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, it is also known by the name "herpes zoster", 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 pathology.
general information
For the first time, doctors noticed the 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 herpes of this type. Modern experts know: pathology develops if a person is infected, and the activity of the immune system is reduced due to some factors. Only with a combination of these phenomena is a manifestation of the disease possible.
Herpes zoster in a child may appear if he received the virus from the carrier. Infection is possible by contact with older children or adults suffering from either this form of herpes or chickenpox. From statistical studies it is known that in children younger than ten years of age, signs of the disease are very rare.
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 the airborne droplet method, through contacts and through the household. The frequency of occurrence is higher in cold seasons. Cases are predominantly sporadic.
Most often, herpes zoster in a child occurs due to contact with the patient. First, primary infection is observed, after which the pathological form of life hiddenly continues to exist in the human body. The area of localization is the nerve ganglia. It is possible to identify particles in the spinal system, trigeminal or sacral nerve. Reactivation occurs endogenously.
Mechanisms and protection
The main factor that does not allow the pathological microscopic life form to reactivate is T-lymphocytes. The weakening of the protective function associated with these cells is possible with somatic severely current pathologies, oncological diseases, and HIV infection. Lymphocytes become weaker if a person is forced to take immunosuppressive medications. Similar processes are observed in those older than 55 years of age. If the deterrent weakens, the disease develops. Between the initial infection and re-activation, a rather long time period usually passes, but there are exceptions. Short pauses are characteristic of children suffering from chronic foci of infection, T-cell deficiency. There is a chance of congenital chickenpox.
If the herpes zoster in a child is reactivated, pathological life forms move axonally to the skin, affecting the cellular structures and multiplying in them. Activation is possible if the nerve endings become inflamed, the integrity and structure of the ganglia between the ribs or of the cranial nervous system is violated, if the posterior spinal roots are affected.
Diseases: Similarities and Differences
Doctors compared the features of herpes and chickenpox. In the first case, the most characteristic symptoms are due to the effect 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 the appropriate immunity. Shingles is the result of a 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, less often vomits. The affected skin attracts attention with itching, 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 diseased area, the zone swells. Papules, vesicles filled with a specific fluid gradually appear. Such formations can merge. After a week or a half, the filling dries, crusts appear. Their upper part may burst. This leads to the formation of erosion of a bright red color. The site is worried about soreness.
Symptoms of herpes zoster in children are usually one-sided. There is one area of skin lesion, beyond which the pathology does not go. Less often, several such sites are formed (up to three). There is a chance 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 soreness changes. Muscular paresis is possible. There are cases when the disease was accompanied by a violation of the health of internal systems: respiratory, cardiac, gastrointestinal tract.
Classic and not only
Herpes zoster in a child can form in the embodiment described above, but there is a likelihood of an atypical course. From medical observations, cases of a bullous rash of a hemorrhagic form are known. There is the likelihood of abortive, gangrenous types. There is a common lichen. The nuances of symptoms, especially skin lesions, a tendency to atypical course depend on the primary focus.
If the virus affects the trigeminal nerve, foci are visible on the conjunctiva. Many have stomatitis. There is a possibility of keratitis, iridocyclitis, neuritis of the elements responsible for ensuring the health of the visual system. The probability of the formation of 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%. Thoracic segments, as can be seen from the statistics, are rarely affected.
Locations and types
Interesting materials can be found in specialized medical guides that talk about herpes zoster in children. Photos in such publications quite clearly demonstrate the features of the development of the process. You can find out that viral brain damage can trigger 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 course also does not exceed one percent.
Possible localization of the virus in the lumbosacral area. Manifestations of this option are paresis of the lower extremities, impaired bladder emptying. Some have intestinal obstruction. The probability of an atypical course reaches 15%. You can learn from directories that tell and demonstrate the development of pathology with a photo: herpes zoster in children is sometimes formed during the invasion of the virus into the meninges. This option is associated with the danger of serous meningitis. The probability of this course reaches 80%.
What to expect?
Usually a period of regression of vivid manifestations takes a couple of weeks. In the presence of serious disorders of the immune system, manifestations are characterized by a longer 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 with the introduction of 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 is practiced adequately, appropriate for the case, there will probably be no consequences. Without the right therapeutic course, secondary neuralgia is likely. Such a pathological condition on average in 60% of patients with illness lasts at least a month after the complete disappearance of the rashes. About one in four reports secondary neuralgia for a quarter to half a year after the rash has disappeared. About 15% suffer from neuralgia for an even longer period. 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 (depriving) in children and adults does not allow to avoid a serious complication - myelitis or encephalitis. The likelihood of such a development of the situation reaches one case per thousand patients. This happens more often if herpes appears in a child younger than one year of age, as well as in the case of a common rash format.
Complications: what and how?
If treatment of herpes zoster in children has not allowed to avoid aggravation of the case, this can usually be noticed a week or two after the first skin rashes. The patient’s consciousness is impaired, convulsions are observed, the ability to empty the bladder, to control the urge to defecate is impaired. There are sensitivity problems and focal symptoms.
Approximately four out of a dozen patients who have experienced serious complications have isolated foci of impaired brain integrity, studies show serous meningitis. Cases of encephalitis, psychosis, paresis are known. The risk of death reaches 25%. Damage to the nerves of the skull is possible. From practice, there are cases when patients developed Guisna-Barre disease. There is a risk of myositis, a granulomatous cerebral vascular 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 danger of a progressive course with lymphogranulomatosis is higher. About 40% of patients with this disease suffer from a common form of herpes.
How to fight?
As can be seen from the clinical recommendations, herpes zoster in children should be treated as soon 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. It is necessary to treat the patient from the very beginning of the formation of rash foci, during the entire period of formation of new and at least two more days after the appearance of the final zone.
The classic approach involves the use of Acyclovir. For infants younger than one year of age, 30 mg / kg is indicated. The daily dose is divided into three servings. If necessary, give the patient medication intravenously shown 1.5 g / ml, also divided into three injections. In case of relapse, the earliest possible use of such a pharmaceutical product can reduce the duration of an acute episode. The patient's pain disappears earlier, crusts form faster, and the risk of complications is reduced. The use of “Acyclovir” from the very beginning of exacerbation reduces the likelihood of dissemination of pathology.
The 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 difficult. In this embodiment, the agent is indicated in an oral form 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 drugs containing ribamrin into the vein. Continuous 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 administration of 0.2 ml / kg. If the pathology is severe, it is allowed to increase the volume several times (no more than four).
What else?
Antiviral medications 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 on the affected areas. Topical formulations containing acyclovir, interferon should be used. To ease the pain, the doctor will prescribe analgesics. Non-hormonal anti-inflammatory will come to the rescue. Sometimes the patient is recommended a course of tranquilizers. To accelerate the recovery process, diseased skin is treated with ultraviolet radiation. Of the additional treatment methods, novocaine blockade and electrophoresis are best recommended.
When choosing a program that helps a child recover, elders caring for a child should remember the infectiousness of this disease. In order to minimize risks for yourself, as well as to minimize the danger of the baby becoming infected by 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
Herpes zoster is a disease initiated by the third type of herpes viruses. The causative agent, having penetrated the human body, remains there for life. It is not possible to get rid of it. The risk of getting sick if a person has undergone an organ transplant surgery is increased. There are cases when a child's shingles were disguised as SARS, differing only in the manifestation of skin rashes. To detect the DNA of the virus, it is necessary to take blood samples for testing by PCR. If specific antibodies are detected in the laboratory, the diagnosis is considered confirmed.