Recently, a baby girl was admitted to the Department of Pediatrics of Taichung Tzu Chi Hospital. Four days after the onset, she went to the emergency department. In addition to repeated high fever, she was covered with chicken pox rash, which caused bacterial infection due to itching. The doctor further investigated the contact history and found that her father had suffered from "skin snake" before the onset of the baby girl, and the baby girl could be vaccinated with varicella vaccine for several days, so it was inferred that the unprotected baby girl was infected with her father's herpes zoster virus. The mother of the baby girl is a new resident from Vietnam. She had never been vaccinated against chickenpox, so she contracted chickenpox while taking care of her baby girl. A family of three is hospitalized at the same time.
Herpes zoster and chickenpox, commonly known as "skin snakes", seem to be two different diseases, but they are both caused by herpes zoster virus. The first infection in childhood is called chickenpox. However, the virus will not disappear because of the remission and recovery of chickenpox, but lurks in the dorsal root ganglion for years or even decades, and is inhibited by human cellular immunity. When the immunity declines due to aging, physical weakness, fatigue, emotional stress or receiving immunosuppressive treatment, the latent herpes zoster virus will be reactivated and spread from the ganglion to the nerve endings, resulting in erythema zoster, blisters and neuropathic pain and numbness in these innervated skin areas, which is miserable. Because it is strip-shaped, it looks like being entangled by a snake, so it is called "skin snake".
Therefore, families with pregnant women and babies should never ignore the power of herpes zoster virus!
Further reading: check! Practice for vaccination during pregnancy
Chickenpox is a highly contagious disease, "chickenpox", which usually occurs in children under 9 years old. This is a highly contagious disease caused by varicella-zoster virus [VZV] (VZV), just like measles. If you have never been infected, it is easy to get infected. And chickenpox is one of the few diseases that can be transmitted by air. Because it can be spread through the air, it is highly contagious. Direct contact through the skin can also be contagious. For example, an adult holding a baby with chicken pox may be infected, which is really difficult to prevent.
The initial fever was followed by a rash. Generally speaking, the incubation period is about 10 ~ 20 days, with an average of 14 days. At first, there will be slight fever, fatigue, loss of appetite, headache, muscle or joint pain and other cold-like symptoms; After that, the skin began to appear erythema papules, and then developed into tear-drop blisters smaller than soybeans; When the blister dries, it gradually turns into pustules and scabs.
Director Huang of the Infectious Diseases Department of Children's Hospital affiliated to China Medical University pointed out that new red papules will appear in this process, so children with chickenpox can have red papules, blisters, pustules and scabs at the same time. It usually extends from the central part of the body (such as the head, scalp and mouth) to the trunk and limbs. For babies with normal immunity, the course of disease is about one week.
Adults are more serious than children, which is different from other diseases. If chickenpox occurs in adults, the complications are more serious. Director Huang pointed out that according to statistics, the severity of adults can reach 20 to 25 times that of children. This is because the immune function of adults is very strong, so the immune response is more intense. Sometimes the rash grows much longer, and the whole body feels uncomfortable, or the high fever will drag on for a long time. And compared with children, children have higher tolerance to fever.
Chickenpox usually occurs in late winter and early spring. Compared with summer, people are more engaged in outdoor activities. During this period, people stay indoors for a long time, have more opportunities to communicate with others, and are easily infected with the virus.
Treatment of chickenpox Although most babies will not have particularly serious symptoms after being infected with chickenpox, if they are under one year old or suffer from chickenpox due to immunodeficiency, complications may still occur, including secondary bacterial infection and septicemia. The most serious complication is chickenpox encephalitis, which may occur two weeks after being infected with chickenpox, and may be fatal in severe cases.
At present, antiviral drugs can effectively treat chickenpox, but if there is no immunodeficiency problem, pediatricians usually take conservative treatment, that is, they will not provide antiviral drugs, but give oral antipruritic drugs or liquid medicine similar to prickly heat to relieve itching, so as to prevent children from scratching chickenpox and avoid bacterial skin infection. If the child is seriously infected, the doctor will doubt whether the child has immune problems. If people suffer from immune diseases, such as hematological tumors or other immunodeficiency diseases, they will use antiviral drugs for treatment.
So, how to prevent it? If you get chicken pox, how to care at home?
Diagnosis, antipruritic, cleaning and prevention, the complete nursing code of "chickenpox" The principle of chickenpox nursing: Children with chickenpox can't help but feel itchy, so they want to scratch it with their hands to make it not itchy. Some parents helped him put on cotton gloves for fear of scratching chicken pox. Director Huang believes that the protective effect is actually very limited, because children are difficult to control at ordinary times and are told not to scratch, but they will still scratch as usual; Even if you wear gloves, you can still scratch chicken pox. Therefore, it is more effective to take antipruritic drugs prescribed by doctors on time. Director Huang suggested that children's nails should be cut short to avoid scratches.
Besides cutting short nails, what should dad pay more attention to when he takes chickenpox children than his mother?
There is no taboo to eat and drink normally. The older generation will say that children with chickenpox cannot eat bananas. Director Huang believes that the statement has no medical basis. During the outbreak of chickenpox, the child's diet should still be normal, and there is no need for special taboos.
Cleaning is the key to normal bathing. Many parents are afraid to help their children bathe at the sight of chickenpox. At most, it is simply washed with water. Director Huang said it was completely wrong! Children infected with chickenpox should not only take a bath as usual, but also wash with body cleanser. Especially in Taiwan Province province, the climate is humid and sultry. Babies over 3 months should use a detergent containing soap to be cleaner, while babies under 3 months have no sebaceous glands because the capillaries have not yet developed, so they can use non-soap cleaning to keep their bodies clean. Otherwise, if children with chickenpox are washed with water alone, or even do not take a bath, bacteria will easily remain on the skin surface; When children feel itchy and scratch with their hands, they may have wounds, allowing a large number of bacteria to invade and cause bacterial infection.
The washing water of coriander is getting worse and worse.
It is rumored that when chickenpox grows, letting children drink coriander (coriander) water and wash coriander water can make chickenpox disappear quickly? Director Huang pointed out that this has no meaning or function. Most coriander is eaten raw, just washed with water. What remains on it is either bacteria or parasites. It is harmful for children to drink or bathe with this water.
Further reading: five common skin conditions of infants
Prevention of chickenpox: Vaccinate on time. From June 65438+ 10/day, 2004, children born after June 65438+1 0, 2003 and over 12 months old were given the second dose of varicella vaccine free of charge. However, vaccination is like wearing protective clothing. Is it impossible to get chicken pox again? Director Huang said that basically, infants are less likely to be infected with chickenpox after vaccination; Otherwise, if you are not vaccinated and have not had chickenpox, you will be very susceptible to infection.
Even after vaccination, it is easy to be infected if the validity period exceeds 15 years. Director Huang pointed out that during the period of 15 years, if a small amount of virus is accidentally exposed, the virus amount will not cause disease, which will * * * the human immune system and produce additional effects, so that the antibody will increase again and the protective effect will be prolonged.
If the parents have not had chicken pox and have not been vaccinated; When the baby grows chicken pox, parents are easily infected. However, parents now have either had chickenpox or been vaccinated. Theoretically, they are not easily infected. When the baby has chickenpox, he can still accompany and take care of it naturally as usual, but still keep his hands clean and wash them in the right way.
Some parents are worried that after the baby's chickenpox is transmitted to their parents, will it be possible for parents to infect their baby again when the baby recovers? Director Huang pointed out that in fact, this situation usually does not happen, because it is unlikely that the human body will be infected with chickenpox again after producing antibodies.
If the child was infected before 1 year, it should still be vaccinated after 1 year. If the child was infected with chickenpox before 12 months, should he be vaccinated after 1 year? Director Huang pointed out that vaccination is still recommended in general, because the antibody of infants below 1 is very poor. Instead of making them likely to be infected with chickenpox again, it is better to let them be vaccinated for protection.
In fact, there is a reason why varicella vaccine is scheduled to be given after 1 year old! Director Huang said that unless it is infected before 1 year, there may be serious diseases, such as whooping cough infected six months ago, with a high mortality rate; The later hepatitis B vaccination, the higher the probability of liver cirrhosis or liver cancer after infection. Otherwise, generally speaking, after 1 year, children's immune function will be better and the antibodies produced will be better.
For the application of varicella vaccine after 1 year old, the foreign practice will be to inoculate two doses, which can improve the effective rate (86% → 98%). This is because in fact 1 ~ 1.5-year-old children's immune system maturity is still not ideal, and it will be more mature after 1.5, so they will usually be vaccinated again in the future, with two doses. Director Huang said that in some countries, the vaccine is vaccinated every 4-6 years. This is because the local epidemiological data show that the antibody response to the vaccine is not very good, so it is recommended to supplement one dose at the age of 4-6. However, in some countries, children are vaccinated when they are 10 ~ 12 years old, because the efficacy of the vaccine is about 15 years, and the antibody may not last as long as 10 ~ 12 when the first dose of vaccine is vaccinated.