Vaccination against chickenpox is the most effective way to protect a child from infection with the Varicella Zoster virus (the causative agent of chickenpox and herpes zoster) and to prevent a severe course of the disease, life-threatening complications in contact persons.

The most effective way to protect against chickenpox is vaccination. Existing antiviral drugs for the treatment of chickenpox are not able to prevent dangerous complications and consequences of the disease and protect against herpes zoster in the future..

All preventive vaccinations are divided into:.

obligatory (included in the national calendar);

for health reasons (patients at risk);

according to epidemiological indications (living in an area where outbreaks of diseases for which there is a vaccine);

recommended (at the request of the child's parents or the patient himself).

In Russia, vaccination against chickenpox is on the list of recommended or can be carried out for health reasons. Vaccinations are available at private clinics.

Characteristics of the varicella zoster virusChickenpox is an extremely contagious infectious disease and is common throughout the world..

The causative agent of the pathology is the Varicella Zoster virus The causative agent of the pathology is the herpes virus, it can only affect humans. Outside the body, it is unstable (remains viable for 10-30 minutes), quickly dies when heated, exposed to sunlight, disinfectants. Freeze resistant.

Only a person with symptoms of chickenpox or herpes zoster can spread the virus.

Ways of infection with the virus:.

drip (getting infectious particles on the mucous membranes when sneezing, coughing);

contact (transmission of the virus by contact with the contents of the vesicles - pox);

vertical (penetration of Varicellavirus through the placenta).

90-95% chance of becoming infected through contact with a person who sheds the virus. Babies under 6 months old, born to mothers who had chickenpox in childhood, are immune to the virus (there are sufficient maternal antibodies in their blood).

Varicellavirus has the ability to invade the nervous system, especially the sensory and autonomic ganglia along the spinal cord, which are inaccessible to cells of the immune system.. After the disappearance of signs of the disease, the pathogen goes into sleep mode and, under favorable circumstances, can cause herpes zoster.

Of the population over 50, about 20% have had herpes zoster at least once. The virus can wake up an infinite number of times.

Pathogenesis and symptoms of chickenpox Varicella-zoster has a tropism (easily penetrates and multiplies) to lymphocytes, epithelial cells of the mucous membranes, nervous tissue. This pathogen is able to elude the immune response, hiding inside these cells, which provides it with the ability to quickly multiply, accumulate, tearing the cell, enter the bloodstream and spread throughout the body..

A characteristic symptom of the disease is a rash. The incubation period for chickenpox averages 2 weeks (from 5 to 21 days). The first symptoms appear from the moment the virus enters the blood.

Chickenpox symptoms:.

increase in body temperature;

intoxication (general weakness, loss of appetite, nausea, drowsiness);

typical skin rashes.

Characteristics of the rash with chickenpox:.

the rash appears within the first 24 hours of the onset of the fever;

the amount increases jerkily, accompanied by a new rise in body temperature, intense itching.

The rash goes through several stages of development. The pathology is characterized by false polymorphism (on one area of \u200b\u200bthe skin there are all stages of rashes).

Stages of rashes with chickenpox:.

rash element.

Characteristic.

Spot.

Round, painless, uncompacted reddening of the skin caused by local dilation of capillaries.

Papule.

A bump (serous swelling of the skin) that rises above the surface of the skin.

Vesicle.

Superficial cavity element that rises above the surface of the skin and contains serous fluid inside. Vesicle single-chambered, thin operculum. Looks like a dewdrop on the skin surrounded by redness.

Pustule.

The same vesicle, only the liquid inside is cloudy, and the tire is more compacted, sluggish.

Crust.

Dense brown mass that is formed from a secreted vesicle or pustule and covers the healing site.

The rash period lasts up to 6 days. The last crusts fall off after 20-23 days.

Adults endure the disease much harder, with severe intoxication and frequent complications..

Complications of chickenpox occur in 5-30%:.

bacterial skin infections;

pneumonia;

acute otitis media;

purulent conjunctivitis;

urinary tract infection;

acute cerebellar ataxia (inability to stand straight, walk);

meningitis;

encephalitis;

hepatitis;

thrombocytopenia.

In patients with reduced immunity or severe chronic diseases, complications occur in 50% of cases.

Treatment of mild disease is symptomatic (fever control, relief of itching, and prevention of bacterial skin infection). In some cases, antiviral drugs are prescribed (Acyclovir tablets or injections for 7-10 days).

Varicella preventionIn 80 countries of the world, the chickenpox vaccine has been introduced into the mandatory vaccination calendar, which gives almost 100% protection against infection with Varicella Zoster.

Vaccination can be done routinely or emergency contact persons within 5 days.

Passive prophylaxis with immunoglobulin varicella-zoster within 96 hours after contact with a sick person is also possible.. But it is administered mainly to people with reduced immunity, newborns whose mothers had chickenpox before childbirth, or pregnant women.. Immunoglobulin does not protect against infection with the virus throughout life and does not replace the vaccine.

Vaccines against chickenpoxToday, there are three types of vaccinations that contain varicella-zoster:.

monovaccine (Varilrix, OkaVax, Varivax);

varicella-measles-mumps-rubella (MMRV) combination vaccine;

herpes zoster vaccine (ZVL, Zostavax).

All of these vaccines are live attenuated Varicellavirus Oka. The difference is how many units of the virus are in one dose. In a monovaccine - 1350 PFU (plaque-forming units), combined - 9772, and in a herpes zoster vaccine - at least 19,400.

Varilrix contains live attenuated VaricellavirusTwo vaccines are registered in Russia:.

Varilrix: manufactured by GlaxoSmithKline, Belgium;

OkaVax: produced by Sanofi Pasteur, France.

Efficacy of vaccinationAfter one dose of vaccination, specific antibodies appear in 97% of children, after the second - in 100%. Among those vaccinated over the age of 13, the rates are 78 and 99%, respectively.

As a result, vaccination against chickenpox in 90% of cases protects against infection with the virus and in 100% - from the severe course of the disease and complications..

In those rare cases when a vaccinated child does get sick, the infection proceeds in a mild form: without high fever, rash elements - usually no more than 50 (they do not develop into vesicles).

IndicationsIn Russia, on an individual basis (optional), the following are vaccinated:.

children from 9 months;

adolescents and adults who have never had chickenpox before;

patients who have been in contact with a patient with chickenpox (up to 5 days);

health and education workers;

women who are planning a pregnancy but have not had chickenpox before;

patients at high risk of complications (leukemia requiring treatment with corticosteroids, organ transplants, chronic renal failure, bronchial asthma, atopic dermatitis, autoimmune diseases).

Vaccination regimens and route of administration. The course is considered completed after the introduction of two doses with an interval of 6 weeks.. All vaccines that contain varicella-zoster are administered strictly subcutaneously in the area of \u200b\u200bthe deltoid muscle or the front of the thigh.. One immunizing dose is 0.5 ml.

The vaccine can be injected into the deltoid muscle region. When administered simultaneously with MMR and other vaccinations (except BCG), it does not lose its effectiveness and safety.. The only rule is that the introduction of each vaccine should be carried out in a separate area of \u200b\u200b\u200b\u200bthe body..

Vaccination against chickenpox for adults does not require a preliminary blood test to determine antibodies to the virus, since this disease does not have a latent course.

Vaccines from different manufacturers are interchangeable. That is, if the first dose was Varilrix, then the second may be OkaVax and vice versa.

Within 6 weeks after the introduction of the vaccine, it is not recommended to use preparations containing salicylic acid, due to the high risk of developing Reye's syndrome.

ContraindicationsContraindications for the introduction of the vaccine:.

severe immunodeficiency (congenital or acquired);

HIV;

hypersensitivity to drug components;

pregnancy (theoretically, the virus can cause fetal varicella syndrome);

period of breastfeeding;

acute infectious diseases with severe fever;

treatment with high doses of corticosteroids (more than 1 mg/kg for children, 20 mg per day for adults);

transfusion of blood, plasma, administration of immunoglobulins less than 5 months old.

Women who have been vaccinated must avoid pregnancy for 4 weeks..

Side effects of chickenpox vaccination In most healthy people, the procedure is well tolerated, post-vaccination reactions are limited to local swelling, redness at the injection site during the first hours after injection (25%). In one case out of 50, there may be a mild course of chickenpox with single rashes.

Swelling and redness at the injection site is more common in patients older than 14 years after the second dose.

Other complications after vaccination (less than 1 case per 1000):.

lymphadenopathy;

headache, drowsiness;

upper respiratory tract infection;

rash;

hives;

muscle and joint pain.

Herpes zoster vaccine 2 out of 10 people who recover from chickenpox have a flare-up of herpes zoster. Peak incidence occurs over 50 years of age.

In adults, vaccination is necessary to prevent herpes zoster. Herpes zoster causes the following complications:.

postherpetic neuralgia (severe pain along the affected nerve endings);

cranial nerve palsy;

hemiplegia;

blurred vision (with damage to the trigeminal nerve).

The vaccine is administered once, subcutaneously. It contains the same strain of the virus as chicken pox, but at a much higher concentration.. This method of prevention by 60% reduces the likelihood of episodes of the disease. It also reduces the likelihood of developing postherpetic neuralgia and the intensity of pain in people who, after vaccination, still fell ill with herpes zoster..

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