Despite the fact that chicken pox is considered to be an exclusively childhood disease, chickenpox in adults is a rare but possible phenomenon. The disease belongs to the category of infections, which is better to be ill in childhood, since, in adulthood, chickenpox acquires an acute and severe course and can cause dangerous health consequences.
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Chickenpox in adults: causes
People call chickenpox chickenpox - a viral infection in which the whole body of the patient is covered with a rash that causes severe itching, fever and intoxication. In this case, the rash cannot be combed - damage to the germ layer of the epidermis remains for life in the form of atrophic scars.
The main cause of infection is the defeat of herpesvirus of the third type of varicella-zoster. This virus is considered the causative agent of two types of pathologies - chickenpox and shingles.
The causative agent of chickenpox is clearly visible in a light microscope - the virus looks like a DNA molecule surrounded by a protective lipid membrane.
A characteristic feature of the virus is its volatility. Infectious particles really have the ability to move with air currents and can penetrate not only into other rooms, but also into apartments through ventilation openings. Therefore, the disease was called chickenpox.
An equally important etiological factor is susceptibility to chickenpox. The level of the body's ability to deal with infection is 100% and is considered unique.
Outside the human body, the virus cannot exist for long - 15 minutes after the varicella-zoster enters the environment, it dies from drying out and changes in the temperature regime.
Ways and sources of infection
The primary source of infection can only be an infected person. In most cases, varicella-zoster enters the body of other people through the respiratory tract. But another way of infection is also possible - through the bloodstream from the pregnant woman to the embryo.
Airborne infection occurs as follows. Upon contact with an infected person, the particles of the virus, together with air, penetrate the respiratory tract, invade the mucous membrane and then penetrate the blood.
Having reached the epithelial layers with blood flow, the virus is fixed in the skin, as evidenced by the appearance of a rash. As the virus multiplies, the remaining signs of an infectious lesion also appear.
Chicken pox infection is not transmitted through objects or animals. Moreover, animals do not get chickenpox at all.
Despite the fact that people who have undergone the disease develop stable immunity, under certain conditions the varicella-zoster virus can remain viable for a long time and appear in the form of shingles over the years.
Pathogenesis of infection
The characteristics of the clinical manifestations and the course of chickenpox are determined by the level of infection.
Doctors distinguish several such periods:
- hatching - from the moment of infection to the appearance of external signs of its activity, due to the multiplication of the virus;
- premonitory - an intermediate stage of transition to the active phase of the disease;
- rash - the formation of a rash on the surface of the skin, as a result of the penetration and localization of the virus in the epidermis;
- crusting - drying of the vesicles, the formation of anti-wind antibodies, recovery.
Repeated cases of varicella with smallpox are possible provided that the body's immune forces are significantly reduced.
Incubation period
After the virus enters the body and before the first symptoms appear, an average of 14 days elapse. In patients under the age of 30 years and with a strong immune system, the incubation period can last 21 days.
When viral molecules reach the surface of the nasopharyngeal mucosa, the chickenpox pathogen begins to proliferate. As the number of pathogens increases, the degree of suppression of the immune system increases, while the activity of T-lymphocytes that destroy foreign proteins decreases.
The incubation period of chickenpox ends after the viral agents enter the bloodstream.
How many days does chickenpox last?
After the incubation period, prodromal occurs and lasts two days. Due to the release of viral agents into the blood, the body is contaminated by their metabolic products, intoxication occurs.
In adults, prodromal conditions differ in the severity of symptoms, while in children signs of prodromal processes may be absent.
As the disease progresses, the varicella-zoster affects the spinal nerves. Having penetrated the nuclei of the nerves of the spinal cord, herpesvirus remains there forever, although special immune proteins block the possibility of its activation.
The defeat of the varicella-zoster virus of the epidermal cells is manifested by the appearance of vacuoles - vesicles formed by intracellular elements. Gradually vacuoles merge and papules filled with fluid appear.
Sometimes papules are transformed into purulent pustules, since the fluid that fills them consists of viral particles and protein molecules and attracts a huge number of bacteria as a nutrient medium.
The rash period takes up to ten days.It takes at least two weeks to completely cleanse the skin from the effects of a rash.
Symptoms and signs of the disease
Common manifestations of chickenpox in children and adults are similar. But since the body of an adult is able to give a powerful immune response, the symptoms and signs of chickenpox are very intense expression.
The onset of chickenpox is manifested by an acute deterioration in well-being.
Observed:
- nausea, vomiting, headaches, drowsiness, general weakness and aches in the lumbar region are signs of intoxication of the nervous system by the products of the virus’s vital activity;
- a sharp increase in temperature precedes every wave of rash. In adults, chickenpox is accompanied by an extremely high level of temperature - up to 40 ° C for two to three days. Longer preservation of high temperature is regarded as a sign of complications;
- the appearance of a rash within two days after a fever. At first, small pimples occur on the stomach, hips, chest, and shoulders. Then the rashes spread to the face and skin under the hair;
- severe itching is a sign of irritation of the nerve endings of epithelial cells. It occurs as a result of the appearance of red spots preceding the rash;
- gradual damage by a rash of mucous membranes of the oral cavity and genitals. In the presence of complications, rashes can affect the mucous membrane of internal organs;
- enlargement and soreness of lymph nodes located behind the ears and on the neck.
During the incubation period of the chickenpox virus, there are no symptoms. Patients become contagious to others one day before the rash appears and remain so for about five days from the moment of the last rashes.
What does chickenpox look like?
The type of chickenpox rashes is constantly changing, in accordance with the phase of infection. The pathological process goes through several stages.
Damage to the skin with chickenpox virus is accompanied by the appearance of characteristic red spots associated with the expansion of capillaries. The spots have a rounded shape and can be from 3 mm to 1 cm in size.
Two to three hours after the appearance of spots, in the places of their localization papules are formed - serous, leafless nodules.
During the pathological process, exfoliation of the epidermis occurs and after 12-20 hours vesicles are formed from the papules - hemispherical vesicles with a pink rim filled with organic fluid.
As they mature, the vesicles burst and a crust forms in their place. From this point on, the rash element stops its development and ceases to be contagious. The itching stops.
From the day the red spots appear until the crust forms, usually five to seven days pass. In the same period, new rashes form every two days. Their number depends on the complexity of the form of the disease.
Mucosal rash
Mucosal cells also affect the process of rash formation. Rashes occur on the gums, palate, and genital mucosa in women. The formation of red spots is replaced by papules, then vesicles, from which itchy and painful sores with a yellowish-gray base and a red rim are formed.
Rashes on the mucosa heal within two days. The size of the rashes is less than on the skin and does not exceed 5 mm.
Can an adult get sick again?
Reactivation of varicella-zoster virus and chickenpox disease is possible only against the background of a significant decrease in the body's defenses.
Is it possible:
- in the presence of HIV infection;
- after organ transplantation;
- due to acclimatization or severe stress;
- after a course of chemotherapy;
- after taking corticosteroids, antibiotics, or immunosuppressants.
Due to the ability of the virus to mutate, re-infection from an external source is also possible. This happens if in the body of a person who had previously had chickenpox, insufficient antibodies against the virus have formed.
In this case, varicella-zoster is no longer manifested in the form of a chickenpox rash, but as another independent disease - shingles, in which the rashes take the form of stripes.
Most often, the re-development of infection occurs in people after 40 years.
Diagnostic measures
Diagnosis of chickenpox is possible already at the initial examination of the patient by a doctor. A characteristic rash and a general deterioration in well-being do not raise doubts about the accuracy of the diagnostic findings, especially if the patient has contacts with infected people.
As additional measures necessary to determine the severity of the disease and the presence of complications, laboratory diagnostic methods are used:
- general blood analysis. An increase in the number of leukocytes indicates a response of the immune system. An increase in ESR is the result of inflammatory processes;
- general urine analysis - protein detection is regarded as a sign of kidney damage;
- serology - determination in the blood of antibodies to chickenpox virus. It is carried out twice - an increase in the number of immunoglobulins M and G several times with a second study confirms the diagnosis.
In addition, laboratory methods can differentiate chickenpox from rubella, herpes zoster, Coxsackie virus.
Adult chickenpox treatment
Depending on the complexity of the course of the infection, treatment of chickenpox in adults can take place at home or in a hospital. Hospitalization is necessary if the disease is accompanied by the development of complications or if the patient needs isolation.
At home, medication and hygiene are indicated.
Drug therapy
One of the main methods of treating chickenpox, which has already become classic, is the antiseptic treatment of a rash with a solution of diamond green.
Among other means are drugs that eliminate the symptoms of chickenpox and have a supporting effect on the body:
- antiviral - inhibit the vital activity of the varicella-zoster virus, preventing its reproduction. Famciclovir tablets are taken orally. Valacyclovir or Acyclovir with chickenpox can be taken orally or administered intravenously;
- antihistamines - reduce the level of allergies and vascular permeability. Reduce itching, soothe, have sleeping pills. The most effective are the tablets Tavegil and Suprastin;
- antipyretic - are necessary to normalize the temperature and eliminate inflammatory processes. Among the best are Panadol and Ibuprofen tablets;
- antibiotic - inhibit the viability of bacteria, in the presence of purulent formations in pustules, prevent the appearance of atrophic scars. Drugs of choice - intravenous administration of Oxacillin or Cefazolin;
- detoxification solutions - reduce the concentration of viral toxins in the blood, provide their withdrawal, contribute to the intensity of blood flow. Intravenous administration of a glucose or Reopoliglukin solution is recommended.
The use of any medications should be carried out only as prescribed by the doctor and under his supervision.
Folk remedies
Traditional medicine methods do not provide effects on the causative agent of the infection, but they can accelerate the removal of toxins and maintain the body in good shape.
For internal use, infusions are prepared from herbal preparations - linden blossom, pharmacy chamomile, string, willow bark, calendula, raspberry. The rule of preparing the infusion is to fill in two tablespoons of the collection with 500 ml of boiling water. Insist no less than half an hour. Take two or three large sips several times a day.
For external use, baths using a decoction of vegetable fees or oats are suitable.
Hygiene rules
Compliance with a special hygiene regime is important to reduce the risk of complications:
- bed rest.It is necessary to improve blood circulation and reduce stress on the heart muscle;
- avoid overheating, since sweat secretes the skin and increases the feeling of itching, which can cause ulcers;
- drink a large amount of liquid to accelerate the removal of toxins. The norm per day is 2.5 liters;
- monitor clean hands, trim nails;
- bathing, add soda to the water;
- rinsing the mouth after each meal - to disinfect and relieve inflammation on the mucous membrane. Effective solutions of furatsilin, soda, as well as herbal decoctions - chamomile, oak bark, calendula;
- treat the rash on the genitals with a weak solution of potassium permanganate.
The implementation of all therapeutic measures helps to improve well-being, accelerates the process of restoration of health and prevents the attachment of bacterial infections.
Chickenpox during pregnancy
The defeat of varicella-zoster is a threat to the development of the fetus. Infection with chickenpox in early pregnancy can provoke spontaneous miscarriage or abnormal development of the child - atrophy of the cerebral cortex, dysplasia of the extremities, cataracts, mental retardation.
However, the diagnosis of chickenpox in pregnant women is not considered a good reason for its interruption. The total percentage of development of defects in the fetus for a period of up to 20 weeks is 2%.
Chickenpox infection in the period after the 20th week of pregnancy and up to the week preceding the birth is not dangerous for the child.
The risk to the health of the fetus increases with infection of the mother in the last week of pregnancy and the first five days after birth. To prevent infection of the newborn, doctors, if possible, provide a delay of delivery for a week. In extreme cases, the mother and the child immediately after birth are given immunoglobulin.
Congenital chickenpox is accompanied by damage to the internal organs of the child and poses a serious danger to his life.
For women planning a pregnancy, doctors prescribe an analysis to determine the antibodies to chickenpox in order to exclude the possibility of infection during the gestation of the child.
Possible complications and consequences
The course of chickenpox in adults is characterized by a severe nature and the development of complications. On average, the consequences of infection are diagnosed in 30% of adult patients who have had severe forms of chickenpox - hemorrhagic, bullous, or gangrenous.
Among the most dangerous conditions caused by damage to the varicella-zoster virus:
- pneumonia. Damage to lung tissue is accompanied by the formation of infiltrates, fever, cough;
- dysfunction of the nervous system, the development of encephalitis. Patients have a loss of balance, confusion, trembling limbs, seizures of epilepsy. Mental abnormalities are possible;
- damage to streptococci and staphylococci causes bacterial superinfection of the epidermis with the formation of a large number of boils and abscesses. Treatment is carried out only surgically;
- damage to cells of internal organs - liver, heart or pancreas. Lethal outcome possible;
- development of hepatitis. It occurs in patients with immunodeficiency;
- damage to the eyeball and optic nerve. May cause partial or complete loss of vision.
In 80% of adult patients, chickenpox passes in moderate form, which is characterized by high fever, vomiting, heavy rashes and severe itching.
Chickenpox vaccine for adults
Vaccination and vaccinations are an effective way to prevent varicella-zoster virus infection in patients who have not previously had chickenpox. The use of a live vaccine or specific immunoglobulin provides persistent resistance to immunity for life.
In addition, an adult chickenpox vaccine is indicated if the patient:
- prepares for an organ transplant;
- sick with leukemia, hemarrhagic diseases or pathologies of a chronic nature - renal failure, bronchial asthma, collagenosis, autoimmune disorders;
- undergoing glucocorticosteroid treatment;
- suffers from malignant tumors.
Mandatory vaccinations for chickenpox are given to the medical staff of the infectious diseases departments, military personnel, and employees of preschool institutions.
Disease prevention
Measures to prevent adult chickenpox infections are carried out in several areas:
- vaccination of patients prone to severe infection;
- isolation of an infected person;
- emergency administration of an immune solution or live vaccine to patients in contact with an infected person, provided that no more than three days have passed from the moment of contact.
Patients who have had chickenpox are advised to diversify their diet to strengthen the body and the immune system, as well as compliance with the drinking regime and the intake of vitamin complexes.
