Chickenpox - An Underestimated Danger?
Expert Dr. Hess: "Drying lotions with tannins help against the itching and possible infection of scratched areas - as with all itch-relieving topical therapeutic agents, the effect is a bit greater when you cool them Photo: private
We adults almost all had them as children, hardly any of them were spared and everyone still remembers the terribly itchy pustules, the pink to purple-colored potassium permanganate bath, which was supposed to relieve the itching and prevent superinfections.
This is what the pediatrician Dr. Nadine Hess:
One or the other has also retained a few scars that tell of the chickenpox infection they had gone through . It was good, uncomfortable, but not really bad either - many parents tell me that. So why is there now a vaccination against it, which is also recommended by the permanent vaccination committee of the Robert Koch Institute (STIKO)?
Chickenpox, also known as varicella, belongs to the herpes virus group and is one of the most infectious diseases of all. Its so-called contagion index - it indicates how contagious a disease is - is almost 1.0, similar to measles . That means that for every 100 people exposed to the virus and not immune, more than 90 will get the disease. Varicella is transmitted as a droplet infection . One of the reasons they infect so many people is that the sick are contagious several days before the characteristic rash breaks out.
Only about 14 days after the infection do those affected initially feel a general malaise, sometimes with a fever . The characteristic rash occurs one to two days later . Blister-shaped changes in the skin, some of which cause severe itching, are particularly evident on the face and trunk . In principle, however, the entire skin, including the mucous membranes, can be affected. Scarring is not particularly common, according to a study from 2001 it is 18.7 percent, but can occur especially with severe scratching effects *.
Chickenpox, also known as varicella, belongs to the herpes virus group and is one of the most infectious diseases of all
Once the annoying blisters are there, not much can be done - and usually does not have to be, if the child is a child with a normal immune system. Drying lotions with tannins help against the itching and possible infection of scratched areas - as with all itch-relieving topical therapeutic agents, the effect is even greater if you apply them chilled. So it's best to store it in the refrigerator.
Complications are very rare in children between one and four years of age, after which they become more common. In the worst case, it can lead to severe pneumonia and brain infections, to superinfections of the skin, and to inflammation of the vessels in the brain, which manifest themselves as strokes with sudden hemiplegia , usually several months after the chickenpox disease. I myself have seen two cases with such complications. Fortunately, one child remained without any consequential damage, and the paralysis completely receded. The other child unfortunately had permanent deficits.
Pregnant women and people with weakened immune systems are also particularly at risk if they contract chickenpox. The severe side effects usually occur directly - for example in the form of pneumonia. If a pregnant woman falls ill in the first 20 weeks of pregnancy, there is a very low risk (around two percent) of what is known as neonatal varicella syndrome, which is fatal - this leads to scarred skin defects, malformations of the brain, eyes, skeleton or muscles. ** If a pregnant woman falls ill two days before to five days after the birth, the child is also particularly at risk, as the mother was unable to pass on sufficient antibodies via the umbilical cord to protect the baby. Up to 30 percent of children then also develop the disease with a high rate of complications.
The babies should be vaccinated and checked closely for any skin symptoms for 12 days after the vaccination. If the typical vesicles (varicella) develop, treatment with a virus-inhibiting agent (aciclovir) via the vein is necessary: ***
Due to the high risk of complications for infants and immunocompromised people, as well as the steadily increasing frequency of complications from the age of four and the rare but sometimes serious malformations associated with infection in early pregnancy, vaccination is generally advisable and sensible. Chickenpox is vaccinated from the 12th month of life together with measles, mumps and rubella , a booster vaccination (which can then be given as an injection with all four components) takes place at the earliest four months later, at best up to the 24th month of life. After that, there should be lifelong immunity.
By the way: Shingles (herpes zoster) is a reactivation of the chickenpox virus . However, there is no danger of this in pregnancy. In this case, only the contents of the vesicles are infectious, so this area should be well covered so that others cannot be infected.
* Leung AK 1, Kao CP , Sauve RS : Scarring resulting from chickenpox. Pediatr Dermatol. 2001 Sep-Oct; 18 (5): 378-80
** German Society for Pediatric Infectious Diseases DGPI, 5th edition, p. 556
*** German Society for Pediatric Infectious Diseases DGPI, 5th edition, especially p. 560
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