Treatment of herpes in children 6 years. Signs, types and development of herpes: the correct treatment of the virus in a child

Viral infections pose a serious danger to children, in particular, the herpes virus is not at all as harmless as it seems, and in addition to external manifestations, it can affect internal organs, the nervous system and cause other serious complications. .

And if in the first months of life the baby's body is still protected by the mother's immunity and antibodies to the virus that he receives with breast milk, then later this protection weakens. Herpes is especially often diagnosed in a child at 2 years of age, but by the age of 5, the baby's body begins to produce its own antibodies that can resist the virus.

What are the symptoms of a herpes infection in young children? What are the main features of the disease and how to treat herpes in a child in order to prevent possible complications? We will try to answer these questions in our article.

Infection of a child in most cases occurs in the children's team or through contact with adult carriers of the virus. A baby can easily become infected from the mother if she has a relapse of the disease and an exacerbation of herpes infection occurs.

This is especially true for infants, since during this period it is impossible to stop the contact of the baby with the mother and take such precautions that would guarantee the absence of infection. In addition, the source of infection, without knowing it, can be any person who has the virus in a latent (not active) form and its visible manifestations are absent.

The transmission of the virus occurs as follows:

• Airborne droplet. When a person with herpes or who is its carrier coughs or sneezes, the virus spreads through the air and easily enters the baby's body through the mucous membranes.
• Household. This type of virus transmission is most common in families where personal hygiene rules are violated. That is, family members share common dishes, cutlery, towels, bed linen.
• Perinatal. From a mother infected with the virus, the infection is transmitted to the child during childbirth.
• During medical manipulations (during blood transfusion).

According to statistics, out of 100 newborns whose mothers first became infected with the herpes virus during pregnancy, up to 50% of babies are born with a congenital herpes virus infection. This can have the most severe consequences for the child. If during pregnancy a woman has a relapse of the disease, then this practically does not affect the child, since the mother's body already has a developed immunity to the virus.

Concomitant factors that provoke the appearance or exacerbation of herpetic manifestations are:

• Colds
• hypothermia
• Weakened immunity
• Irrational nutrition, with a lack of nutrients and vitamins necessary for the child
• stress factor
• Influence of the environment (infection occurs more often in the autumn - winter period)

The herpes virus has many varieties, the most common being the types that cause "colds" on the lips and chickenpox. In fact, there are many more types of herpesvirus and each of them has its own characteristics. A child can become infected with any type of pathogen, so parents need to know the main symptoms of the disease and methods of fighting the infection.

Types of herpes

To date, scientists know more than 200 varieties of herpesvirus, of which the most common and well-studied are 6 types:

All types of herpesvirus infections in children pose a serious danger and need timely treatment, as they can provoke serious complications.

The danger of herpes in young children

Infants and newborns are usually immune to the virus that they receive from their mother, but from 1-2 years of age, this protection weakens. Herpes in a 3 year old of life appears as a result of the fact that the child's own immune system is still weak and cannot resist infection. In some cases, the consequence of infection can be serious complications affecting the internal organs and body systems. The following conditions are among the complications caused by the herpes virus:

• Herpetic eye lesions (keratitis, iridocyclitis, uveitis, corneal erosion)
• Ear lesions, often resulting in deafness
• Herpetic sore throat, stomatitis, gingivitis
• Damage to the cardiovascular system (myocarditis)
• Damage to the nervous system (neuritis, paralysis of the limbs) and the brain (encephalitis, meningitis)
• Damage to internal organs (liver, kidneys, spleen)

All of the above complications are very serious, it is difficult to cope with them even for an adult. In a child with a weak immune system, they can be life-threatening and, in severe cases, result in disability.

Diagnostics

The specialist makes a diagnosis based on the general clinical picture and a number of laboratory and instrumental studies confirming the presence of the virus in the body. The main diagnostic methods are:

When making a diagnosis, it is important to differentiate herpes from other viral diseases with similar symptoms (SARS, rubella, allergic reactions, dermatological diseases accompanied by rashes). An early and correct diagnosis will allow timely initiation of therapy. The pediatrician will advise the parents and explain how to treat herpes in a child.

Main symptoms

From the moment of infection to the first symptoms of herpes, a certain time passes (incubation period), which can range from several days to 2 weeks. Then there are characteristic symptoms corresponding to the type of herpes infection.

Cold sores

Herpes of the first type begins with a sensation of tingling, burning, itching and redness in the place where the rash subsequently appears. The primary stage is accompanied by a general malaise: fever, fever, headache, an increase in lymph nodes is observed. These manifestations resemble the symptoms of a cold, but soon parents notice other signs of infection. Herpes on the lip of a child is manifested by the appearance of small itchy vesicles filled with transparent contents.

After some time, they open and secrete a liquid containing the virus in high concentration. At this time, you need to make sure that the child does not touch the formed erosion with his hands, this can lead to further spread of the infection. After a few more days, the weeping sores begin to dry out and become covered with a crust, which soon disappears.

With primary infection, the development of herpetic stomatitis is possible, when painful blisters form on the tonsils and palate. Herpes in the mouth of a child leads to the fact that the baby becomes capricious, does not sleep well. Painful erosions that form at the site of burst bubbles cause refusal to eat and lack of appetite. With weakened immunity, primary infection with the virus can lead to the development of complications associated with damage to internal organs.

Genital herpes

Herpes of the second type is especially dangerous for a child, since infection most often occurs in utero, when a pregnant woman becomes ill with herpes. If the infection of the expectant mother occurs for the first time, then the risk of developing severe complications in the fetus is very high.

The first symptoms in a newborn appear within 2 days after birth. Characteristic bubble rashes appear all over the body, the temperature rises, febrile conditions occur, lymph nodes increase. The child is diagnosed with malformations of the nervous system, liver, heart, pancreas. Rashes and sores appear on the genitals. After a few days, jaundice develops, convulsions may appear, and the risk of developing viral pneumonia increases, with a high degree of death.

Herpes in a child of type 3 - 6

Type 3 herpes virus causes chicken pox, accompanied by characteristic rashes all over the body, high fever, chills, and weakness. After treatment of chickenpox, the virus remains in the body and reminds of itself with relapses of herpes zoster, when, with weakened immunity, bubble rashes appear on the back, along the nerve fibers. Herpes zoster is accompanied by intense itching, fever and severe pain.

Type 4 virus causes infectious mononucleosis, manifested by tonsillitis, swollen lymph nodes, and fever. Herpes in the throat of a child accompanied by painful rashes in the oral cavity, fever, enlarged lymph nodes (mainly cervical), liver and spleen. Infectious mononucleosis can occur with complications affecting almost all internal organs and body systems (nervous, pulmonary, cardiovascular).

Herpes type 5 is a cytomegalovirus infection. The virus is introduced into the body and is waiting in the wings, manifesting itself with a decrease in immunity with a common respiratory infection (ARVI). A virus of this type is dangerous when a pregnant woman is exposed to infection, resulting in intrauterine infection. In this case, the child dies or is born with severe lesions of the central nervous system.

Herpes type 6 in children causes exanthema, the manifestations of which resemble rubella. The disease begins acutely, with a sharp rise in temperature and the appearance of a pale pink rash on the body, dense to the touch and slightly rising above the surface of the skin. In this case, damage to the mucous membranes of the oral cavity is noted. Herpes in the mouth of a child manifested by a painful rash on the soft palate and tongue, as a result of which the child becomes restless, often cries and refuses to eat.

Treatment of the disease

Treatment of herpesvirus infections in children should be comprehensive. The doctor selects a treatment regimen and dosage of drugs on an individual basis, depending on the age, weight and condition of the child. What is included in the complex therapy?

To strengthen and support the child's body, a complete diet containing the necessary nutrients and vitamins is recommended. Preference should be given to dairy products, dietary meat, fish, vegetables and fruits. Doctors advise to adhere to a plentiful drinking regimen, this will help remove toxins from the body. It is necessary to give the child compotes, juices, fruit drinks, decoctions, rehydration solutions. This will eliminate dehydration and relieve intoxication.

With generalized forms of infection, congenital herpes and a severe course of the disease, accompanied by complications, therapeutic measures are carried out in a hospital.

Treatment with folk remedies

As additional measures, you can use traditional medicine. This will help ease the course of the disease and speed up recovery. In order to avoid allergic reactions or other complications, you should consult your doctor before using alternative recipes.

The following measures will help prevent recurrence of cold herpes in a child:

Since the virus is transmitted in different ways, including household ones, parents need to teach their child to observe personal hygiene from a very early age. The kid should keep his hands clean and know that you can only use your own towel, toothbrush, clothes and other personal items.

In the winter season, parents can give their child drugs that stimulate the immune system as a preventive measure. The attending physician should prescribe such funds.

Herpes is a disease of a viral nature, characterized by damage to various organs and tissues: skin, mucous membranes, brain, lungs, genital organs, etc.

There are several types of herpes virus: eight are currently known. One of these viruses can cause both, and. In children, the cause of the disease is most often the herpes simplex virus with damage to the skin (for example, on the wings of the nose, thighs, buttocks, etc.) and mucous membranes (most often). But in some cases, this virus can also affect other organs (eyes, genitals).

Children of the first year of life rarely get sick, as they receive immunity from the mother. Only severely weakened babies can get sick. But if the mother has it, then it can become infected during childbirth and then even a healthy newborn can get sick: the virus in the birth canal is in an active state.

Most often, children become infected at the age of 3-4 years, and by the age of five, about 80% of children have antibodies to the herpes simplex virus.

Infection of children comes from sick family members or other infected children. The virus enters the child's body in two ways: airborne and contact-household. After infection of the baby, the virus does not always immediately cause manifestations of the disease. It penetrates into clusters of nerve cells (nerve ganglia) and remains in them throughout life.

For a long time, the virus may not manifest itself. During this period, an infected child is not dangerous to other children, since it will become a source of infection only during the period of active reproduction of the virus. If it is good, then the virus can be “in a dormant state” for a lifetime, and the disease will not develop.

When immunity is weakened, when any diseases occur in a child, even when hypothermia (or overheating), the virus multiplies rapidly and manifests itself. Most often this happens in the autumn-spring period.

The following factors can also provoke the first manifestation of infection or its exacerbation:

• irrational nutrition;
• and ORZ;
• stressful situations.

Symptoms

Most often, rashes in children appear on the lips, near the nasal passages. But bubbles can also appear on other areas of the skin (cheeks, thighs, buttocks, arms). Children often scratch the bubbles, and wounds form as a result.

The hands of the baby can transfer the virus to the mouth, ears, eyes. Quite often, children develop aphthous at the same time. Herpetic eye lesions are very dangerous (not only the cornea, but also the retina can be affected). The development of the process in the ears can lead to hearing loss.

At first, the bubbles have a transparent content, and after a couple of days it becomes cloudy. If the child does not comb the bubble, then it dries up, a crust forms. On the lips, the crust falls off after about 2 days, on the skin - after a few days. With constant combing and tearing off the crust, the healing time is delayed.

As a rule, the general condition of the child remains satisfactory. Some children may develop a fever.

Most often, rashes during exacerbations always appear in one place. But the location of the rash can change with each exacerbation.

After the disappearance of the clinical symptoms of the disease, the virus will again wait in the nerve ganglia for the next moment for a new exacerbation. Therefore, herpetic infection has a recurrent cyclic course. The frequency of occurrence of exacerbations is different (from several weeks to several years).

In newborns the disease is severe. Clinical manifestations after infection in childbirth appear by 4-7 days of life. The temperature rises to high numbers. Abundant rashes appear not only on the oral mucosa, but also on the skin, in the eyes, in the intestines. The bronchi, liver, adrenal glands can be affected.

Often, the infection also captures the central nervous system (spinal cord and brain). Such an extremely severe course of a herpes infection can lead to the death of an infant or cause disability in a child.

Treatment

All mild cases of a child with herpes are treated at home. Of course, the treatment of newborns is carried out in a hospital. Children of any age with damage to the eyes and nervous system are hospitalized.

At home, with an exacerbation of the disease before the appearance of bubbles, it is possible to prevent the development of the disease, to “break off” the process. To do this, you can burn the place of the rash with 70% ethyl alcohol (can be camphor), or alternate the application of pieces of ice and napkins moistened with hot water.

If the bubbles have already poured out, then it is necessary to process them 2-3 r. a day with brilliant greens, Castellani paint, paste, tea tree oil (undiluted).

In case of damage to the oral mucosa, rinsing with a solution of furacilin, Rotokan, calendula tincture (1 tsp per 200 ml of water) is used.

The use of ointments, which include (Hydrocortisone, Flucinar, Elocom, Celestoderm, Advantan, etc.) contraindicated!! These drugs contribute to an increase in the duration of the disease and suppuration of the vesicles.

From the very first day of the disease, special ones that affect the virus itself are also prescribed. These drugs are available both in the form of external use (ointments, gels, creams, liniments), and in tablets for internal use.

You can only use external agents on your own. Antiviral ointments are used (Acyclovir, Zovirax, Oxolinic, Florenal, Tebrofen, Bonafton ointments). The earlier treatment is started, the more effective it is.

Tablets of antiviral drugs for a child should be prescribed only by a doctor! He will determine not only the necessary drug, but also select its dose and the duration of the medication. The doctor will prescribe the child and the vitamin complex, and (if necessary).

For faster skin cleansing, you can apply applications for 10 minutes. 1 p. per day with enzymatic preparations (Chimopsin, Pancreatin, Lysozyme). Crusts formed on the lips or on the skin can be lubricated or lotioned with rosehip oil, sea buckthorn oil, Shostakovich balm, oil solutions of vitamins E and A. Sodium nucleinate, methyluracil ointment can be used to stimulate local immunity.

Known and methods of treatment of herpes by means of traditional medicine. They can relieve discomfort in a child and speed up recovery, but these recipes can only be used in children who do not have a predisposition to allergic reactions.

• Celandine grass juice for lubricating bubbles: it should be lubricated 5 times with an interval of 5 minutes, and this procedure should be repeated three times a day. Lubrication can be replaced with lotion with juice on the rash area 3 r. per day for 4-5 minutes. When a rash occurs in the nasal passages, celandine juice can be dripped into the nose.

If herpes recurs often, then you can prepare the grass for future use in this way: thoroughly wash the plant (all its parts, even the root), grind it with a blender (or through a meat grinder), squeeze the juice and pack it in small bottles or jars (not to the very top), leave at room temperature for fermentation, covered with gauze. After a week, close the jars with lids and store in the refrigerator.

• In the initial stage of the manifestations of the disease, the effect can be exerted by lubricating the foci of infection with toothpaste.
• Lubricate the affected areas with fresh quail egg protein.
• On the affected areas, you can apply a compress of freshly grated potatoes, apples, garlic.
• For severe itching, you can apply an ice cube.
• Lubricate the rashes with onion juice or milkweed.
• Lubricate the affected areas with alcohol tincture of propolis.
• 1 tbsp mix honey with 0.5 tsp. mustard and lubricate herpetic eruptions.
• Infusion of calendula (1 tsp flowers pour 100 ml of boiling water, leave for 1 hour) can be used as lotions.
• You can lubricate the rashes in the crust stage with sea buckthorn oil.
• Add 5 drops of eucalyptus oil to 1 tbsp. vegetable oil and wipe the affected area (peel).
• Lotions can also be made with vegetable oil and salt (a pinch of salt per 1 tablespoon of oil).

In addition to local treatment, the child should be provided with plenty of fluids, high-calorie nutrition, fruits and vegetables (sources of vitamins), and fermented milk products.

Prevention

In order to prevent infection of the child, the following measures are necessary:

• isolation of a family member with herpes or a child from the children's team from the very first day of illness;
• observance of the rules of personal hygiene and the allocation of individual dishes, towels, etc. to the sick person;
• timely examination of pregnant women for TORCH infection.

• sanitation of all foci of infection in the body;
• hardening of the body;
• taking vitamin complexes and minerals;
• prevent overheating and hypothermia of the child.

An antiherpetic vaccine exists and has begun to be used. But the experience of using vaccination is still insufficient.

The human pathogen is herpes simplex virus (HSV) types 1 and 2 (DNA viruses).

Allocate:

• primary infection
• recurrent infection: symptomatic recurrent infection (presence of herpetic vesicles due to a previous infection, as well as neutralizing antibodies) and asymptomatic virus isolation.

Although herpes simplex usually affects young people, sometimes this infection is also found in children.

Epidemiology of herpes simplex virus in children

Infection involves close contact with mucous membranes or affected skin.

Infection of the adult population with the herpes simplex virus type 1 is approximately 70-90%. Antibodies to HSV 1 may also have a protective effect against HSV 2.

Primary HSV 2 infection occurs through sexual contact. As a result, in most cases, there is a local herpes genitalis or a latent infection. Approximately 1% of pregnant women have recurrent herpes genitalis.

HSV-associated infections are rare in newborns (1:2000 to 1:3000 among all live births).

• Perinatal infection occurs in approximately 85% of cases.
• Transplacental or ascending prenatal infection (5%), as well as postnatal (10%) infection are rare.
• Postnatal infection in most cases is due to HSV 1. When a nosocomial infection occurs, any person (mother, father, relatives, staff) who has had contact with the patient, for example, herpes labialis, acts as its source.

The risk of infection in a newborn child associated with HSV 2 depends on the stage of the disease of the mother:

• > than in 50% - when a pregnant woman has a primary genital infection in a period of > 32 weeks, since on the one hand there is a high isolation of the virus, and on the other - there are no protective antibodies.
• with recurrent herpes simplex, virus isolation is noted only for 2-5 days, the number of viral bodies is much lower, in addition, the fetus in this case receives protective antibodies (risk of neonatal infection< 5 %).
• Least Risk (< 0,5-3 %) заражения существует при бессимптомном выделении вируса организмом матери. Но, поскольку такой статус чаще всего встречается у матерей, инфицированных ВПГ 2, и зачастую это остается неизвестным, то, как правило, именно такая ситуация имеет место при возникновении манифестированных инфекций у новорожденных (60-80 %).
• premature rupture of amniotic fluid increases the risk of infection. Therefore, a caesarean section in pregnant women with an active form of genital herpes is performed only if the period from the moment of rupture of the membranes was< 4 часов. Во время родов не накладывать электроды на волосистую часть головы и не производить заборы крови у плода.

Symptoms and signs of herpes simplex virus in children

In a primary herpes infection, clustered small vesicles or pustules appear. Herpetic rash usually resolves within 2 weeks. Herpes simplex often recurs, and relapses often have a milder course, less pronounced rash and duration of clinical manifestation. If herpes is suspected, a virological examination of the contents of the vesicles and an immunofluorescence reaction are indicated to determine the type of HSV.

Symptoms of perinatal/postiatal infection: there are three flow options:

Disseminated infection(in about 30% of HSV-infected newborns):

• Often after primary maternal infection in the peripartum.
• The dramatic course of the disease (the clinic may very much resemble bacterial sepsis).
• The onset of symptoms, as a rule, is on the 4-5th day of life, the maximum manifestation is on the 9-11th day.
• All organs can be affected: the brain, mucous membranes of the oropharynx, esophagus, intestines (pneumatosis intestinalis). Diffuse interstitial pneumonia, myocarditis with rhythm disturbances, anxiety of the child, centralization of blood circulation and shock, jaundice associated with biliverdin against the background of high activity of transaminases and disorders in the blood coagulation system may occur. Typical vesicular skin lesions occur in about 80% of cases.

Enzefsyi t (in 30% of HSV-infected newborns):

• The onset is usually 2-3 weeks after birth.
• Seizures, drowsiness or restlessness, tremors, sluggish suckling, temperature fluctuations.
• A typical vesicular skin rash occurs in only 50%.
• Encephalitis is not limited to the temporal lobes, but extends to other departments.
• In the cerebrospinal fluid, the number of mononuclear cells and protein is increased, the concentration of glucose is moderately reduced.

HSV infection of the mucous membranes and skin with lesions of the skin, eyes and / or oral cavity(in about 40% of HSV-infected newborns):

• Beginning in most cases on the 11th day of life.
• Typical groups of red vesicles with a cloudy secret are found mainly on the part of the child's body presenting during childbirth, namely: on the head, chest, oral mucosa, in the oropharynx.
• Eye damage manifests itself in the form of keratitis or chorioretinitis, less often cataracts.
• Without treatment, progression to encephalitis is possible.

Symptoms in case of intrauterine infection / congenital infection:

Very severe, unfavorable prognostic intrauterine infections are rare.

Vesicular rash from birth, hydrocephalus, chorioretinitis, microphthalmia.

Subclinical infections: It is still unknown whether subclinical HSV infections exist in newborns. A tactical issue arises in a situation where, for example, signs of HSV are detected in the cerebrospinal fluid of absolutely asymptomatic newborns by PCR. Until this situation is clarified, these newborns should be monitored and treated as if they had HSV infection.

Diagnosis of the herpes simplex virus in children

Clinical suggestion arises in the event of the onset of symptoms of sepsis with a significant increase in transaminase activity and / or disorders in the blood coagulation system.

Detection of the virus in the contents of the vesicles, buffy coat preparations or smears from the mucous membranes (conjunctiva or nasopharynx), as well as in the cerebrospinal fluid by PCR. The culture of HSV in the cerebrospinal fluid with encephalitis can be obtained only in 40%. PCR is more sensitive than culture. Infection is confirmed by positive PCR or virus culture.

Detection of antibodies by CSC, indirect immunofluorescence, or IgM detection by ELISA at the onset of the disease is of little sensitivity, so these tests are not performed at this stage. In the case of encephalitis, intrathecally formed HSV-specific oligoclonal antibodies are detected after about 10 days.

Imaging studies (ultrasound, MRI): pictures of an isolated lesion of the temporal lobes, typical of older children, cannot be expected, in most cases disseminated encephalitis occurs.

Prevention of herpes simplex virus in children

Delivery by caesarean section:

• If a woman has clinical signs of obvious genital herpes by the time of delivery, and no more than 4-6 hours have passed since the outflow of amniotic fluid. The protective effect of delivery by caesarean section in case of primary infection in the last 6 weeks of pregnancy has been proven. In recurrent HSV infection, the effect is less clear, but prophylaxis is strongly recommended.
• Whether delivery by caesarean section is a protective measure in the case when > 4-6 hours have passed since the moment of rupture of the amniotic sac is still unknown.
• Herpes simplex of the vessels or organs of the abdominal cavity of a pregnant woman is a less significant problem.

It is difficult to make a decision in the case of preterm birth. Possible options:

• Expectant management during acyclovir therapy for a pregnant woman, as well as the introduction of betamethasone to induce maturation of the fetal lungs.
• Rapid delivery by caesarean section with the introduction of a premature newborn surfactant and acyclovir.

Pregnant women with genital HSV infection (primary or secondary) from 36 weeks of gestation should be treated with acyclovir at a dose of 1200 mg / day for 3 injections (a reduction in the frequency of caesarean section is possible against this background).

Asymptomatic shedding of the virus occurs in about 2% of women with recurrent genital herpes, while the risk of infection in newborns is less than 3%. Thus, the overall risk of newborn infection from pregnant women with recurrent genital herpes is< 1:2000. В целом это не является показанием для проведения кесарева сечения.

Isolation of HSV culture in pregnant women is not prognostically significant in terms of labor management, so this technique has fallen into disuse.

HSV-exposed newborns:

• Careful monitoring of newborns for 6 weeks in relation to the occurrence of symptoms of HSV infection.
• Sowing culture of HSV or PCR in swabs from the mucous membrane of the throat, oral cavity and conjunctiva within 14 days, starting from 24 (-48) hours after delivery. Perhaps, in order to assess perinatal exposure to HSV, it is rational to obtain a culture of the virus from the mother's vaginal discharge. If HSV is detected in a newborn, then acyclovir therapy is recommended in the absence of symptoms of infection.
• Prophylactic administration of acyclovir to newborns from mothers with primary or recurrent symptomatic HSV infection.

Mothers shedding the virus, as well as infected newborns, are isolated.

In the case of recurrent infections (Herpes labialis, Herpes genitalis), the spread of the virus must be prevented by preventive measures, such as hand disinfection, protection of affected skin areas (face mask). Breastfeeding of the mother is allowed with all precautions, provided that she does not have lesions of the nipples of the mammary glands.

Treatment of herpes simplex virus in children

Treatment is with valaciclovir or famciclovir given orally.

Of fundamental importance is the immediate initiation of therapy in case of any suspicion of HSV infection (this improves the prognosis).

Acyclovir or vidarabine can be used. Both substances are equally effective. Due to the lower toxicity and volume of the solution, preference is given to acyclovir.

Dose of acyclovir: 60 mg / kg / day for 3 injections, duration of therapy 14-21 days (21 in case of HSV sepsis). Premature infants with limited renal function: 40 mg/kg/day for 2 doses (60 mg/kg/day, one landmark study found better than 30 mg/kg/day for HSV sepsis and HSV encephalitis ).

Forecast of herpes simplex virus in children

In disseminated HSV infection, mortality decreases from more than 90% without treatment to almost 40% with therapy. Long-term results, however, are not yet known. High risk of delayed psychomotor development.

Without treatment, 2/3 of newborns with HSV encephalitis die. Surviving children have severe psychomotor damage with microcephaly, tetraspastic paresis, chorioretinitis, hearing loss. Against the background of therapy with acyclovir or vidarabine, 90% of newborns survive, 30-40% of these children subsequently develop normally. However, in the long term, the symptoms may worsen progressively.

Isolated lesions of the skin, eyes, or oral cavity are more prognostic in terms of prognosis.

Despite adequate therapy, relapses of vesicular rash during the first year of life are very common. At the same time, only the course of outwardly manifested local HSV infections is known, the mortality in which is low (about 7%), but the relatively long-term prognosis seems doubtful, since many of these children, especially with frequent relapses, at the age of 6 months, there is a delay psychomotor development. If necessary, these infants are treated with acyclovir 900 mg/m 2 /day for 6 months.

Relapses similar to acute progressive infectious encephalitis of the CNS are known, the treatment of which is always carried out with acyclovir. The effectiveness of adjuvant therapy with glucocorticosteroids is currently under debate.

Herpes in children is an infection caused by the herpes virus. This common disease poses the greatest danger to a child during fetal development, as well as in the first 1.5-2 years of life.

Symptoms

Signs of the disease in children may depend on the type of virus. Each species has its own characteristics, for example:

• The main route of transmission of genital herpes is sexual. Young children could become carriers by passing through the birth canal of an infected mother during birth;
• a type of herpes, called the Epstein-Barr virus, can lead to the development of infectious mononucleosis or cancerous tumors;
• The causative agent of shingles is the type of herpes Varicella-Zoster.

Herpes in children may have signs characteristic of several types of the disease:

• the prodromal period rarely makes it possible to understand that the child is sick with herpes. Headaches and discomfort in high fever are similar to flu symptoms. As with this pathology, the child looks apathetic, loses his appetite;
• at the next stage, the virus manifests itself in the form of rashes and redness on various parts of the body. There is itching;
• gradually the itching intensifies and begins to be accompanied by painful sensations. At the site of the rash, vesicles appear - fluid-filled vesicles. In children, the area affected by the vesicular rash is larger than in adults. With herpes gingivitis or stomatitis, not only the skin, but also the mucous membranes of the oral cavity are in the affected area.

Types of herpes

A herpetic rash, depending on the type of virus, appears on the tongue, on, on the back. Varieties of herpes in children and adults:

• - HSV (herpes simplex virus), or "cold", looks like a rash of blisters on the lips;
• - HSV, which causes a rash on the genitals;
• type 3 - the virus causes chicken pox, can recur in the form of shingles;
• - Epstein-Barr virus, provokes infectious mononucleosis and Burkitt's lymphoma;
• type 5 - CMV (cytomegalovirus);
• - is the cause of sudden eczema in children (pseudo-rubella);
• Type 7, type 8 - viruses that are currently poorly understood.

Causes

Infection with the herpes virus in a child can be observed already in the first years of life. The disease has various ways of transmission. If close relatives are healthy, infection occurs through primary contact with a herpes virus carrier in a preschool, school, or public place. For a long time, herpes is in a passive state. Activation occurs under the influence of factors such as:

• overheating or hypothermia;
• malnutrition;
• heavy physical and mental stress for children;
• stressful situations;
• infections (in most cases it is ARVI).

The main one is a decrease in immunity.

Treatment of herpes in children

Treatment of herpes in children at home with alternative medicine should be limited. The child needs to be seen by a doctor. Folk remedies can be used as an addition to the treatment course.

Which doctor treats

At the first symptoms of herpes in children, you need to contact the local pediatrician. If, after passing the tests, the diagnosis is confirmed, the pediatrician will also take care of the treatment.

Diagnostics

Diagnosis of herpes begins with an examination of the mucous membranes and skin in children in the pediatrician's office.

With severe symptoms, laboratory tests may not be required, and treatment is prescribed immediately.

If it is necessary to clarify the diagnosis, the doctor prescribes:

• enzyme immunoassay. This is a blood test that looks for the type of virus (qualitative) and the amount of antibodies in the blood (quantitative). If the level of the latter increased, the herpes virus became more active.
• Polymerase chain reaction (PCR) method. For the study, materials are used from the area of ​​the skin or mucous membrane located in the affected area.
• cultural method. It is allowed to identify the pathogen using a swab taken from the affected area. Viruses are sown on a nutrient medium. After some time, it becomes possible to establish their belonging to any type of herpes.

How to treat

Treatment for herpes may include:

• Antiherpetic and antiviral drugs. Forms of release of medicines - ointment, gel, injections, tablets. External treatment is the least effective. To accumulate antiviral substances in the body, injections or taking pills are required. The most effective drugs include: Acyclovir, Gerpevir, Zovirax.
• Immunostimulants. Necessary to maintain and strengthen the immunity of the child. The pediatrician may prescribe Groprinosin, Immunal.
• Vitamin therapy. It is also aimed at supporting the immune system. The patient will benefit from Eleutherococcus tincture, with which you can relieve emotional and physical stress. Tincture strengthens the immune system and improves the overall tone of the body. The patient needs to take vitamins B and C.
• Antihistamines. They are prescribed for extensive skin lesions and severe itching. An example of such drugs can be: Cetrin, Erius, Claritin.
• Antipyretic drugs. They are prescribed for chicken pox, infectious mononucleosis and roseola, when the child's body temperature rises above 38 ° C.

Folk remedies

Non-traditional recipes for external use are suitable for children:

• a compress of aloe juice or Kalanchoe. A clean piece of tissue should be moistened with plant juice and applied to the affected area for 20-30 minutes;
• garlic ointment. To prepare the medicine, you need to take 3 medium-sized garlic cloves, 1 tsp. honey and 1 tbsp. l. ash. The ingredients must be mixed with a mixer. The ointment is applied to the affected area for 15-20 minutes. Parents need to ensure that the medicine does not cause a burn or irritation. For the first application, it is enough to apply the ointment for 5-10 minutes and check the skin reaction;
• melissa compress. 1 st. l. Plants should be poured with 1 cup of boiling water. The broth should be infused and cooled to room temperature. The compress is applied for 30-40 minutes. The decoction is suitable for internal use. Melissa drink should be consumed 100-200 g 3 times a day 20-30 minutes before meals. The treatment course lasts 10-15 days.

Prevention

Prevention is necessary for both healthy babies and those children who have already become carriers of the virus. Parents are obliged to teach the child the rules of personal hygiene: wash hands before eating, use only their own things, etc. Children should not come into contact with infected peers or relatives.

Herpes in the blood of a child will not harm him if the immunity is strong enough.

Children need a balanced diet. Twice a year, in spring and autumn, you need to carry out vitamin therapy. The district pediatrician should choose the most suitable drugs for this.

Children need to be protected from factors that activate the virus. The child should not overcool or overheat, have the flu, or be stressed. Additional loads should be abandoned, for example, attending several circles at the same time. At the same time, it is desirable to involve children in sports. Moderate physical activity increases the body's stamina and strengthens the immune system.

Complications and consequences

It is more difficult for a child's body to fight the virus than for an adult. In the absence of timely treatment, herpes located in the nerve nodes in a child can have consequences in the form of complications on the central nervous system, resulting in depressive disorders and schizophrenia. Serious consequences are violations of the internal organs.

Herpes on the eye (ophthalmic herpes) with complications leads to iridocyclitis, keratitis and other eye diseases.

With the defeat of herpes ENT organs in children, hearing is reduced or deafness occurs, herpetic sore throat may occur. The virus is also dangerous for the reproductive system. In the future, it can lead to infertility.

The opinion of Dr. Komarovsky

According to Dr. Komarovsky, the herpes simplex virus occurs in 65-90% of the world's population. By the age of six, 80% of children are infected. The course of the disease depends on the state of the defense system: the stronger the immune system, the less often the manifestations of the disease will be. In many children, the virus is inactive and does not pose a threat to life and health.

Herpes infection covers more than 90% of people on Earth. Moreover, herpes is characterized by a high level of contagiousness, it can be transmitted from mother to baby during childbirth or during pregnancy. Statistics say that out of 1000 children, 1 is infected with this disease. Herpes in infants can be fatal if left untreated. This is fraught with the development of dangerous complications.

Causes

Usually a disease of this type in children is herpetic stomatitis. This happens when the baby reaches 6 months of age. After six months of life, the baby has a lack of antibodies that provide protection against infection, which he received from his mother.

This phenomenon is observed at the time of teething in violation of the integrity of the gums. The virus penetrates into the injured areas of the mucosa.

Symptoms

When a child is infected with herpes, symptoms of herpes appear on the inner surfaces of his cheeks and gums, for example, redness, itching begins to be felt, and then sores appear, which are accompanied by pain. Sometimes there is an increase in the submandibular and cervical lymph nodes.

These symptoms are difficult to detect in infants, so the first step is to pay attention to how the baby behaves.
Behavior in pathology is characterized by:

• Capricious state of the child.
• Constant crying.
• An increase in temperature in a child.
• The presence of a drowsy state.
• The appearance of seizures.
• Bad appetite.

Diseases caused by herpes

The listed symptoms are also characteristic of complications that have developed against the background of primary herpes. Among them, several diseases can be distinguished.

1. Kaposi's eczema is a disease of the epidermis, which is accompanied by a blistering rash in the cheeks, hands, on the head, and also on the lip. Usually, with this disease, itching appears, and the skin becomes covered with crusts, body temperature sometimes rises to 40 degrees. When infected, you need to urgently put the child for treatment in an infectious diseases hospital.
2. Primary eye herpes is characterized by the presence of redness in the eye area, accompanied by pain, profuse lacrimation, in some cases the disease can cause corneal clouding.
3. Panaritium of the herpetic type is otherwise called inflammation of the fingers. This is due to the introduction of infection into the human body through damage to the epidermis. Typically, symptoms are characterized by swelling, pain, and redness.
4. Encephalitis develops due to the entry of the virus into the central nervous system of a child still in the womb. This usually causes seizures and fever. In this case, urgent treatment and hospitalization is necessary.

In childhood, the incubation period for infection ranges from 2 to 21 days.

Transmission routes

The most popular route of spread of the herpes simplex virus among children under the age of 12 months is airborne. Infection is also possible during childbirth. Of particular danger to the child is the infection of a woman in the second period of pregnancy, if timely and correct treatment has not been carried out.

Children under one year old are mainly infected with herpes if parents do not follow the rules of hygiene. This is due to the fact that the infection can spread through the use of the same dishes, towels, and children's toys. Also, a person who is in the stage of relapse, a secondary manifestation of the disease, can infect a baby with a labial type of herpes.

Diagnostics

The appearance of the disease can be determined visually. Its distinguishing symptoms are vesicles on the skin with liquid contents, as well as changes in the behavior of the baby.

To make sure the diagnosis is accurate, doctors order tests of urine, nasal mucus, blood, and cerebrospinal fluid.

Principles of treatment

Treatment is prescribed only by a doctor after the necessary diagnosis. To exclude the possibility of developing neurological diseases, as well as death, a complete treatment is required, which consists in an integrated approach.

First, it is necessary to use drugs that reduce the activity of the virus and its ability to reproduce. Acyclovir is usually prescribed, which should be applied externally, treating rashes on the child's body.

Secondly, you should use pills for herpes. If the herpes complications described above occur, intravenous administration of Acyclovir is recommended.

Thirdly, a special place is given to improving immunity. For this, interferon is used in the form of injections. For infants, Neovir or Cycloferon may be prescribed.

Secondary herpes

The virus does not disappear from the human body, and during the weakening of the immune system it manifests itself with relapses. Relapses can flare up on different parts of the baby's body:

• On mucous membranes and skin.
• On the genitals.
• In the eye area.

Complications caused by relapse

If timely treatment of herpes was not carried out, the baby may experience complications, consisting in:

1. damage to the organs responsible for vision and hearing;
2. disruption of the cardiovascular system;
3. diseases of internal organs;
4. circulatory disorders and blood composition.

In most cases, these complications can lead to death. Of particular danger is a relapse that has arisen on the genitals.

To eliminate the risk of herpes in the baby, the parents of a woman before pregnancy should adhere to a healthy lifestyle, and also avoid sexual intercourse with infected people.

It is from the mother that the level of immunity of the child and his ability to resist the herpes virus depends.

In the first day of life, the crumbs require a thorough regular examination of its skin in order not to miss the pathological symptoms. It is also necessary to constantly monitor the behavior of the baby. If you have any concerns, you should consult your doctor.

Contact of the baby with people who may be carriers of the virus should be excluded, especially contact with people who have a rash on the lip should not be allowed.

Maintaining cleanliness in the room where the child grows, as well as hardening it, will help to avoid infection.