Causes rubella. Rubella - symptoms, signs, diagnosis and treatment of the disease

This disease is difficult to endure in adulthood. It is especially dangerous during pregnancy. Children get sick easily, acquiring immunity for the rest of their lives. Malaise due to infection has symptoms similar to ARVI. It is very important to know the signs unique to this disease.

Main symptoms of rubella

Viral disease begins in acute form. The infection spreads through airborne droplets, but the infected person does not know about it for about ten days until the first signs appear. Throughout this period he poses a threat to others. The disease often occurs in children, but in adults who were not ill in childhood, it is painful. The most dangerous thing is infection during pregnancy, which leads to pathologies in the development of the fetus.

Viruses that enter the body infect the skin, lymph nodes, and embryonic tissue. Penetrating into the blood, they reach small capillaries, which burst when damaged - this is how a rash appears. What does rubella look like? The rash goes through the following stages very quickly:

are formed first on the face;
descend down the body;
cover the buttocks;
cover the back;
appear on the oral mucosa;
affects the flexures of the limbs.

The rash appears small round spots red-pink color, having a diameter of up to 4 mm. Unlike other types of infections, they do not rise above the surface of the skin and are not filled with fluid. At the same time, the rashes can itch, causing inconvenience. They appear after signs similar to ARVI. A special manifestation of rubella is the absence of a rash on the feet and palms. These accumulations pass quickly - after five days there are no traces left on the skin. This is what the rash looks like in the photo.

What are the main symptoms of rubella? In addition to skin rashes, inflammation of the lymph nodes located in the back of the neck occurs. They become painful and increase in size. This is especially felt when pressing. The disease is accompanied by:

swelling of the joints;
severe headache that cannot be relieved by medication;
temperature rise.

The first signs of rubella

An infected person may not experience any symptoms during the incubation period, which lasts up to 23 days. How does rubella begin? Everything is very similar to a viral infection. The following symptoms of rubella are observed, reminiscent of ARVI:

fever;
runny nose;
malaise;
elevated temperature;
dry cough;
muscle pain;
sore throat.

An infected person poses a threat to the environment, being a carrier of the virus, but initial stage this can only be revealed through testing. How to identify rubella? Infection can be diagnosed in adults and children when signs appear:

enlargement and tenderness of the lymph nodes located on the back of the neck;
skin rashes.

Rubella without symptoms

Very often, an infectious disease occurs latently without much pronounced signs. Rubella passes without symptoms in mild form. For atypical appearance development is characterized by the absence of rashes, everything looks as usual viral infection. A sore throat appears and the temperature rises. Enlarged lymph nodes may cause suspicion, but an accurate diagnosis can only be made through tests.

Rubella - symptoms in children

The disease in children passes easily and does not require special treatment. It is only necessary to isolate the patient from others. This disease does not occur until the child is one year old - the immunity transmitted by the mother is strong. To protect children from infection, they are vaccinated at the age of 6 years. Girls, as expectant mothers, get another one - at the age of 13. If the baby has suffered from the disease, then immunity will remain for life.

The onset of the disease looks similar to a cold and appears two weeks after infection. Observe signs of rubella in children:

weakness appears;
muscle pain is observed;
temperature rises to 38;
a runny nose and cough develops;
conjunctivitis occurs;
enlarged lymph nodes in the back of the neck;
a rash appears that looks like in the photo.

Measles rubella in children - symptoms

One of the outdated names for an infectious disease is measles. After incubation period it develops in an acute form. When does it start measles rubella in children - symptoms manifest themselves as fever. The rash spreads quickly and is accompanied by itching. Children often tolerate the disease without complications. Only in isolated cases do the following occur:

otitis;
angina;
arthritis;
pneumonia.

Rubella - symptoms in adults

The disease is difficult to tolerate in adulthood. All symptoms are pronounced, but appear after the end of the incubation period. Signs of rubella in adults begin with severe headaches that are difficult to eliminate with conventional medications. They are accompanied by an increase in temperature in the evenings. Symptoms occur:

fever;
dizziness;
cough;
chills;
lacrimation;
enlarged liver, spleen;
conjunctivitis;
enlarged cervical lymph nodes;
photophobia.

The rash develops quickly, and individual points merge into continuous masses. It lasts up to five days, but the accompanying itching causes trouble. Features of the disease in adults - high probability the appearance of complications. In this case, the following may develop:

cerebral edema;
meningitis;
irregularities in work cardiovascular system;
rubella encephalitis;
arthritis;
nervous system disorders;
convulsions;
impaired coordination of movements;
decreased intelligence.

Symptoms of rubella measles - in adults

Starting from adolescence, the disease becomes much more severe. If an adult develops rubella measles, the symptoms are specific. Redness of the pharynx appears, itching in the throat occurs. The reason is the formation of a rash on the surface of the cheeks from the inside, the oral mucosa. The manifestations of infection vary skin. Rashes from individual points merge into continuous areas. In the photo it looks like this.

Symptoms of rubella in pregnant women

Contracting this infection during pregnancy poses a huge danger. Viruses damage embryonic tissue, thereby disrupting the attachment of the fetus. The infection disrupts its development, causing severe pathologies. A woman can become infected if she did not have the disease in childhood or was not vaccinated. If infected in the first trimester, when the basic life systems of the child are formed, the pregnancy is terminated.

To exclude severe consequences, women expecting a child are tested for the presence of this virus. How does rubella manifest in pregnant women? The rash spreads very quickly and disappears just as quickly. When infected, the following are observed:

long-term preservation elevated temperature;
dry cough;
swelling, joint pain;
sore throat;
headache;
weakness;
enlarged lymph nodes on the back of the head, pain when pressed;
drowsiness;
redness of the throat;
decreased appetite.

Video: what is rubella and how does it manifest itself?

As a rule, rubella occurs easily and without any peculiarities. Not the least of this is the absence of epidemics for recent years belongs to universal vaccination. But despite powerful prevention, one must remember about the disease, because one of its most severe complications leads to fatal outcome.

What is rubella? How does the disease manifest itself and what are its features compared to similar diseases? Who is more likely to get sick and how does the immune system behave during the development of infection? Is rubella dangerous in our time and how to treat it in case of infection?

What is rubella

This infection was first mentioned in medicine in the 16th century, but the study of the virus proceeded very slowly. Only two centuries later, the Austrian scientist Wagner clearly described the differences between this infection and measles and scarlet fever. Shortly before the outbreak of World War II in 1938 in Japan, scientists proved viral nature diseases. And in 1961, the causative agent of rubella was isolated.

The disease haunted all pediatricians. Several decades ago, infection ranked third in the ranking of diseases, causing rash in children. It was widespread and it was considered normal to get it in childhood. And since full treatment have not been invented until now - complications were observed in almost every sick child.

In the middle of the 20th century, it was proven that the rubella virus leads to disorders proper development children when their mother becomes infected during pregnancy.

But in the last century, since the invention of a vaccine against the disease, doctors breathed a sigh of relief. In countries where 100% of the population is vaccinated, the disease has almost been forgotten, and doctors study rubella according to medical literature.

Causes and methods of infection

Rubella cannot be contracted from animals; it does not mutate thanks to them. Only a sick person serves as a reservoir for the virus. The infection is classified as anthroponotic, that is, it develops only in the human body. How is rubella transmitted? Mainly by airborne droplets. Another route of transmission is transplacental, when the virus passes from an infected mother through the placenta to the child. This is the cause of congenital rubella.

The microorganism is unstable in the external environment. There are several features of the virus and the disease that make rubella one of the relatively mild infections.

In this case, the disease resembles a time bomb. Why is rubella dangerous? - its complications are often much more serious than the acute infection. Congenital rubella and complications from the nervous system are superior in course, manifestation and consequences to many infectious diseases.

Routes of entry of the rubella virus and effects on the body

The mucous membranes are the first barrier to the virus entering the body. Once on the mucous membrane, the rubella virus is absorbed and rushes to the lymph nodes, so one of the first signs of rubella in a child is enlarged lymph nodes.

At the next stage, the virus penetrates the blood and skin. The next known and common manifestations of rubella are rash and itching. The microorganism has a special relationship with embryonic tissues - that is, when a pregnant woman is infected, the virus penetrates the placental barrier and affects many systems of the unborn child. In many cases congenital disease is considered as a slow-acting infection, because often the child after birth experiences suppression of the development of organ systems.

The virus also impairs the functioning of the immune system and affects nervous system.

Symptoms

How does rubella manifest? During the incubation period, the disease will not manifest itself in any way, and it may sometimes last about three weeks and even more. Cases have been described in medicine when this stage of disease development was 24 days.

Then the symptoms depend on the period of development of rubella:

the incubation period of rubella in children lasts from 11 to 24 days;
prodromal period - about three days;
period of rashes;
permit period;
consequences of infection.

headache, dizziness

Rubella symptoms change in stages.

Weakness, headaches and dizziness.
The first symptoms of rubella in children include malaise, mood swings, and loss of appetite.
Sometimes muscle pain also appears in the joint area; wrist and ankle pain is more common.
IN in rare cases The child is bothered by nasal congestion.
It is possible that body temperature may rise for several days, but it does not exceed 37.5 °C.
At this time, the baby complains of a sore throat.
Rubella manifests itself as slight redness of the eyes.
How do you know when rubella starts in children? The cervical lymph nodes are enlarged. The occipital and posterior cervical lymph nodes become more visible.

All this manifests itself within 1–3 days. The first stage of the disease proceeds like many other infections. At this time, it is difficult to suspect the presence of the rubella virus in the body. And only information about contacts helps in making a diagnosis, which is extremely rare.

Clinical manifestations at the height of the disease

What does typical rubella look like in children? The disease manifests itself more actively during the third period, when a rash appears. What other symptoms accompany this period of infection development?

From this moment, body temperature jumps to 38.5 °C, but more often stays within 37–38 °C.
This is the time of active development of catarrhal phenomena - redness of the throat, enlarged tonsils, rhinitis.
Often a child is bothered by a cough.
A rash in children with rubella in the form of small red spots, abundant in size from 2 to 4 mm, is not prone to merging, unlike other infections, appears immediately on the face and neck, after which very quickly without a certain sequence occurs throughout the body. Most of the stains are on the back and buttocks, on the back of the arms and legs, but the palms and feet remain absolutely clean.
Lymphadenitis (inflammation of the lymph nodes) is more actively expressed during this period of the disease, which persists until the disease is completely resolved.

Does the rubella rash itch? - yes, minor itching persists. After just three days, the rash disappears without a trace, leaving no pigmentation, scars or other changes on the child’s skin. But according to doctors, typical symptom Rubella is not spots, but enlarged lymph nodes. In almost 30% of cases there may be no spots, but lymphadenitis is always present.

When a child is infected intrauterinely after birth, various developmental defects develop. In the first trimester, the number of complications after an illness is greatest and reaches 60%.

Complications of rubella

Ideally, rubella goes away without a trace. But in fact, no one can predict the further course of the disease. Even after a few months, she can present many surprises.

Here are the most common and severe ones: possible complications.

Diagnosis of rubella

Diagnosis is sometimes difficult, because about a third of cases of disease in children after a year progress slowly or without the usual signs, such as a rash on the body.

What helps in correct positioning diagnosis?

In most cases, to special methods studies are rarely used, since many of them are expensive or require a long time for the growth of the pathogen. If a focus of infection is detected, rubella is tested for antibodies using HRA (hemagglutination inhibition reaction); the minimum protective titer should be 1:20, otherwise the child must be vaccinated.

In addition to increasing peripheral lymph nodes and the appearance of a rash, there are no clear external signs development of rubella, looking at which one can confidently make a diagnosis. A mild or asymptomatic course of infection baffles even experienced doctors. Therefore, it is important to know about diseases that are somewhat reminiscent of rubella.

papules with pseudorubella

The first disease to remember is pseudorubella. There are several names for this disease: roseola infantile, sixth disease and exanthema subitum. This infection has nothing in common with ordinary rubella. The viruses that cause these two diseases belong to different families. The cause of the development of pseudorubella is the herpes virus types 6 and 7. In adults, this microorganism causes the syndrome chronic fatigue, and in children roseola. Unlike rubella, the body temperature can rise to 40 °C, catarrhal manifestations are completely absent, and the rash, despite the fact that it also spreads, has the appearance of papules (small-sized elements with liquid inside). The peak appearance of false rubella in children is the end of spring, the beginning of summer, which coincides with classic rubella. An analysis for the presence of the herpes virus in the body helps to distinguish diseases.

What else should be used in the differential diagnosis of rubella:

With allergic reactions for medications;
with measles;
infectious mononucleosis;
adenovirus infection.

You can only get confused in diagnoses if the course of these diseases is atypical or asymptomatic.

Treatment of rubella

Treatment of uncomplicated rubella in children begins with general recommendations.

How to treat rubella in children at home? Basically, the above measures are sufficient; the infection does not always require specific therapeutic effects. Sometimes therapy comes down to just a prescription symptomatic drugs.

Symptomatic treatment of rubella

What medications are prescribed to treat rubella?

Severe course of the disease or the development of serious complications, such as panencephalitis, is an indication for hospitalization in infectious diseases department or intensive care. In these cases, you should not wait for a doctor, you need to call ambulance, because the quantity deaths with rubeolar encephalitis it reaches 30%. But in most cases, the prognosis for rubella is favorable.

Anti-epidemic measures for rubella

Despite universal vaccination, which is still the most effective measure prevention, outbreaks of the disease occur every 10 years in various regions.

What anti-epidemic measures are taken for rubella?

General events in foci of infection are ineffective, since the incubation period of the disease is long and there is hidden forms diseases.
According to some sources, a child becomes contagious a week before the rash appears and 1–2 weeks after it. In most cases, on the fifth day after the onset of the rash, the virus is not released into the environment. Plus, in order to become infected, you need long-term contact with someone who is sick. Therefore, the child is isolated until the fifth day from the moment the rash is discovered.
No quarantine is announced.
Is it possible to walk with rubella? It is better to avoid walking until the fifth day inclusive from the moment the rash appears, so as not to infect others. At this time, the room where the patient is located is frequently ventilated. If the child lives in the private sector or falls ill while staying at the dacha, walks are allowed within the designated area.
Is it possible to bathe a child with rubella? If the disease is mild, there are no complications or severe itching, you can swim, but it is not advisable for the child to stay in the water for a long time. Swim for 5–10 minutes or warm shower- optimal evening exercise. There are often foreign impurities in the water that will aggravate some symptoms. During the period of illness, you should not swim in reservoirs until complete recovery.

Prevention of rubella

For today the only in an efficient way Rubella prevention is vaccination. Almost from the first days of vaccine development, it became part of National calendar vaccinations. In countries where high level immunization of the population against rubella, the disease occurs only if the virus is imported from other regions.

Today, killed and live attenuated vaccines are used to prevent infection. According to the vaccination calendar, the first injection of protective antibodies against rubella is given to children at the age of 12 months. Revaccination occurs at 6 years of age. In some cases, based on indications or at the request of parents, girls aged 12–14 years are vaccinated to protect the body from infection. This is necessary if girls plan pregnancy at an older age, then the likelihood of congenital rubella in children will decrease.

Nowadays, three-component vaccines are mainly used, when the baby is vaccinated according to the calendar at 12 months with simultaneous vaccination against mumps and measles. Single-component drugs are also administered to protect specifically against rubella.

Can a vaccinated child get rubella? Such cases are possible if more than 10 years have passed since the last vaccination (although according to some sources the vaccine protects for up to 20 years) or you have only had one vaccination against rubella, then the protection is not yet 100%. If vaccination was carried out with a low-quality vaccine, protection may also not work.

Frequently asked questions about rubella

Rubella is not a dangerous disease and it can be defeated not at the moment of infection, but long before that. Basic preventive measures will help you cope with the disease and its consequences forever. Hand washing and timely cleaning of premises play an important role in this. But still, the main function in the fight against rubella belongs to immunization through vaccinations.

Rubella is infectious disease viral origin, which has a very high level of contagiousness, that is, infectiousness. Its main signs are the appearance of elements typical of rubella on the skin, symptoms of moderate intoxication of the body, changes in the blood picture and enlargement of regional lymph nodes.

There are the following forms of rubella:

acquired- When healthy child becomes infected from a patient;
congenital– with it, a sick child receives the virus in utero from the mother and secretes it for 12-24 months after birth.

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Rubella in children can occur either in a mild form or with complications, most often of a neurological nature (rubella, arthritis, etc.). The disease is quite common, its outbreaks are recorded every 4-5 years in groups of children and adults. It is also characterized by seasonality, and the peak of activity occurs in winter. Children's body very susceptible to the rubella virus, especially between the ages of 1 and 7-10 years. Infants up to 12 months have innate immunity. Those who have already had this disease have strong immunity for the rest of their lives.

Rubella infection occurs from a sick person who is the source of the viral infection.

The disease is transmitted in the following ways:

airborne (kiss, conversation);
vertical route of infection (transplacental) - from the sick mother to the fetus;
contact – when using shared toys and personal hygiene items.

In total, the patient is contagious to others for 21-28 days.

Please note: It should be taken into account that a person with rubella is contagious both during the incubation period - 7-10 days before the rash, and after the onset of symptoms - about another 3 weeks.

Virus carriers who do not show signs of illness and are healthy can also be carriers of the disease.

Important: special danger this disease occurs during pregnancy in the first trimester. Rubella causes in the fetus during this period birth defects severe form, up to his death.

Pathogenesis

Rubella gets into healthy body through penetration through the respiratory tract and mucous membranes. By hematogenous route the virus spreads and penetrates into lymphatic system, where it multiplies in the lymph nodes for about 7 days. Clinically, this manifests itself as a noticeable increase in the size of the nodes themselves. Catarrhal phenomena may also be observed - sore throat, dry nonproductive cough, lacrimation. A rash begins to appear in the background, which looks like small spots of oval or round shape pink-red color. IN childhood This disease is much milder than in adults.

Please note: at laboratory research blood and nasopharyngeal swab, the virus can be detected 8 days before the rash appears. After the rash, the virus is diagnostically confirmed by isolating it from a stool or urine test.

Rubella is caused by an RNA virus of the Rubivirus genus, which belongs to the Togaviridae family. Virus particles containing pathogenic RNA have very small sizes – 60-70 nm. The rubella pathogen dies at a temperature exceeding 56°C for 60 minutes, but in a frozen state it can live for many years. Once on mucous membranes or damaged skin, the virus begins to rapidly multiply under favorable conditions. It accumulates in the lymph nodes, spreads with the blood to all organs and systems, eventually settling in the skin.

Rubella in children is much easier than in adults. The disease occurs in 4 stages:

incubation period– takes on average from 7 to 21 days;
period of catarrhal phenomena– with it there are often no pronounced symptoms of rubella, but there may be a runny nose, redness of the nose, enlarged lymph nodes (this period lasts 1-3 days, no longer);
the height of the disease– at this time, exanthema and rash begin to appear (small, pink or red, with clear and smooth edges), in some cases it can merge, which often happens in children.
convalescence period(recovery).

It is worth separately clarifying the location and type of rubella rash, as these are its characteristic signs.

When differentiating the disease, pay attention to the following points:

with rubella, skin rashes are located in the back, face, buttocks, neck, scalp, inner flexor surface of the knees and elbows, behind the ears;
with rubella there is no rash on the feet and palms;
the rash looks like round elements with a diameter of up to 5 mm;
the body becomes covered with a rash within 24 hours;
elements on the oral mucosa are not excluded;
3-5 days after appearance, the rash disappears and leaves no marks on the skin;
There is no peeling or pigmentation left after rubella.

Upon examination, the doctor notices enlarged lymph nodes of the following groups: mid-cervical, occipital, posterior cervical. They are about the size of a large pea, and they remain that way even when the rash goes away.

The general condition of the child is slightly impaired, parents may observe lethargy and malaise. Body temperature usually does not exceed 38 °C and remains at 37-37.5 °C. Older children with rubella complain of pain in the joints, muscles, headache. Conjunctivitis may develop in parallel with the rash. mild degree, rhinitis and cough. Most often during examination oral cavity there is looseness of the tonsils and exanthema on the mucous membrane soft palate(pale pink spots).

Please note: V In some cases, erased symptoms of rubella occur, when the signs of the disease are very mild. In this case, laboratory tests will help make a correct diagnosis.

Diagnostics

Sometimes confirming the diagnosis of rubella can be difficult. In some cases it is confused with scarlet fever or measles. This is why it is important to visit a doctor who will objective examination. If a pediatrician or infectious disease specialist doubts the correctness of the diagnosis, then additional tests are prescribed.

Examination for rubella consists of the following points:

Inspection. The doctor will notice a characteristic rubella rash on the child’s skin, which almost instantly spreads throughout the body, enlarged lymph nodes and catarrhal symptoms.
Laboratory research:

Urinalysis. It contains a large number of leukocytes.
. With rubella, there is an increase in ESR, the level of monocytes and leukocytes, and sometimes the appearance of plasma cells is possible.
. Its task is to determine the stage of rubella and the presence of antibodies to it in the blood.

Important: doctors prescribe additional research to differentiate rubella from enterovirus, and allergies to medications.

Complications of rubella

In fact, with rubella complications are quite rare occurrence, and they usually occur in children who suffer from immunodeficiency.

Among possible manifestations The following pathologies are distinguished:

angina;
eustacheitis;
arthritis;
thrombocytopenic purpura;
meningoencephalitis;
orchitis

The cause of complications is severe rubella, lack of treatment, non-compliance medical prescriptions, secondary infection bacterial nature against the background of reduced immunity.

Complications of rubella during pregnancy are distinguished separately. The disease mainly affects the fetus, causing various malformations, sometimes incompatible with life. The mother’s body does not suffer, but the virus overcomes the placental barrier and provokes spontaneous abortion and fetal deformities.

Treatment for rubella is symptomatic, since there is no specific treatment. If there is no critical increase in body temperature, then hospitalization is not required, and the patient is treated at home with the permission of the doctor, but subject to bed rest.

Treatment for rubella includes:

when connecting a secondary bacterial infection;
vitamin and mineral complexes to support the body during illness;
are prescribed if the rash, itching and pain are severe;
for conjunctivitis, albucid is used;
physiotherapy in the form of UHF and dry heat is prescribed in case of painful and enlarged lymph nodes;
it is important to limit the load on the child’s vision as much as possible, that is, to minimize staying in front of the monitor, watching TV, computer games, reading;
an antipyretic is required only if the temperature exceeds 38°C, which is extremely rare with rubella;
sprays are used locally for sore throat;
stuffy nose is treated with rinsing saline solutions and the use of nasal drops;
herbal medicine is recommended only with the permission of a doctor (raspberries for fever, rose hips and calendula for a general strengthening effect, etc.).

Treatment of congenital rubella in children involves the use of etiotropic drugs in the form recombinant interferon. With it, Re-aferon, Viferon are usually prescribed. If meningoencephalitis develops in parallel, then corticosteroid hormones are also indicated. Interferon has a powerful antiviral effect and activates the reduced one. At the cellular level, it increases the phagocytosis of macrophages, which successfully fight the virus. Rubella is systemic viral pathology, therefore, it requires the administration of interferon both parenterally and orally up to 3 times a day. This is due to the fact that these drugs penetrate the body at the tissue level and are then quickly inactivated.

The main prevention of this disease is vaccination. It is definitely worth taking not only for children, but also for those women who have achieved childbearing age, but have not had rubella before. Especially if they are planning a pregnancy in the near future. To prevent the spread of the virus, a child with rubella should be isolated for up to 7 days after the rash appears. Quarantine in children's team, which was visited by a sick child, are not taken. In this case, it is imperative to protect the patient’s contact with pregnant women.

One of the most common infections of viral etiology is rubella. This disease is usually mild and rarely accompanied by complications. On the other hand, infection of a pregnant woman represents serious threat for the health of her unborn baby. In some cases, the disease causes developmental defects in the fetus and its intrauterine death.

Description of the disease

Rubella is an infection of viral etiology, characterized by the appearance of rashes on the skin and moderate intoxication. The disease first appeared full description F. Hofmann in 1740. Only 140 years later, a unanimous decision was made to separate the pathology into a separate nosological group.

Today, the prevalence of the disease has decreased significantly. These results were achieved thanks to the population vaccination policy. Despite this, about 100 thousand new cases of infection are recorded annually. Every 3-4 years, the incidence rate increases and then declines.

and methods of transmission

Rubella is a disease of viral etiology. Most often it is diagnosed in children. Its causative agent is an RNA genomic virus with teratogenic activity. He is comfortable existing only in human body. In the external environment, it quickly dies under the influence of ultraviolet radiation, due to insufficient humidity or changes in pressure. In conditions low temperatures The virus lives for a very long time and can retain the ability to reproduce.

The source of infection is usually a person with pronounced (rarely erased) signs of rubella. A week before the rash and for another five days after, rubivirus is released into external environment. In epidemiological terms, children with a congenital variant of the disease are considered the most dangerous. In this case, the pathogen enters the external environment along with feces, saliva or urine for several months. Favorable conditions Organized groups serve for infection ( kindergarten, school). Therefore, patients are isolated immediately after the diagnosis of rubella is confirmed.

How is the infection transmitted? There are two ways of transmitting the disease - airborne and transplacental. The mechanism of development of this disease has not been thoroughly studied. The rubella virus enters the human body through mucous membranes respiratory tract. Then it begins its activity, settling on skin cells and lymph nodes. The body reacts to the introduction of agents by forming special antibodies. During illness, their volumes in the bloodstream constantly increase. After recovery, a person remains immune against this virus for life.

What does rubella look like?

The duration of the incubation period is about 15 days. Next after him catarrhal period- 3 days. In young patients, symptoms of damage to the mucous membranes of the upper respiratory tract appear very rarely. Adults usually complain of photophobia, severe headaches, runny nose, cough and lack of appetite. On the first day of the disease in 90% of patients against the background skin itching rashes appear. They look like small pink spots correct form that rise above the surface of the skin.

Rubella rash initially appears on the face, behind the ears and on the neck. Within 24 hours it rapidly spreads to other parts of the body. It should be noted that exanthema never appears on the soles and palms. Sometimes single spots are found on the oral mucosa. In 30% of cases, there are no rashes, which significantly complicates diagnosis. Other symptoms of this disease include slight increase temperature. Rarely do patients complain of muscle pain and gastrointestinal dysfunction.

Types of rubella

Depending on the route of infection, it is customary to distinguish two types of this disease:

Acquired rubella. This form of the disease is accompanied by multiple rashes throughout the body, but may have an atypical clinical picture. In 30% of cases, there are no symptoms at all, which makes diagnosis difficult and contributes to the spread of the epidemic. The disease is usually mild, and those infected are treated at home. Hospitalization is indicated only in case of complications.
Congenital rubella. This is very dangerous form diseases. In most cases, it is characterized by a complicated course. Among likely consequences disturbances in the functioning of the central nervous system, hearing and vision organs can be noted.

Considering the above facts, it is necessary to make one significant remark. Rubella disease in adults is diagnosed extremely rarely. The vast majority of people experience this disease in childhood, and the resulting immunity lasts for the rest of their lives. Currently, about 85% of women are immune to this infection by the time they reach reproductive age.

Medical examination of the patient

Confirming the diagnosis is usually not difficult. Initially, the doctor conducts a physical examination and pays attention to specific symptoms(we already told you what rubella looks like a little higher). The next stage of the examination is laboratory testing:

General blood test.
Assessment of immunoglobulin concentration.
mucus from the nasal cavity.

IN mandatory carried out differential diagnosis with measles, enterovirus infection, scarlet fever.

Basic principles of treatment

A person who already has rubella does not need emergency hospitalization. Special drugs has not been developed against this disease, it is only used symptomatic therapy. It is important for the patient to adhere to bed rest, eat and drink properly more water. In most cases, the rubella rash lasts only a few days. After recovery, the resulting immunity lasts for life. Sometimes the disease returns. Experts explain this phenomenon individual characteristics immune system.

Only if complications occur is treatment in a hospital setting indicated. Patients are prescribed immunostimulating therapy (Interferon, Viferon). To prevent the development of cerebral edema, hemostatic agents, diuretics and corticosteroids are used. During the convalescence stage, patients are recommended to take nootropic drugs to improve cognitive functions.

Why is rubella dangerous?

Complications from this disease are extremely rare. As a rule, they appear if a bacterial infection occurs. Rubella in this case is complicated by secondary pneumonia, sore throat or otitis media. In adult patients, lesions from the central nervous system cannot be excluded. This disease poses the greatest threat to women during pregnancy. This will be discussed later in the article.

Pregnancy and rubella

The consequences of this disease during pregnancy can affect his health. The virus penetrates the fetus through the placenta, affecting the endocardium and capillaries. Then the pathogen spreads to all organs of the child, where it begins to rapidly multiply. The most common complications of rubella in pregnant women include stillbirth and spontaneous abortion.

If the baby is nevertheless born, he may develop the following disorders over time:

heart defects;
exanthema;
jaundice;
myocarditis;
encephalitis;
mental retardation;
dystrophy.

Such complications lead to premature death baby in 30% of cases. About 70% of children die in the first year of life. Individual manifestations of the disease make themselves felt only in puberty. This autoimmune thyroiditis, diabetes, and growth hormone deficiency. In the blood infected child The rubella pathogen can remain active for several years. Specific treatment this disease modern medicine cannot offer.

Disease prevention

General preventive measures in areas of infection are ineffective. It is almost impossible to determine the presence of a virus in the body before its first symptoms appear. However, the sick person is isolated for 5-7 days from the moment the rash appears.

Specific prevention involves vaccination against three diseases simultaneously: measles, rubella, which is done a second time at 6 years of age, and the first time at the age of one year. Among the contraindications to vaccination are the following:

Can be combined with other mandatory vaccinations (against whooping cough, hepatitis B, polio, diphtheria and tetanus). Various drugs It is forbidden to mix in one syringe. In addition, it is advisable to place injections in different places. The only exception is the complex (measles-rubella-mumps) vaccination. At the age of 6, many children have it repeated. This revaccination helps develop immunity to three diseases at once. After the procedure, swelling of the skin and slight redness may be observed. Adverse reactions from the body include enlarged lymph nodes, nausea, runny nose, and general malaise. IN adolescence After vaccination, it is possible to develop arthralgia and polyneuritis, which go away on their own over time.

Rubella– spicy viral disease, manifested in the form of a small maculopapular rash, increased body temperature and enlarged lymph nodes throughout the body.

Rubella can be contracted at any age, but children from one to ten years of age are more likely to get it. Babies up to six months are protected innate immunity, so among this age category the disease is extremely rare.

Causes of the disease

Rubella is caused by a virus of the Rubivirus genus of the Togaviridae family, which is transmitted by airborne droplets. First, the virus penetrates the mucous membrane of the upper respiratory tract, then multiplies in the lymph nodes and enters the blood.

The incubation period of the disease lasts from ten to twenty-three days; an infected person begins to release viruses into the environment before the first symptoms of the disease appear.

The greatest number of morbidity cases is recorded in the cold season, often in epidemic outbreaks in children's groups. In adults, the disease is more severe and can lead to serious consequences, rubella is especially dangerous for. Those who have recovered from rubella develop lasting immunity to this disease.

Rubella symptoms

The incubation period of the disease can occur without any manifestations; the first symptom is most often a rash. The rash first appears on the face, gradually spreading throughout the body, mainly localizing on the back, buttocks, extensor surfaces of the legs and arms around the joints. The rash is pink, maculopapular, does not rise above the surface of the skin, and its individual elements do not merge with each other. In adults, the rash may merge. After the rash disappears after 2-3 days, there is no peeling or other marks left on the skin.
Simultaneously with the appearance of the rash, the temperature rises; in adults it can reach 40 degrees and is difficult to reduce.
Then comes lymphadenopathy - enlargement of the lymph nodes, sometimes they can become noticeably enlarged even before a rash appears.
Cough, runny nose, redness of the throat, conjunctivitis without purulent discharge, and photophobia appear. The mucous membrane of the mouth becomes covered with a small pinkish rash - enanthema.
In adults, pain in muscles and joints appears, sometimes dyspeptic disorders occur (nausea, bloating, discomfort in the stomach and intestines), and the liver and spleen may become enlarged.

Complications of the disease

Rubella in children is usually mild and without complications. In adults with reduced immunity, otitis media, inflammation of the lungs, can sometimes develop due to the addition of a bacterial infection. There are known cases of encephalitis and encephalomyelitis, but they are very rare. Arthritis can also develop as a result of rubella.

Complications during pregnancy

Rubella is most dangerous for pregnant women: it does not pose a threat to the mother, but the virus penetrates the placenta and affects the fetus. If infection occurs in the first trimester of pregnancy, fetal death occurs, and more later The child develops various severe disorders:

Heart defects.
Deafness.
Mental retardation.
Various developmental disorders of internal organs.
Eye lesions: cataracts, glaucoma, retinal detachment.
Deviations in the development of the skeleton and skull.

If pregnant women are infected with the rubella virus in the first three months of pregnancy, termination of pregnancy is indicated. If there has been contact with a person with rubella, but the pregnant woman has no symptoms of the disease, a serological examination should be carried out every ten days to identify the asymptomatic course of the disease.

If a woman is infected late in pregnancy, the baby may not have obvious abnormalities, but will be delayed in physical development from their peers.

Diagnosis of the disease

When making a diagnosis, it is very important to distinguish rubella from measles, scarlet fever, drug rashes and other types of rashes. The diagnosis is confirmed based on:

Epidemiological data.
The presence of rash, fever, catarrhal phenomena in the upper respiratory tract.
Enlarged lymph nodes, especially the occipital and posterior cervical ones.
Blood test: leukopenia, the appearance of plasma cells, an increase in the number of monocytes, and relative lymphocytosis are observed.
Serological methods: ELISA method enzyme immunoassay; This method is used to diagnose rubella in pregnant women.
PCR diagnostics: PCR – polymerase chain reaction, this analysis method is highly accurate and allows you to identify single cells of the virus before the onset of symptoms of the disease. The study is also carried out for early diagnosis diseases in pregnant women and intrauterine infection of the fetus.

It is important to carry out laboratory diagnosis of rubella in the following categories of patients:

In women planning pregnancy and who have not had rubella or who do not know for sure about past illness. The ELISA method allows you to determine the level of specific IgG: negative result research is a reason for vaccination against rubella, while planned pregnancy must be postponed for three months.
In pregnant women with suspected rubella infection and in adult patients with severe disease. The test results will serve as the basis for choosing further treatment.
In newborns, if there are signs of congenital rubella.

Treatment of rubella

Treatment of the disease is symptomatic, the main efforts are aimed at relieving the symptoms of the disease:

Bed rest is recommended.
Nutritious food, consumption large quantity liquids.
Vitamin therapy, herbal remedies to boost immunity.
Antihistamines to relieve itching.
Non-steroidal anti-inflammatory drugs to reduce fever and eliminate pain in muscles and joints.
If a bacterial infection occurs, antibiotics are used.
In late pregnancy, immunoglobulin is administered and other drugs are prescribed to protect the fetus.
At severe course sickness, the patient is hospitalized.

Disease prevention

Patients with rubella are isolated for 4–5 days from the onset of the rash at home; separation for persons in contact with patients is not applied.

Pregnant women who have not had rubella and have not previously received preventive vaccination, must be under constant monitoring doctor If you become infected with the virus in the first months of pregnancy, the doctor decides to terminate the pregnancy.

Rubella vaccine

Vaccination against rubella virus is included in the list mandatory vaccinations, exist combination vaccines and monovaccines.

The vaccine is administered to children at the age of one year, and at the age of six they are revaccinated.

If for some reason vaccination has not been carried out, it must be carried out for girls and women of childbearing age before pregnancy.

Those who have had rubella do not need to be vaccinated.

Contraindications for vaccination:

Oncological diseases.
Pregnancy.
Acute infectious diseases.
Exacerbation of chronic diseases.
Individual intolerance to the vaccine.

After the vaccine is administered, patients experience swelling and redness of the skin at the injection site, a slight increase in temperature, enlarged lymph nodes, and mild malaise. Symptoms do not require treatment and go away on their own.

Important to know

Sometimes when immunity decreases under the influence various factors Maybe reinfection rubella. Reasons for decreased immunity:

Stress;
Chronic viral and bacterial infections;
Alcohol and drug use;
Hormonal disorders;
Oncological diseases;
Suffered severe injuries with large blood losses;
Bone marrow dysfunction;
Helminthiases;
Operational disruptions digestive system and absorption of nutrients.