Signs and symptoms of rubella. How long does a rubella rash last?

Diseases such as rubella, measles, chicken pox, scarlet fever have been known since ancient times. They belong to infectious processes that are highly contagious. These diseases can overtake a person at any age, but are most often found in babies. Childhood infections are widespread throughout the world. Currently, the incidence of these pathologies has decreased, since compulsory vaccination has been introduced into pediatric practice. However, they are still dating. One of the pathologies that parents and doctors often encounter is the so-called "rubella measles" in children. You can suspect this disease by high fever and rashes on the baby's skin. Previously, when these symptoms appeared, the diagnosis was made: measles rubella in children. In modern medicine, this concept is not used, since it combines two different infections.

Epidemiological characteristics of the disease

Rubella is one of the most common viral infections that is known in all countries. Its incidence depends on a number of factors. First of all, this is age: most often it occurs in children between 2 and 9 years old. In addition, the incidence increases significantly in winter and spring. Rubella can only be contracted through direct contact with a carrier. Ways of transmission - airborne, parenteral, vertical (from mother to child). Due to the fact that the infection is transmitted during stay with a sick person, another factor is the location. In large cities, the rubella virus spreads much faster than in villages. The disease is not dangerous for people with normal immunity and passes within a few weeks, leaving no consequences. However, the rubella virus has a harmful effect on the body of pregnant women, which is transmitted to the fetus. Terrible consequences of infection are miscarriages in the early stages and malformations in children who become infected in utero in the second and third trimesters.

Cause of rubella

To have an idea of ​​how rubella begins in children, you need to know about the causes of its occurrence. This disease has a specific etiology. Rubella is caused by a virus of the Togaviridae family. It is characterized by low stability in the external environment. The virus dies under the influence of high temperature and chemical compounds. This explains why rubella cannot be transmitted through household items. The pathogen has a spherical shape, the genetic information about the virus is in the form of RNA. The infection is highly contagious, however, there are factors that contribute to the rapid development of rubella. First of all, it is a weakening of the immune system. Also, the risk of morbidity increases when you are in poorly ventilated areas.

Actions of infection in the body

Signs of rubella in children do not appear immediately. This is preceded by an incubation period during which the virus exerts its effect on the body. The place through which it penetrates is called the entry gate of infection. Most often they are the respiratory tract. The virus enters the nasal or oral cavity by inhalation of the air in which it is contained. It then settles on nearby lymph nodes and multiplies. When its concentration becomes sufficient, it penetrates the blood vessels and spreads throughout the body. This condition is called viremia. The virus stays in the blood for 10-14 days, this time coincides with the incubation period and the first week of the manifestations of the disease. The immune system then produces antibodies that neutralize the pathogen. Due to the fact that the virus has a tropism for the tissues of the lymph nodes and skin, the main signs of rubella in children are observed in these organs. After the illness, a strong immunity is formed, so secondary infection with this virus is impossible.

Symptoms and signs of rubella in children

This disease can occur both with a pronounced clinical picture and asymptomatically. This course of infection is called virus carrying and occurs in people with good immunity. Signs of rubella in children are most often obvious, since at this age the defenses are not yet fully formed. This is especially true for children under 3 years of age. In order not to miss the disease, parents often ask the question: "What does rubella look like in children?" You should know that the first 2-3 weeks the virus does not manifest itself in any way, at this time antibodies begin to be produced. Symptoms of "rubella measles" in children (as the infection used to be called before) occur acutely with a rise in body temperature and signs of catarrh of the upper respiratory tract. There is a sore throat, nasal congestion, general weakness. Subsequently, rashes on the skin join. First of all, they appear on the head, then descend to the upper half of the body, after which they spread throughout the body. The rash disappears after 3 days, leaving no defects on the surface of the skin.

Rubella differences in young children

Signs of rubella in children under one year of age are somewhat different from the symptoms that are observed in older babies. This is due to an immature immune system. Infants tolerate the disease more severely, so the signs of rubella in children under one year old are not immediately recognizable. In the first place they have an intoxication syndrome, that is, general weakness, fever, tearfulness, vomiting can be observed. Children often refuse to breastfeed, are capricious or, conversely, apathetic. The characteristic symptoms of rubella in babies under 1 year of age may appear partially, for example, only with a rash or only with catarrhal phenomena. In some cases, the disease at this age can become chronic.

Methods for diagnosing rubella

Only an infectious disease specialist can make a diagnosis of rubella. To do this, you need to know whether the child had contact with the virus carrier, whether he attends a kindergarten, or whether one of the relatives was sick. Rubella can be suspected by characteristic clinical symptoms (rash, signs of a cold, swollen lymph nodes). In addition, it is necessary to detect the causative agent of the disease, for this, swabs are taken from the nose and throat and a bacterioscopic analysis of the material obtained is performed. In modern laboratories, an immunological study is also carried out, thanks to which it is possible to obtain a titer of antibodies to the virus, as well as to find out whether the child had this infection or not (by the presence of IgG).

What diseases should rubella be differentiated from?

Rubella is often confused with infectious diseases such as measles, scarlet fever, or chicken pox. In order to make a correct diagnosis, it is necessary to know the differences between the symptoms of these pathologies. It should be remembered that the first sign of rubella is an increase in the submandibular, parotid or posterior cervical lymph nodes. It can be observed already in the incubation period. Another feature is the rubella rash in children. It differs in that it has a very small size (up to 3 mm), a rounded shape and does not tend to merge. This distinguishes it from the rash seen in scarlet fever and measles. With chickenpox, vesicles appear filled with a clear liquid, after which crusts remain. With rubella, the rash disappears without a trace. The virus can only be definitively detected in a laboratory test.

How to treat rubella in children of different ages?

Despite the fact that rubella is an infectious disease of viral etiology, it does not require specific treatment. This is due to the fact that when it manifests itself in the body, antibodies are already beginning to be produced that can cope with the problem on their own. Nevertheless, children, regardless of age, need to strengthen their immunity during illness. For this purpose, vitamins are prescribed. Symptomatic treatment of rubella includes the use of antipyretics and antihistamines. During illness, it is necessary to observe a stationary or home regimen in order to avoid the spread of infection.

Rubella prevention in children

In recent years, the incidence of rubella has decreased significantly, thanks to timely prevention. To avoid infection, mandatory vaccination is carried out for all children at the age of 1 year, and then at 7 and 15 years. Secondary prevention should include: maintaining immunity, declaring quarantine when a disease is detected (in kindergartens, schools, medical institutions), airing rooms.

Rubella- an acute viral disease that occurs with a short-term fever, a spotted or maculopapular rash and an increase in cervical lymph nodes.

The occurrence of rubella disease

The rubella virus belongs to the togaviruses (family Togaviridae, genus Rubivirus).

Virions are spherical particles with a diameter of 60-70 nm, on the surface there are rare villi 8 nm long, contain RNA. Unlike other togaviruses, rubella virus contains neuraminidase. The virus is pathogenic for some species of monkeys. It is able to multiply on many cell cultures, but it has a cytopathic effect only on a few, in particular on the VNK-21 culture (hamster). The rubella virus agglutinates the erythrocytes of pigeons, geese, and has hemolytic properties. In the external environment, the virus is unstable, quickly dies when dried, with changes in pH (below 6.8 and above 8.0), under the influence of ultraviolet rays, ether, formalin and other disinfectants.

The course of rubella disease

The infectious period begins 2 days before the rash, the peak of contagiousness decreases with the extinction of the rash. Neurological manifestations in these cases may occur on the 3-4th day of the rash, but sometimes precede them. CNS lesions in congenital rubella may be due to direct exposure to the virus, as evidenced by its release from the cerebrospinal fluid. Encephalitis with acquired rubella is rare, usually in young children, is characterized by a severe course and high mortality. In this case, the rubella virus cannot be isolated. The infectious-allergic nature of encephalitis is assumed. It has also been established that the rubella virus can cause progressive panencephalitis.

Incidence: 396 per 100,000 population (2001).

Source of infection- a sick person or carrier. The patient is contagious 2-3 days before the onset of the first signs and within 7 days of illness. Susceptibility to infection is high. Airborne route of distribution. People of all ages get sick. Congenital rubella with a transplacental route of penetration from a sick mother to a fetus, such newborns are dangerous as a source of infection during the year.

With acquired rubella - contact with the patient 11-21 days before the onset of the disease.

Rubella symptoms

On the first day of illness, a roseolous or roseolous-papular rash appears on an unchanged background of the skin, mainly on the extensor surfaces of the extremities around the joints. After 2-3 days, this rash disappears without a trace. Moderate fever, mild catarrhal phenomena, patchy hyperemia of the soft palate, enlarged and moderately painful cervical, parotid and occipital lymph nodes. On the 4-7th day of illness, a complication may develop in the form of serous meningitis or encephalitis with a relatively favorable course. Sometimes rubella panencephalitis progresses with an increase in neurological symptoms in the form of ataxia, convulsive seizures, and depression of consciousness.

When a woman is infected with measles in the first 8-10 weeks. pregnancy often occurs intrauterine death of the fetus or severe violations of the process of embryogenesis with the formation of gross developmental anomalies in the form of the Gregg triad: eye lesions (cataract, retinopathy, glaucoma, chorioretinitis, microphthalmos), deafness and malformations of the cardiovascular system (open ductus arteriosus, defects in the interatrial and interventricular septa, hypoplasia of the pulmonary arteries). Possible malformations of the central nervous system - micro- and macrocephaly. Therefore, with the development of measles in the first trimester of pregnancy with typical seroconversion, abortion is recommended. When the fetus is infected after 16 weeks. pregnancy, the risk of congenital malformations is less, single developmental defects develop, sometimes meningoencephalitis joins.

Rubella Diagnosis

Virus isolation is used by the classical virological method - inoculation of nasal mucus on embryonic tissues. Anti-rubella antibodies and an increase in their titer in RSK and neutralization by 4 times or more are detected.

Rubella should be differentiated from measles, enterovirus infections, scarlet fever, secondary syphilis, and allergic skin rashes.

Rubella treatment

There is no specific therapy. The main measures should be aimed at eliminating edema and swelling of the brain (corticosteroids, lasix, cryoplasma), nootropic drugs are used during the convalescence period.

Prevention of rubella disease

Patients with acquired rubella are isolated until complete recovery, but not less than 5 days from the onset of the disease. It is recommended to isolate the first sick person in a children's institution for up to 10 days from the onset of the rash. In some cases (if there are pregnant women in the family, the team), it is advisable to extend the period of separation to 3 weeks.

The impact on the mechanism of rubella transmission is airing and wet cleaning of the room, ward where the patient is located.

Contact children under the age of 10 who have not had rubella are not allowed to be sent to closed-type children's institutions (sanatoriums, orphanages, etc.) within 21 days from the moment of separation from the patient.

specific prophylaxis. They use a live attenuated vaccine "Rudivax", as well as a combined vaccine against measles, mumps, rubella - "MMR". In order to prevent congenital rubella, girls aged 12-16 years old should be vaccinated, followed by revaccination of seronegative ones before a planned pregnancy.

It is impossible to vaccinate pregnant women: pregnancy is undesirable for 3 months. after immunization against rubella (the possibility of post-vaccination damage to the fetus is not excluded). The introduction of the rubella vaccine is accompanied by the development of specific antibodies in 95% of the immunized.

In case of contact of a pregnant woman with a patient with rubella, the issue of maintaining pregnancy should be decided taking into account the results of a 2-fold serological examination (with the obligatory determination of the quantitative content of specific immunoglobulins of classes M and G). If a pregnant woman has a stable titer of specific antibodies, contact should be considered not dangerous.

Today we will talk about another acute infectious disease, mainly of childhood - rubella, its symptoms and treatment, methods of diagnosis, prevention of morbidity, we will tell the site about the possible complications of the transferred rubella disease.

What kind of disease is rubella, what is it caused, photo

Rubella (rubeola) is a fairly common disease of viral etiology, which is manifested by such characteristic signs as an increase in the volume of lymph nodes and the presence of a rash.

Due to the fact that in the list of pathologies that cause a rash on the body of a child, rubella was in third place, it is often called the “third disease”. The first description of this disease took place in 1740, and evidence of a viral origin was recorded only in 1938.

rubella virus It has a protein shell covered with peculiar villi, with the help of which it attaches to healthy cells of the human body. The virus contains molecules of ribonucleic acids and is capable of sticking together destroyed red blood cells. Among other things, the rubella virus quickly dies, being exposed to the environment.

Mostly children are susceptible to the disease, but there are cases of infection of unvaccinated groups of the adult population. Infection is especially dangerous for pregnant women, since the virus molecules easily penetrate the placental barrier and interfere with the normal division of developing embryonic cells, causing various anomalies.

It is divided according to the type of origin.

1.congenital type determined by the disease of the baby in the womb. The safest period is the second trimester. In other cases, the chance of stillbirth is high. Children born already with this disease pose a danger to others for a couple of months.
2. Acquired type. This is the entry of the rubella virus into an already born person. Children who are breastfed, up to a year, practically cannot become infected, as they receive immunity from mother's milk.

Methods of transmission, ICD code 10 rubella

The most common is the airborne route of transmission. Also dangerous is direct contact with an infected person, the use of his personal belongings, or the ingestion of nasopharyngeal discharge.

Outbreaks of the disease occur periodically, but only among the unvaccinated population and more often in the cold season.

Rubella code according to ICD 10 - B06.

Rubella symptoms, signs of the disease in children and adults

The course of the disease is divided into several stages, each of which has individual symptoms and manifestations.

1. Incubation period the initial stage of the disease is called, which does not give itself out by external signs, but is dangerous to others. The course lasts an average of two to three weeks.

2. catarrhal or prodromal period. In children, the initial stage of rubella practically does not manifest itself. Adult patients tolerate this period of rubella quite hard:

• critical ;
• severe muscle and headaches;
• general malaise, loss of appetite;
• sore throat, ;
• runny nose;
• fear of light, inflammation of the conjunctiva of the eye;
• throat hyperemia;
• pain when affecting the posterior cervical and occipital lymph nodes. This is the only symptom that unites the catarrhal period in children and adults.

The duration of this period is usually no more than 3-4 days.

3. The appearance of a rash is an important symptom on which specialists are based when making a diagnosis. Rashes in children occur brighter and more in number than in adults. In rare cases, before the rash, there may be a feeling of severe skin itching or the complete absence of a rash.

Rubella rash - how it manifests itself

Distinguish between exanthema and enanthema.

Exanthema- This is the formation of oval pinkish spots on the skin. Spots are formed due to the destruction of superficial capillaries and do not rise above the skin. The rash appears in turn:
neck, face, scalp, area behind the ears.
- in the area of ​​​​the elbows and under the knees, buttocks, the surface of the back.

In children, exanthema is characterized by the appearance of distinct, separately located spots and a longer duration. In adults, the rash often merges into one spot, but disappears faster.

Enanthema This is the appearance of a rash on the mucous membrane of the oral cavity.

Symptoms of this rubella period:

• normal body temperature or its slight increase;
• rarely joint or muscle pain;
• dyspepsia;
• an increase in the size of the spleen and liver;
• joint swelling and pain;
• the spot size does not exceed 4-5 mm, there is no liquid filling;
• there is no rash on the feet and hands.

The brightness of the course of this period is different and depends on the individual indicators of the body. Usually the time of rashes does not exceed 4-5 days, but the danger of infecting others continues.

4. convalescence period. At this time, all symptoms and signs of the disease disappear. From the moment the rash disappears, a person releases the virus within a week.

Features of rubella in adults

Rubella prevention in children and adults

The main preventive measures are only routine or emergency vaccination with live or semi-living viruses. Routine vaccination applies to children at the age of one year and then six years. Girls are re-vaccinated by the age of 13.

A person who has been in contact with a rubella patient, children and women during pregnancy is given emergency vaccination with the introduction of immunoglobulin.

Complications of rubella, consequences

In children, the consequences of the transferred rubella practically do not occur.

Adult patients with rubella have a stronger and more severe course of the pathology and a high level of complications.

• cerebral edema, meningitis, encephalitis;
• disturbances in the work of the heart;
• damage to the nervous system, convulsive conditions, impaired coordination, decreased intellectual abilities;
• development of a secondary infection (tonsillitis, and more).

Rubella during pregnancy

A pregnant woman who is ill with rubella may practically not feel the symptoms of the virus, but in any case, this will negatively affect the health of the unborn child, everything is especially sad if rubella develops in pregnant women in the first trimester, when there is intensive growth and formation of the fetus.

• incorrect formation of cranial bones;
• cataract;
• heart pathology;
• diabetes;
• or complete deafness;
• jaundice, hepatitis;
• hydrocephalus, microcephaly;
• anomalies in the development of the soft and hard palate;
• premature birth or stillbirth;
• malfunctions of the nervous system. One of the common phenomena is the presence of adolescent sclerosing panencephalitis, which is diagnosed 2-3 years after birth. And it is manifested by such characteristic signs as weakness of the intellect and a violation of the motor apparatus.

Fetal malformations associated with rubella infection

Rubella Diagnosis - Methods

1. Characteristic rash. Based on this method, it must be remembered that a number of other serious diseases have a similar rash that require immediate and specific treatment.
2. Before the rash appears, it is possible to study feces and blood.
3. In the presence of a rash, nasopharyngeal discharge is used as a laboratory material.
4. The serological method of blood analysis ELISA is necessary to detect special antibodies that indicate the presence of immunity, a recent infection or the incubation period of the disease.
5. Other diagnostic methods are used in the presence of complications or if their development is suspected. Such methods include the study of the lungs, the brain, consultations of narrow specialists according to indications.

After a disease or vaccination, immunity is formed, which is manifested in the development specific antibodies of the IgG type. With high numbers of this indicator, re-infection does not threaten a child or an adult.

Antibodies IgM To virus rubella are normally absent in blood serum. At the very height of the disease or only after it, antibodies of the IgM class are found in the patient's blood.

In a weakened state, the IgG antibody titer decreases, which often happens during pregnancy. Therefore, when planning pregnancy, special attention is paid to this indicator. With a negative result of the study of both titers, a woman planning to conceive is recommended to be vaccinated. In special cases, vaccination is prescribed before the period of 10-12 weeks of pregnancy.

Rubella treatment in children and adults

Hospitalization of the patient occurs only in case of a severe course of the disease. Almost always, recovery occurs on its own, thanks to the formed immunity, which remains for life. Therapy in most cases is symptomatic, that is, aimed at alleviating the condition.

1. Compliance with bed rest, especially for the catarrhal period;
2. Eating healthy foods that are easy to digest;
3. Drink plenty of fluids to speed up the elimination of toxins. Especially good are apples or just still water;
4. Non-steroidal anti-inflammatory drugs will relieve joint and muscle pain. Diclofenac, ibuprofen.
5. stimulate the production of human interferon, which leads to the suppression of the reproduction of virus cells. Arbidol, Anaferon, Genferon.
6. Remedies for a runny nose or congestion. Nazol, Nazivin, Otrivin, Sanorin, Tizin.
7. Antipyretic. In most cases, paracetamol-based products are used for children, and aspirin-based products for adults. You can also use ibuprofen. Ibuklin, efferalgan. Medicines can be in the form of tablets, syrups or suppositories.

Treatment of congenital anomalies has not yet been developed. It is possible to alleviate the condition of the child in some conditions by surgical intervention. These are defects of the cardiovascular system and pathologies of vision and hearing. But there is no 100% guarantee of a child's recovery.

An important point is the process of increasing immunity and adapting to the social environment, since most of the kids have mental retardation, which can only be corrected, not treated.

Rubella is an acute viral infection with mostly mild tolerability. It refers to the ubiquitous (global) diseases that most of humanity suffers from. The causative agent is togavirus from the Togaviridae family.

Rubella pathogens are unstable in the environment. At room temperature, they remain viable for several hours. When boiled, they die in a few seconds, are quickly inactivated under the influence of conventional antiseptics, drying, and direct sunlight.

There are four forms of rubella:

• congenital;
• atypical;
• hardware;
• acquired.

Causes

The source of infection is a rubella patient. Rubella viruses are released into the environment along with microparticles of mucus from the nasopharynx and sputum. Most often, infection occurs through direct contact with a carrier of the virus.

Among the main routes of infection:

• contact (through contact with infectious material);
• intrauterine route (through the circulatory system from mother to fetus);
• airborne route.

The incubation period of the infection is quite long. On average, it is 2-3 weeks. But others can become infected from a sick person only in a certain period of time: seven days before the onset of the first symptoms and about 5 days after they pass.

The susceptibility of the human body to rubella is extremely high - in most cases it is 100% (we are talking about unvaccinated people who have not previously encountered the virus). Individuals who have previously had rubella develop strong immunity, so re-infection is excluded.

Rubella affects the greatest number of people in winter and early spring - at this time the virus is most aggressive. This is due to favorable weather conditions, a sharp change in air temperature and a massive decrease in immunity.

In the typical course of rubella, an infected person begins to shed pathogens 7-10 days before the rash appears. Most intensively, viruses are excreted from the patient's body in the first five days of the rash period. The release of pathogens stops after two to three weeks from the onset of the rash.

With inapparent and atypical forms of rubella, pathogens are excreted from the body of an infected person less intensively and for a shorter period of time. However, these forms of rubella represent the greatest epidemiological danger, since they occur in adults several times more often than in the typical course of the disease and usually remain unrecognized.

Children with congenital rubella also pose a significant epidemiological danger. With congenital rubella, viruses are found not only in mucus from the nasopharynx and sputum, but also in urine and feces. They can be released into the environment within 1.5-2 years.

The main mechanism of spread of rubella is airborne. Infection can also occur through household contact (much less often, mainly in children's groups (through toys). It does not have significant epidemiological significance.

Most often, rubella affects preschool children, schoolchildren, adolescents and socially active adults. Most often, children between the ages of two and nine are sick. During the first two or three years of life, children, as a rule, do not yet attend preschool institutions, so the risks of their infection and disease are several times lower compared to children of senior preschool and primary school age. Most adolescents and adults are immune to rubella because they carry the infection during childhood.

Also temporarily immune to rubella are children in the first six months of life, born to mothers who have specific immunity.

The main targets for the rubella virus are the structures of the lymphatic system, the skin, the mucous membranes of the respiratory tract, the synovial tissue of the joints, and during pregnancy, the placenta and fetal tissues.

Symptoms and signs

After entering the human body, the rubella virus falls into a short-term “hibernation”. He begins to actively attack the immune system in the first days after the onset of the rash. In adults, the first symptoms resemble a mild cold.

During the incubation period, the rubella virus penetrates the mucous membranes of the body and is fixed on their surface. Soon after that, he settles in the submucosal tissues. The virus then spreads rapidly through the lymphatic system. There is a significant increase in the cervical lymph nodes, with their palpation, the patient experiences pain.

From this point on, the disease passes into a prodromal period, the duration of which ranges from several hours to two days. The incubation period ends with the appearance of rashes.

The characteristic rash is the first and key sign of rubella. It first appears on the skin of the face and behind the ears. In the future, the rash spreads to the scalp, after which they affect the entire surface of the body. Rash elements can also occur in a different sequence.

The rashes are round or oval in shape. Their color varies from pink to red. The size of each speck is from 2 to 3 millimeters. The rash does not rise above the skin and looks more like stains from spilled paint. On manual examination, the rash is smooth to the touch.

In some cases, rubella is accompanied by a confluent rash. In this case, solid red fields appear on the body. Because of this symptom, the disease can be difficult to distinguish from scarlet fever or measles, after which a false diagnosis can be made.

But there is a visible difference: with confluent eruptions, the face and body of the patient looks the same as with measles, while the extremities are covered with a rash that is similar to scarlet fever. It is important to know that the rubella rash is slightly larger in diameter than that of scarlet fever, and slightly smaller than that of measles.

In adults, rashes are more pronounced than in children. They completely cover the body, while the spots are as close as possible to each other. Often they are combined into one large spot. Whole erythematous areas may appear on the skin of the back and buttocks.

In some patients, rubella disappears without a rash, with mild or moderate manifestations of intoxication and catarrhal syndromes (atypical course). According to some data, rubella without a rash occurs in 30-50% of patients, according to others, this is a very rare form of the disease, and more often such a diagnosis is the result of an insufficiently thorough examination of the patient.

The course of rubella in children and adults, including pregnant women, does not differ significantly. Asymptomatic rubella is more common in adults than in children. The condition of children changes a day before the appearance of rashes. They are capricious a lot, get tired quickly, may complain of discomfort and general malaise.

In children, rubella can proceed in completely different ways:

• with rash and fever;
• exclusively with rash;
• with the simultaneous presence of rash, fever and catarrhal phenomena.

In childhood, severe rubella and moderate rubella are diagnosed 10 times less often than in adult patients.

One of the first symptoms of the manifestation of the virus is damage to the mucous membrane of the nasopharynx. In combination with a rash or long before it, an enanthema appears on the mucosa - a dermatous change in the form of spots of a pale pink color. This phenomenon is also called Forksheimer spots. In children, this symptom is usually mild.

With rubella, the patient is accompanied by an elevated body temperature for some time (no more than 38 degrees Celsius). It testifies to two things at once: the inflammatory process in the body and the fight of the immune system against infection. There is no need to artificially lower the temperature if it does not rise above 38.5 degrees.

Rubella invariably accompanies a deterioration in general well-being. The patient is concerned about the standard manifestations of an infectious disease:

• malaise;
• headache;
• weakness;
• drowsiness;
• body aches.

In some cases, there are changes in the blood test - there may be a slight leukopenia and lymphocytosis.

Rubella can also appear in an atypical (erased) form. The patient is not worried about the rash and other manifestations of intoxication. The only symptoms are sore throat and fever. Due to uncharacteristic symptoms, the erased form of rubella is often confused with tonsillitis or acute respiratory infections. In this case, the disease can be detected only with the help of laboratory tests.

Despite the absence of a rash, a patient with atypical rubella is still a distributor of the virus. This is the most common cause of epidemics and outbreaks of infection in communities.

Rubella in pregnant women: symptoms of congenital rubella

Rubella is especially dangerous for pregnant women. Often it leads to catastrophic cases:

• frozen pregnancy;
• miscarriages;
• stillbirth;
• formation of pathologies of fetal development.

Most of all, the virus threatens a pregnant woman and a child in the first trimester of pregnancy. It enters the fetus through the placenta. After that, it gradually affects all tissues and organs that are just starting to form, which leads to their abnormal development.

The degree of damage to the fetus depends on the form in which the disease occurs. Often a woman can be disturbed only by catarrhal manifestations: runny nose, sneezing, lacrimation. But the fetus at this time can suffer much more. Therefore, any symptoms during pregnancy, even the most insignificant, are a reason to consult a doctor and pass the necessary analysis.

The shorter the gestation period, the greater the likelihood of serious complications. For example, for 3-4 weeks it is 58-62%, and 14-15 - already 8%. The nervous system of the fetus most often suffers: hearing, vision, conditioned reflexes. Often there are congenital heart defects, underdevelopment and diseases of the gastrointestinal tract.

At 9-12 weeks from the moment of conception, rubella can lead to the most terrible consequences. As a rule, during this period, it entails a miscarriage or intrauterine fading of the fetus. Even if the pregnancy can be saved, the possibility of its normal course in the future is almost excluded.

In the last weeks of pregnancy, the child's organs are already fully formed, therefore, the rubella virus does not pose such a serious danger to his life and health.

Depending on which organs and systems of the fetus were affected by rubella viruses, congenital rubella syndrome can be clinically manifested by disorders of:

• hearing organs - complete or partial, uni- or bilateral deafness, and deafness may not appear immediately, but several years after birth;
• organs of vision - one- or two-sided cataract, microphthalmia, glaucoma, chorioretinitis, pigmentary retinopathy;
• heart - pulmonary artery stenosis, aortic valve defects, atrial or ventricular septal defect, ductus arteriosus disease;
• musculoskeletal system - open anterior source, osteoporosis of tubular bones, joint diseases;
• nervous system - microcephaly, meningoencephalitis, impaired consciousness, diseases of the language apparatus and psychomotor reactions, mental retardation, convulsive syndrome;
• endocrine system - diabetes and diabetes insipidus, hypothyroidism, thyroiditis, growth hormone deficiency;
• genitourinary system - cryptorchidism, hydrocele, cereal kidneys, prostate diseases;
• gastrointestinal tract and abdominal organs - pyloric stenosis, hepatitis, hepatosplenomegaly.

In addition to these disorders, the characteristic features of congenital rubella syndrome are low birth weight, thrombocytopenic purpura, hemolytic anemia, interstitial pneumonia, inguinal hernia, and various dermatoglyphic anomalies.

Visual impairment manifests itself in different ways. With cataracts, clouding of the crystal is observed (in one or two eyes). The eyeball may increase or decrease in size. In general, eye diseases are recorded in 85% of cases.

Heart or arterial defects are diagnosed in 98% of newborns with "small" rubella syndrome. The remaining 22% account for hearing pathologies (most often - complete or partial deafness). Usually it is accompanied by disorders of the vestibular apparatus.

More serious damage to organs and systems is called the "big" rubella syndrome. Children often have dropsy of the brain - hydrocephalus. The main symptom is a significant increase in the skull, which is due to the accumulation of fluid inside it. Sometimes the opposite disease can develop - microcephaly, which is characterized by a decrease in the brain and skull in volume.

In the presence of such congenital pathologies, the forecasts of doctors are disappointing. Infants are often diagnosed with severe mental disorders, and in the future - developmental delays. The congenital form of rubella also leads to disorders of the musculoskeletal system, convulsions, and paralysis.

If a woman has been ill with rubella in late pregnancy, the likelihood of visible disorders in the child is significantly reduced, but not completely eliminated. Instead, the infection may become chronic. In this case, the pathology is difficult to detect at birth - it manifests itself later and can periodically worsen.

Diagnostics

The most reliable laboratory methods for diagnosing rubella are virological and molecular biological (PCR) analysis. The virological method is based on the isolation of viruses from swabs from biological fluids:

• saliva;
• blood;
• feces;
• urine, etc.

The virus can be detected by infecting the cell culture. The PCR method makes it possible to detect the DNA of viruses in all the above-mentioned biological fluids. Both methods can be applied to patients with both acquired and congenital rubella.

However, the virological method, due to its complexity and high cost, is almost never used in practice. The PCR method is mainly used to diagnose congenital rubella. In newborns and children under the age of 1.5-2 years, blood and swabs from the nasopharynx serve as the material for research, and urine analysis is less common.

In the perinatal period, from the 11th week of gestation, the amniotic fluid of the pregnant woman is examined, and from the 22-23rd week, the amniotic fluid and umbilical cord blood are examined. These materials for analysis can be obtained by amnio- and cordocentesis.

In clinical practice, serological methods are most widely used to diagnose rubella - a blood test for antibodies to the virus. The presence of specific antibodies indicates that at the time of blood sampling, the patient's body is fighting this disease.

The evaluation of the results of the study is carried out taking into account the characteristics of the body's immune response to the penetration of viruses. This makes it possible to differentiate an acute process with immunity and reinfection. With the help of such an analysis, it is also possible to diagnose intrauterine infection of the fetus.

It has been established that with acquired rubella, specific antibodies to the virus appear in the blood from the first days of the disease. This means that you can go to the doctor immediately after the first symptoms appear. After all, the sooner a diagnosis is made and a treatment regimen is prescribed, the better. This is especially true for pregnant women.

The highest concentration of antibodies in the blood of a patient is reached three to four weeks after infection. After that, their level gradually decreases. Finally, antibodies cease to be determined only after three months, that is, they can be detected in the blood even after complete recovery.

Regardless of the form of rubella infection, specific antibodies in low concentrations are found in human blood for life. Acquired immunity is developed, which eliminates the possibility of re-infection. Cases of reinfection are still known to medicine, but they are caused by problems with the immune system and they happen extremely rarely.

The atypical (hidden) form of rubella is usually asymptomatic, so the examination of the therapist is meaningless. In this case, a reliable diagnosis can only be established based on the results of a blood test.

Serological research methods are also the most informative in the screening examination of women during pregnancy and during its planning. It is best to be examined in advance, because an infection that is detected during pregnancy can already cause irreparable harm to the child.

In this case, a positive result for the presence of antibodies to the virus excludes the possibility of having a child with congenital rubella syndrome. After all, if the mother has a specific immunity, it is transmitted to the fetus. In this case, the possibility of infection of the fetus is excluded. Immunity to infection persists during the first six months of a child's life.

A negative result involves planning pregnancy after immunization (vaccination).

The most informative methods for diagnosing intrauterine rubella are the results of serological studies that were obtained before the 12th week of gestation. Thanks to them, you can most accurately determine the degree of damage to the fetus by the virus. If there is a high risk of having a child with severe abnormalities, termination of pregnancy may be indicated.

Negative results of the analysis for the determination of antibodies necessitate dynamic monitoring of a pregnant woman. Be sure to show a periodic blood test and the use of medications that are aimed at preventing infection.

If a woman at any stage of pregnancy, who has never had rubella and has not been vaccinated, finds an increase in antibodies by two or more times, then an acute process of infection is taking place in her body. This also indicates a high probability of fetal damage.

Rubella treatment

In uncomplicated cases, the treatment of rubella is limited to a sparing regimen, the appointment of antipyretic and desensitizing agents. The infection leads to general intoxication of the patient's body, so treatment should be aimed at removing toxins from the body.

With the development of complications, drug treatment of the concomitant disease is used. In adults, against the background of rubella, most often occur:

• encephalitis;
• arthritis;
• thrombocytopenic purpura;
• meningoencephalitis.

In this case, treatment is carried out in accordance with the protocol of medical care that should be provided for these syndromes. Both tablets and intravenous and intramuscular injections can be prescribed.

There is no specific antiviral treatment for rubella. After all, soon after infection, the human immune system begins to develop specific protection, which, as a result, overcomes rubella.

There are data on the use of donor immunoglobulin in pregnant women and recombinant α-interferons in congenital rubella. These methods are aimed at creating artificial immunity to the virus. However, scientists did not find a significant effect in the treatment of congenital rubella syndrome with these drugs.

You can quickly overcome rubella with the help of a special diet. It helps prevent complications and improve well-being during the period of the disease. First of all, you need to exclude from the diet foods that are difficult to digest: fried and fatty foods, spicy dishes, etc.

Give preference to fermented milk products and lean meat (preferably boiled). Eat plenty of fresh fruits and vegetables, as well as greens. For the duration of the disease, it is worth giving up food that provokes gas formation: starchy and sweet.

To avoid complications, you need to forget about bad habits: cigarettes and alcohol. They irritate the mucous membranes of the nasopharynx and esophagus, which are already exhausted from the effects of infection. In addition, it is contraindicated to combine drugs and alcohol.

As a rule, full recovery occurs in 3-4 weeks. The patient is shown bed rest. Most of the symptoms of the disease are caused by the vital activity of the virus. To quickly cleanse the body of toxins, you need to drink plenty of water (1.5-2.5 liters per day).

Which doctors to contact additionally

If the patient still has complications, you should immediately contact a specialist of the appropriate profile. In this case, treatment will be aimed at eliminating the concomitant disease. Problems can be both internal and cosmetic in nature.

In most cases, rubella is accompanied by a rash, after which traces may remain. To fix the problem, you need to contact a beautician. Traces of rashes can be removed with laser resurfacing.

If you are concerned about diseases of the nasopharynx, make an appointment with an otolaryngologist (ENT). A pulmonologist deals with respiratory problems.

Sometimes the patient has an individual intolerance to the infection. With a strong allergic reaction of the body, especially in children, it is necessary to consult an allergist.

Prevention

Today, the only way to prevent congenital rubella syndrome is to prevent the disease in the mother. First, it is necessary to carry out generally accepted sanitary and hygienic measures. Among them:

• isolation of patients;
• a ban on attending collective or group events;
• sanitary and educational work, etc.

Unfortunately, they are ineffective and practically do not protect the pregnant woman from infection, although they reduce the likelihood of infection. It is possible to prevent rubella disease in pregnant women and, accordingly, congenital rubella syndrome, only through specific prophylaxis by creating artificial active immunity at the population level.

According to WHO, in countries where there is no mandatory rubella vaccination program, the frequency of children born with congenital rubella syndrome is four cases per 1000 children. At the same time, only those children who were born alive are included in the statistics, not counting miscarriages and missed pregnancies caused by intrauterine rubella.

These figures are several orders of magnitude higher than in countries where routine vaccinations against this disease are carried out.

Specific prophylaxis of rubella is carried out mainly by live rubella vaccines. Well proven vaccines, which are obtained using a weakened strain of the rubella virus Wister RA 27/3. They stimulate the humoral and secretory immune response.

Antibodies appear two to three weeks after the introduction of the vaccine, immunity is formed in 95% of vaccinated individuals and remains tense for 15-20 years. Live rubella vaccines should not be used during pregnancy, as when they are administered, a short-term infection of the body with the virus occurs. This can lead to damage to the fetus and the birth of a child with congenital rubella syndrome. Pregnancy can be planned no earlier than three months after the vaccination. In three months, the body will be cleansed of excess antibodies and will be ready for bearing a child.

A full-fledged effect in the prevention of congenital rubella syndrome can only be achieved with the planned vaccination of boys and girls in childhood and mass immunization of both adolescent girls and boys at the age of 15 years.

This is an acute illness caused by the rubella virus. It is characterized by the appearance of small rashes, an increase in lymph nodes and a moderate increase in temperature. If the infection occurs in a pregnant woman, intrauterine damage to the fetus is possible. In this case, urgent medical attention is needed.

Infection occurs by airborne droplets. The incubation period is 15 to 24 days. Rubella in children is usually mild. The main symptoms are skin rash and swollen lymph nodes. The child's health remains satisfactory.

The disease is more severe in adults. They are worried about fever, headache, muscle pain. Significantly enlarged lymph nodes.

Complications may develop:

• encephalitis;
• meningitis;
• pneumonia;
• arthritis and others.

When a virus enters the body, antibodies appear in the blood. After the disease remains strong immunity. Antibodies to pathology persist for life, protecting a person from re-infection.

The congenital form of the disease is especially dangerous. If the mother has had an infection during pregnancy, children are born with malformations. They secrete the virus, so they are dangerous to others.

Vaccination against the disease is included in the National calendar.

Causes and signs of the disease

The infection is caused by a virus. The incidence increases in winter, but in closed groups (for example, barracks for military personnel), outbreaks of an epidemic nature are possible. Most often, children aged 1 to 7 years get sick. The causes of rubella are the contact of an unvaccinated person with a sick person or a virus carrier.

The first signs of rubella appear 16 to 18 days after infection. Their appearance is preceded by an incubation period during which the virus multiplies in the lymph nodes and enters the blood.

A rash in the disease is its first symptom. It occurs first on the face, and spreads throughout the body within a few hours. The rash is small, spotted, pink in color, lasts 1-2 days. At the same time, there is a slight runny nose, cough and conjunctivitis.

A characteristic sign of the disease is an increase in lymph nodes, especially the occipital and posterior cervical. When they are palpated, pain may appear.

The state of the body practically does not worsen. Dangerous complications develop in isolated cases. The usual form of the course of the disease does not require the appointment of drugs.

The patient is contagious from about 10 days after infection (one week before the end of the incubation period and the onset of the rash). The end of the isolation of the virus occurs a week after the onset of the rash. Children with a congenital form of the disease are sources of infection up to 1 year or more.

Symptoms of the disease

The incubation period of the disease is 15 to 24 days (usually 16 to 18 days). A week before the end of this period, the patient becomes a source of infection, and contact with him can cause illness.

Then rubella symptoms appear - a rash, a slight increase in temperature. Before rashes, some patients have a slight runny nose and cough, as well as pink spots on the mucous membrane of the cheeks and palate.

Initially, a rash appears on the face, then it spreads to the entire skin. Its manifestations are especially well seen on the back, buttocks and extensor surfaces of the joints. At the same time, the lymph nodes in the neck and in the back of the head are enlarged. Based on these characteristic symptoms, the doctor easily makes a diagnosis.

Symptoms of the disease in children do not require the use of specific drugs. Complications are almost non-existent. Help lies in creating peace and isolation from healthy children.

Symptoms of the disease in adults are more pronounced. They often experience acute headache, sore joints and muscles, and fever. The disease is severe and may be accompanied by complications.

Vaccination is used to prevent this infection.

Rubella during pregnancy

Rubella is most dangerous during pregnancy in the first trimester of childbearing. If the mother has had the disease before 8 weeks, the risk of developing congenital malformations of the fetus is very high. Contact of an unvaccinated woman with the infectious agent can lead to miscarriage.

The virus in pregnant women causes infection of the child. Characteristic signs of a congenital infection are deafness, heart disease, cataracts. There may be such consequences: damage to the nervous system, thrombocytopenia, hepatitis, pneumonia, pathology of the bones and urinary system, mental retardation. In some cases, the appearance of signs of a congenital form of the disease is noted with the further growth of the child. It releases viruses into the environment for at least a year after birth.

If the mother was vaccinated on time, antibodies circulate in her blood. They provide immunity, including in a child up to six months.

Pathology in pregnant women is a dangerous disease. With its development in the first 3 months, there may be indications for termination of pregnancy. For diagnosis, a repeated determination of the level of antibodies is carried out with an interval of 10 to 20 days. If their number increases, this indicates a disease of the mother.

Rubella measles

Measles and rubella are diseases caused by different viruses. However, the elements of the rash are similar. On the basis of this, measles rubella is sometimes isolated. This disease is transmitted by airborne droplets.

The disease is accompanied by rashes on the skin, an increase in the occipital and posterior cervical lymph nodes and a slight fever. The rise in temperature lasts no more than 3 days, hence one of the names - "three-day measles." The patient's condition almost does not worsen.

Unlike measles, the measles form of the disease develops a rash within a few hours. The elements themselves are smaller than with measles. These are pale pink spots that do not merge with each other. They are located on the back, gluteal region, outer surface of the limbs. The rash disappears in 2 - 3 days, leaving no traces. Very rarely, there is slight pigmentation, dusty peeling or slight itching. Some patients do not develop a rash. Only a doctor can distinguish measles from rubella.

The method to avoid infection is vaccination. It enables the body to acquire a strong immunity that protects against disease.

Diagnosis of the disease

The disease has a characteristic clinical picture, on the basis of which rubella is diagnosed. Data on contact with the patient, type of rash, swollen lymph nodes, mild fever and minor catarrhal phenomena are taken into account. The disease proceeds easily, without respiratory and other disturbances.

In the blood test, a decrease in the number of leukocytes is determined, an increase in the number of lymphocytes. Up to 10 - 15% increases the number of plasma cells - this is a rather specific sign of the disease. With the development of encephalitis, the number of neutrophilic leukocytes increases.

Enzyme immunoassay for antibodies is carried out. Detection of IgM confirms the diagnosis. Another laboratory analysis is the detection of an increasing amount of antibodies using a direct hemagglutination reaction.

If an intrauterine form of the disease is suspected, the pregnant woman is re-examined with the help of RPGA.

Differential diagnosis is carried out with such diseases:

• measles;
• enteroviral exanthema;
• drug rash (for example, ampicillin).

Rubella treatment

The virus enters the nasopharynx by airborne droplets. The incubation period of the disease is about 17 days. Then characteristic rashes and enlarged lymph nodes appear. The child's body tolerates the disease well. Therefore, the treatment of rubella in children is bed rest for the duration of the rash. Medicines are not prescribed.

Treatment of rubella in adults is carried out using symptomatic drugs - antipyretics and painkillers. In severe cases, with the development of encephalitis, the patient is hospitalized, detoxified, and symptomatic drugs are prescribed.

With a congenital form, treatment has not been developed. Symptomatic correction of malformations is carried out. However, the affected child remains disabled for life. This is the danger of the disease for pregnant women.

A vaccine is used to prevent complications. It builds immunity by stimulating the production of protective antibodies. This helps to avoid infection, which is dangerous for the expectant mother and her child.

Children are vaccinated at 1 year of age. Revaccination (re-introduction of the drug) is necessary at the age of 6 years. If the girl has not been vaccinated, the vaccine against the disease is administered when she reaches fertile age (the time of the onset of menstruation). The dangers of not vaccinating should be explained to the child's parents.

Vaccination against the disease is safe, side effects after it are extremely rare and do not pose a threat to health.

Disease prevention

The disease in rare cases can cause complications of rubella: encephalitis, meningitis, pneumonia or arthritis. In adults, the disease is severe, with high fever and intoxication syndrome. Very dangerous infection of pregnant women.

Rubella prevention is mandatory childhood vaccination. It is carried out using the Rudivax vaccine or combined preparations (Priorix, MMR), which also protect against measles.

To prevent the spread of infection, the sick person is isolated from the moment the disease is diagnosed, and admitted to the team 5 days after the rash disappears. Disinfection is not carried out, contact children are not separated.

Particular attention is paid to pregnant women who have not been vaccinated before and who had contact with the patient during the 1st trimester of pregnancy. They do a blood test for pathology. If the disease is confirmed, the issue of termination of pregnancy is decided. If the pregnancy is decided to be retained, further regular ultrasound is recommended for early detection of fetal malformations.

If a woman is vaccinated, then there are antibodies in her blood that are transmitted to the fetus and protect the child in the first six months of his life. In this case, contact with the patient at any stage of pregnancy is not dangerous.

Rubella video