A feature of chickenpox pneumonia is the extreme paucity of clinical symptoms. The diagnosis can only be made by x-ray, and the image reveals small inflammatory foci throughout almost the entire length of the lung tissue;
6. Myocarditis is inflammation of the heart muscle. It is manifested by dullness of heart sounds, pain in the heart area, as well as changes in the cardiogram;
7. Nephritis is an inflammatory kidney disease that most often occurs on the 10th-12th day of illness. In most cases, this pathology goes away on its own and does not require any specific therapy.

However, chickenpox can still serve as a reason for the appearance of another disease, not as a complication. As you already know, chickenpox is a type of herpes virus, therefore the virus remaining in the body is inactive and occurs in a latent state. However, as a result of repeated exposure to the chickenpox virus and a number of associated factors, it can lead to the occurrence of a disease such as herpes zoster.

Forms and stages of the disease

The disease occurs with or without obvious symptoms. Dermatologists identify several characteristic forms of chickenpox:

The hidden or atypical form has several varieties. All of them are dangerous with serious complications:

Sanitary standards for chickenpox

According to SP 3.1.3525-18, to prevent the spread of chickenpox in groups, anti-epidemic and quarantine measures are carried out.

Quarantine is a set of restriction measures aimed at preventing contact between infected people and healthy people.

Sanitary standards require:

• rapid timely notification of sanitary services about a case of disease;
• isolation of sick people;
• carrying out disinfection measures at the source of the disease;
• identification and medical surveillance of contact persons;
• prevention of infection.

Chickenpox during pregnancy

If a woman does not have immunity to the chickenpox pathogen at the time of conscious planning of pregnancy, she will be recommended to undergo appropriate vaccination. Infection during pregnancy is dangerous for the fetus until about 20 weeks. At this stage, the virus causes intrauterine death of the fetus, which ends in miscarriage or stillbirth. It is also possible to develop severe defects that lead to disability of the born child.

At later stages, the effect of the virus on the body of both mother and fetus weakens, reaching a second peak immediately before childbirth. Infection with chickenpox in the later stages is fraught with the development of pneumonia, which can also lead to the death of the child. In such cases, special therapy with immunoglobulins and specific antibodies is carried out.

Lack of immunity to chickenpox in general is not an indication for termination of pregnancy.

SanPin standards do not require mandatory vaccination.

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How to treat chickenpox in an adult?

Comprehensive treatment of chickenpox in adults includes antiviral therapy and symptomatic measures; in complex cases, placement in an infectious diseases hospital is indicated. To avoid negative consequences, you must strictly follow medical recommendations on how to treat chickenpox in adults at home:

1. Limit any types of loads. High fever and the appearance of neurological symptoms necessarily require bed rest.
2. Isolate the patient for the entire “infectious” period, since susceptibility to chickenpox in people without specific immunity is 100%.
3. Follow a low-carbohydrate diet with normal protein content: unsweetened dairy products, vegetables, fruits.
4. Keep skin clean. It is recommended to take a daily shower at a comfortable temperature, without a washcloth, steaming or rubbing. Gently dry the wet body with a soft towel so as not to damage the crusts.
5. Increase fluid intake, priority is berry fruit drinks.
6. Carry out antiviral therapy. The drugs Acyclovir, Virolex, Panciclovir and others block the reproduction of the virus, stop the growth of rashes, and prevent the generalization of infection and complications.
7. Reduce the temperature if it rises to 38 degrees. Paracetamol and ibuprofen can be used as an antipyretic. Taking aspirin for chickenpox is strictly prohibited!
8. Treat rashes with alcohol- and water-based antiseptics to relieve itching and drying. Apply the solution, gel, ointment after bathing pointwise, 1 – 2 times a day.
9. Take antihistamines (Suprastin, Diazolin, Tavegil). They reduce the itching of chickenpox in adults and promote faster drying of the elements.
10. Include antibiotic ointments in treatment if a bacterial infection is identified.
11. If papules appear in the oral cavity or on the genitals, rinse with antiseptic solutions (furacilin, weak potassium permanganate, boric acid).
12. Place a person in a hospital for any manifestations of severe or atypical chickenpox.

How long chickenpox lasts in adults depends on the severity of the condition and the intensity of the rash. In mild cases, about 2 weeks pass from infection to complete recovery, in more complex cases it takes a month or more: up to 21 days – latent period, up to 10 days – wave-like addition, up to 20 days – cleansing of the skin.

Causes and features of pathogen transmission

The disease spreads quickly and easily indoors, since the causative agent, the herpes virus, can be transmitted through coughing, sneezing, i.e. by air. A greater number of chickenpox cases occur in preschool children. Children staying in the same group room of a kindergarten get sick faster, although the virus is able to penetrate with air flow into neighboring rooms. Less commonly, the pathogen is transmitted through toys or third parties, since it is unstable in the external environment.

The peak of the disease occurs in spring/autumn, together with the peak of colds. The pathogen is transmitted by the bloodstream to the epithelial layers of the skin, where it begins to actively multiply. There are subjective signs of the onset of the disease: irritability, tearfulness of the child, the appearance of a common rash similar to hives. Due to the mobility of the virus in the blood, internal organs may be affected. The mucous membrane is an excellent “soil” for the virus; as a result, small hemorrhages form at the site of the papules. Immunity after the disease is stable (except for early infection by the virus).

Adults who did not have chickenpox as children may not get sick at all if they have a strong immune system. But when infected, adults become seriously ill, with a high rise in body temperature, and subsequently scars and visible dents form in place of the papules.

Features of the pathogen:

• papular fluid contains DNA;
• the virus is deactivated at a temperature of 45 to 50 degrees. It is enough to soak the patient’s clothes in hot water for half an hour to destroy the virus. Disinfectants should not be used when processing children's clothing; they can cause increased itching and rashes;
• the virus is not destroyed by freezing; after defrosting, the pathogen is still active. But it does not tolerate sunlight well, so when disinfecting a room, you can use ultraviolet lamps;
• the pathogen can be transmitted through the placenta from a sick pregnant woman to the fetus, as a result of which there may be damage to the fetus that does not threaten its life;
• in exceptional cases, chickenpox is contracted twice, if the first time occurred before the age of one year, when the child’s own immunity is not yet “working.”

Symptoms of the disease

On average, up to two weeks after the virus enters the body, the child feels normal. Then the body temperature rises sharply and quickly, and at the same time rashes appear on the head under the hair, cheeks, near the lips, and on the mucous membranes of the mouth. Due to the rash, the child becomes restless, the unpleasant tingling sensations in the papules a little later turn into severe itching, and the baby’s condition worsens.

Development of chickenpox

Initially, only a rash is visible on the skin, similar in appearance to miliaria. Then characteristic small spots become visible, in place of which bubbles with transparent contents - vesicles - form. There is always a small border around the bubble - a hyperemic halo. After a few hours, the liquid in the bubble becomes cloudy, and even later the bubble bursts and the liquid begins to flow out of it. If the vesicle is not touched, then after two or three days it begins to dry out. A dense crust forms from the center to the edges of the bubble, and after the crust has completely dried, the skin remains pink, but without scars, smooth to the touch. If a child actively scratches the rash, indentations may form, as after a BCG vaccination.

The bubbles do not appear all at once, but several days apart, so quarantine for chickenpox lasts up to three weeks. During this time, rashes in different stages of development may be visible on the skin - from spots to crusts. To treat chickenpox, doctors still recommend using a solution of brilliant green, which disinfects and dries watery blisters. Yes, it is ugly, the child will walk around with spots, but it is effective in preventing suppuration from scratching and the rapid healing of wounds.

If the course of the disease is severe, with a large amount of rash, the child is prescribed medications that lower the temperature and antihistamines. Acyclovir is effective only if used in a timely manner; if the disease is protracted, it should not be used. Sometimes doctors prescribe immunostimulants, for example, cycloferon liniment - it successfully replaces brilliant green. The drug facilitates the course of the disease and prevents the development of purulent infection when the blisters are scratched.

Folk remedies

Treatment with folk remedies is not officially recognized by medicine, but has the right to exist.

1. Immunity can be supported with a tincture of chamomile flowers, calendula, basil leaves and lemon balm. For the same purpose, you can use a mixture of lemon juice and honey, which should be taken three times a day, 1 tsp.
2. To reduce pain and itching on the skin, use a soda solution (1 glass of warm water, 1 teaspoon of soda), which is used to dip the affected areas.
3. Baths with chamomile or calendula, celandine remove the manifestations of chickenpox.
4. At elevated temperatures and if you have a headache, viburnum drink, sea buckthorn tea, rosehip infusion and cranberry juice help well.
5. At home, you can brew chopped parsley leaves and drink 1-4 glasses several times a day.
6. Those who do not tolerate the acute period of intoxication well can try fresh celery juice.
7. Skin itching and pain disappear perfectly under the influence of tea tree oil, applied directly to the elements of the rash.
8. Blueberries have an excellent antiviral effect in any form.

Traditional methods do not replace qualified medical care and taking medications prescribed by a doctor.

Prevention

Usually people get chickenpox in early childhood, since the pathogen is extremely easily transmitted from person to person. However, some people reach adulthood without having immunity to the Varicella Zoster virus.

To avoid getting sick, it is recommended to undergo a special vaccination, after which lifelong immunity will be developed, as if the patient had chickenpox. You can get vaccinated even if you had contact with a sick person and no more than 72 hours have passed since that contact.

Is it worth getting vaccinated?

Doctors began vaccinating children against chickenpox relatively recently. The composition of the vaccine is represented by live but weakened pathogens. The first vaccination is usually given at 12–14 months. The chickenpox vaccine is re-administered after 3 to 5 years. Adolescents and adults who do not have natural immunity are vaccinated twice, with an interval of 1 month or more between injections.

Young children tolerate chickenpox vaccinations well, and pediatricians do not record any adverse reactions. However, if the child is part of a group of frequently ill children, it is necessary to consult with the local pediatrician about the advisability of vaccination. A weakened body may react to vaccination with unpredictable phenomena.

Chickenpox vaccine for adults

The chickenpox vaccine is not included in the mandatory vaccination schedule and is used only at the request of the person. Vaccination against chickenpox among adults can be used at any time, especially if the person has not previously suffered from this pathology in an active clinical form. In most situations, persons whose work involves daily contact with children are interested in vaccination against chickenpox, since chickenpox is a fairly common infectious pathology among organized children's groups.

Currently, vaccines such as Okavax and Varilrix, which exhibit identical effectiveness, are used to vaccinate against chickenpox in adults.

1. Vaccination using the Varilrix vaccine is used in most situations as an emergency preventive measure, and its effectiveness directly depends on the time of use. Thus, in a situation where more than 72 hours have passed since a healthy person came into contact with a chickenpox-infected patient, vaccination is considered irrational. Vaccination against chickenpox using the Varilrix vaccine should be carried out twice at intervals of three months. Among the contraindications to the use of the Varilrix vaccine, it should be noted that the patient has signs of immunodeficiency or any acute infectious pathology.
2. The Okavax vaccine is a live chickenpox vaccine and is approved for use in both children and adults. Vaccination using Okavax is a subcutaneous injection of one dose of the drug in the projection of the outer surface of the shoulder. In most situations, vaccination against chickenpox in adults proceeds without complications, however, in some situations, the patient may experience a short-term local reaction in the form of slight swelling, thickening or hyperemia in the projection of the direct injection. An absolute contraindication for vaccination against chickenpox using a live vaccine is any trimester of pregnancy and severe somatic pathology accompanied by immunodeficiency.

In a situation where vaccination against is carried out routinely in relation to a woman of reproductive age, it should be carried out no later than three months before the expected pregnancy. Active synthesis of specific antibodies against the chickenpox virus in adults, which is observed after vaccination with a live vaccine, may be accompanied by the appearance of a low-intensity rash on the skin, the pathomorphological elements of which are similar to those of chickenpox. This condition is considered by infectious disease specialists as reactive and does not require drug correction. The effectiveness of chickenpox vaccination has a limited duration of thirty years.

Answers to common questions

Is there a way to prevent chickenpox?

The preventive measure – not to contact people who are sick – is not always effective. The fact is that infection can occur even before the first manifestations of the disease are detected in the patient. That is, he can communicate with friends without knowing that he is contagious.

It is possible to prevent the onset of the disease by vaccination with special live vaccines, which are based on a weakened chickenpox virus.

Which specialist should I contact for treatment?

Chickenpox in children is treated by a pediatrician or pediatric infectious disease specialist. If an adult gets sick, you should call a therapist or an adult infectious disease specialist immediately after detecting the first symptoms of chickenpox.

Is it possible to swim if you have chickenpox?

Due to the fact that the quality of tap water in most cities leaves much to be desired, in case of this disease you should take a shower (not a bath) using boiled or filtered water. Otherwise, there may be a risk of a bacterial infection joining the viral form, which, in turn, can cause serious complications. It is better to wash with warm water. It is strictly forbidden to use a washcloth, rub the skin or steam it.

What to do if scars appear after chickenpox?

There are various options to solve this problem:

1. Ointments and gels for the treatment of scars. A small amount of gel is rubbed into the scar 2-3 times a day. For old scars, apply the gel under the bandage at night. The course of treatment can take from 1 month to a year. For treatment the following are used: Contractubex; Aldara; Dermatix; Kelofibrase; Skarguard.
2. Chemical peeling using phenol. Under the influence of aggressive chemicals, the keratinized layer of the epidermis and dermis is removed. After the epidermis is restored (takes up to 2 weeks), the skin becomes smooth.
3. Injection of collagen under the skin. The substance fills the skin defect and stimulates the formation of connective fibers.
4. Microdermabrasion is the mechanical polishing of the skin with particles of a solid substance (diamond). As a result of microtraumas, collagen production is activated. The procedure allows you to even out the skin texture and make scars less noticeable.
5. Laser skin resurfacing. A focused laser beam penetrates the superficial layers of the dermis and heats them, evaporating the water. After the regeneration of skin cells, its surface is leveled. Caution: Carbon dioxide laser treatment may cause the appearance of a hypertrophic keloid scar that rises above the skin. Therefore, an erbium or carbon dioxide laser is used.

Before use, you should consult a specialist.