Mother tells about her child's journey of treating meningitis caused by chickenpox
5 days before admission, baby Mam, 7 years old, in Do Luong commune, Nghe An had blisters and high fever. He was diagnosed with hand, foot and mouth and was monitored at home.
The family took the baby to a private clinic and was informed that he had hand, foot and mouth disease, took medicine and monitored him at home. Five days later, the blisters began to dry but the baby had a fever of over 39 degrees Celsius and did not respond to medication. Children are lethargic, convulsing, vomiting, talking loudly and constantly pinching their ears and pulling their hair. The family immediately took the baby to the hospital.
Test results confirmed that the baby had chickenpox and the cerebrospinal fluid showed signs of inflammation. The doctor diagnosed chickenpox-related meningitis and treated it aggressively with intravenous antiviral, anti-inflammatory, and anti-cerebral edema drugs.
After a week, the baby's fever was gone and he no longer had seizures, but he still had to be monitored. While taking care of her child, Ms. Thuy Linh, 33 years old, the baby's mother, also had fever, fatigue and blisters all over her body. The doctor determined that she had chickenpox after close contact with her child. After 20 days of treatment, the baby's cerebrospinal fluid results returned to normal, the risk of neurological sequelae was low and he was discharged from the hospital.
Dr. Nguyen Tien Dao, Medical Manager, VNVC Vaccination System, said that chickenpox and hand, foot and mouth disease can both start with fever, fatigue, anorexia and blister-like lesions. Therefore, the two diseases may be difficult to distinguish if symptoms are minimal or appear in atypical locations.
Chickenpox often causes an itchy rash, progressing from red patches and papules to blisters and then scabs. Lesions often appear first on the face, scalp or body, then spread to the limbs and can grow in many waves, so there are many types of lesions on the skin at the same time.
Hand, foot and mouth often causes painful mouth ulcers, accompanied by a rash on the palms of the hands and soles of the feet; Lesions can also appear on the buttocks, arms, and legs. However, the location of the rash is not always typical. Parents should not just look at skin lesions to determine the disease themselves or use medicine at home.
Most cases of chickenpox are mild, but the disease can still cause skin infections, pneumonia or neurological complications such as encephalitis. The patient needs to be re-examined if the fever is high or prolonged, difficult to awaken, confused, difficult to walk, stiff neck, vomiting a lot, difficulty breathing, or the skin around the blister is red, hot, painful, and oozing pus.
Hand, foot and mouth usually heals on its own after 7-10 days, but children can become dehydrated due to mouth pain and stop eating and drinking. Children should be examined if they cannot eat or drink, have a fever that lasts more than three days, or have symptoms that get worse or do not improve. Children who have had hand, foot and mouth disease can still get it again because the disease can be caused by many types of intestinal viruses.
According to Dr. Dao, the risk of disease transmission is noteworthy when children return to school, especially in preschool and kindergarten classes. Children have close contact and share toys, tables, chairs and many surfaces in collective spaces.
The chickenpox virus is transmitted mainly through air, respiratory secretions or direct contact with fluid from blisters. Meanwhile, the hand, foot and mouth virus can be transmitted through nasopharyngeal fluid, saliva, fluid from blisters, feces and virus-infected surfaces. Because transmission routes are different, disease prevention requires a combination of measures.
Parents should instruct children to wash their hands with soap, not share personal items, limit close contact with people who are sick, and clean toys and frequently touched surfaces. Children who have a fever or have symptoms suggestive of illness should stay away from school and be monitored and examined appropriately.
When a child has a rash, parents should note the time of appearance, location, speed of spread, level of itching or pain and accompanying symptoms. Do not pop the blister yourself or give your child medicine for unknown indications. If the condition changes rapidly or signs of neurological or respiratory abnormalities appear, the child needs to be taken to a medical facility.
Vaccine is one of the measures to prevent chickenpox. Vietnam currently has 3 single varicella vaccines and one combined vaccine to prevent measles, mumps, and rubella. Children and adults who have never had the disease or have not been fully vaccinated need to be evaluated by a doctor and advised on an appropriate vaccination schedule. People who have had chickenpox can still develop shingles later because the Varicella Zoster virus exists latently in the body.
People with shingles do not transmit shingles to others, but can transmit Varicella Zoster virus to someone who has never had or received the chickenpox vaccine, causing this person to get chickenpox. Therefore, people with shingles lesions need to cover the rash area and limit contact with children who are not immune. Adults in the group recommended to receive the shingles vaccine should proactively consult a doctor to prevent the disease and reduce the risk of transmitting the virus to children who are not immune.
The hand, foot, and mouth vaccine due to EV71 has been licensed for circulation in Vietnam by the Ministry of Health. VNVC is promoting procedures to deploy protective vaccination for children. The vaccine helps prevent the EV71 virus strain that causes dangerous hand, foot and mouth disease and has the ability to cross-protect with different subtypes, helping to reduce the risk of disease and reinfection. This vaccine only prevents disease caused by EV71, not all viruses that can cause hand, foot and mouth disease. Therefore, hand hygiene, surface cleaning and early symptom detection still need to be maintained.
Before the new school year, parents should review vaccination history to detect missing shots, insufficient doses, or needing booster shots. Compensation injections need to be based on age, medical history, health condition and doctor's instructions.
Dr. Dao noted that vaccination does not replace monitoring disease progression. When a child has a fever with a rash, it is important to recognize changes in perception, movement, breathing, eating and taking the child to the doctor promptly.
