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Rubella (from lat. rubella) is an acute, highly contagious airborne (respiratory) viral infection that occurs in people who do not have acquired immunity to it. It belongs to the group of strict anthroponotic diseases, i.e. diseases that can only be transmitted from a sick person to a healthy person. However, it has been established that the virus that causes rubella can cause disease in some species of monkeys of the ape family. Cercopithecidae(macaques, green monkeys) and in rabbits. The possibility of infection of animals allows the development of vaccines against the rubella virus.

Historical reference

The first documentary description of the symptoms of rubella was given by the German physician F. Hofmann in 1740, but it was identified as an independent disease only 140 years later. The nature of the disease was discovered in the 20th century by Japanese scientists Hiro and Tasaka, who, using a group of volunteers, showed that filtered sputum wash collected from the nasopharynx of people infected with rubivirus causes the development of this disease. After the work of Hiro and Tasaki, it took another 24 years to identify the rubella virus. Scientists from around the world participated in this work: P. D. Parkman, T. X. Weller, F. A. Neva, S. A. Demidova, etc.

Studying congenital anomalies of eye development in newborns - cataracts, microphthalmos, retinopathy and corneal opacities, Australian ophthalmologist Norbert Gregg in 1941 published data confirming the connection between rubella infection in early pregnancy and the occurrence of malformations in newborns. The complex of congenital anomalies was called the “classic Gregg triad”, in which the author included, in addition to cataracts, heart defects and.

The first rubella vaccines were developed at the turn of the 1960s and 1970s, and the first immunization was administered to American Air Force recruits at Lackland in 1979. Subsequently, the use of rubella vaccines in preventive practice made it possible to significantly reduce the overall incidence of rubella - up to 95%. Results are often given on the incidence of rubella over 20 years summer period vaccine use in the USA in 1964 and 1984, from which it is clear that the ratio of rubella incidence in these years was 1,800,000: 745 cases of the disease.

Classic symptoms of rubella

According to the International Classification of Diseases (ICD-10), in 1972, it was recommended to use the nosological term rubella as the official name of an acute viral disease characterized by small-spotted exanthema, generalized lymphadenopathy, moderate fever and damage to the fetus in pregnant women.

In the definition of disease there are The four most likely manifestations of rubella (symptoms):

• Small spotted exanthema;
• Generalized lymphadenopathy;
• Febrile fever;
• Abnormalities of fetal development (if the mother is infected in early pregnancy).

Small spotted exanthema(from Greek exantheō- flower, bloom) is the general name for a skin rash that appears in the form of small spotty redness of a pale pink or red color with a small diameter of up to 0.5 cm, which are called raseola. They have a smooth round edge and, as a rule, do not merge or peel off. With this disease it occurs in 2/3 of infections. Along with skin rashes, or shortly before them, pale pink enanthems (i.e. rashes) on the mucous membranes are possible. The rash begins on the face and then moves to the trunk and limbs. Usually the rash lasts 2-3 days. In addition, catarrhal phenomena in the throat, minor inflammation of the pharynx and conjunctivitis without redness (hyperemia) of the oral mucosa are possible. In children younger age The rash with rubella often does not appear, so it is difficult to distinguish it clinically from similar respiratory viral infections of the oropharynx and nasopharynx (adeno-, para- or rhinovirus infections).

Generalized lymphadenopathy manifests itself as a systemic enlargement of several (more than two) lymph nodes; the infection primarily affects the posterior cervical and occipital lymph nodes. Lymphadenopathy manifests itself in the first days of the disease, even before the rash appears, and lasts for a long time - for several weeks or more. This is one of the earliest symptoms, in which the lymph nodes take the shape of peas or beans, have an elastic consistency and are sensitive to light pressure.

Manifestations of rubella rash

Mild to moderate fever, the first is typical for a mild form, the second for a moderate and severe form of the disease. Mild (low-grade) fever, accompanied by an increase in body temperature to 38ºC, moderate (febrile) fever, accompanied by an increase in body temperature to 38-39ºC. The increase in temperature is the result of the last phase of infection - viremia, in which the rubella virus multiplies massively and enters the bloodstream of an infected person. As a rule, viremia begins a week after lymph node enlargement.

The causative agent of the disease

The etiological cause of the development of rubella is a single-stranded plus-stranded RNA-containing togavirus (family Togaviridae, genus Rubivirus). The virus genome is covered with a supercapsid, i.e. its own protein nucleocapsid is additionally covered with a lipid bilayer, on the surface of which there are glycoprotein spikes, thickened at the ends, average length 6-10 nm. Glycoprotein spikes have two varieties - E1 and E2:

1. The first (E1) has hemagglutinating properties against the red blood cells of birds (pigeons, geese), i.e. determines the ability to dissolve the membrane of red blood cells and their subsequent hemolysis (destruction);
2. The second (E2) is a receptor for interaction with cells.

Glycoprotein E1 (hemagglutinin) is the only external antigen of the virus. Therefore, the antigenic structure is stable and there is only one serotype (antigenic type) of the rubella virus. One of the features of the virus is the presence in its shell of the enzyme neuraminidase, which helps viral particles penetrate through the mucous membrane into the blood and epithelium of the respiratory tract of the infected organism. In addition, it is believed that during the replication cycle it is neuraminidase that makes it possible for the newly synthesized virus to be released from the cell. Neuraminidase hydrates the bonds between sialic acids and is therefore sometimes called sialidase. It is part of such pathogens as cholera and virus (up to 7% of the total content in the shell), as well as the causative agent of gas gangrene ( Clostridium perfringens). Because neuraminidase is found on the surface of the rubella virus envelope, it is also one of the surface antigens that is involved in antigen-antibody immune reactions.

Reproduction (replication) of the virus begins from the moment it attaches to the surface of sensitive cells, which are the mucous membrane of the nasopharynx of adults or the amniotic cells of the embryo. After binding to the surface of a sensitive cell, the virus enters the cytoplasm through endocytosis and accumulates in the cell in the form of endosomes (endocytotic vesicles). The contents of the endosomes become acidified, due to which the virus leaves the endosome and begins the process of transcription (reading information) and subsequent replication (doubling of the viral RNA molecule), which includes three stages:

• Genome doubling
• Synthesis and maturation of protein structures,
• Virus assembly.

Replication ends with the separation of the new virus from the host cell membrane.

The virus is resistant to low temperatures (preserves well when frozen, at temperatures from -70 to -200 ºС). When frozen, it can remain infectious for years. At the same time, the rubella virus is sensitive to high temperatures (above 56 ºС) and an acidic environment pH below 5.0 (some authors indicate a pH limit of 6.8), as well as in an alkaline environment - pH above 8. Therefore, it is quite easily disinfected with conventional disinfectants means. At room temperature, the virus can remain stable for several hours. It may be noted that, Like many viruses, rubivirus is not sensitive to antibiotics.

Epidemiology of the disease

The main source of infection is a sick person, and the clinical picture may be well expressed, or it may proceed without any external signs(the absence of rash is recorded in 50% of cases). As a rule, infection occurs in 30-60% of cases of contact with a sick person.

Children who are infected transplacentally from their mother pose a particular risk of infection. After birth, such children remain contagious for up to 1.5-2 years, and pose a danger to adults who do not have acquired immunity, as well as children older than 0.5-1 year. It should be noted that healthy infants are not susceptible to infection because they receive antibodies from the mother who has suffered “childhood infections” and which continue to support the child’s passive immunity for 3-6 months. The most common age of the disease is 5-10 years, however, cases of rubella in adults under 40 years of age are not uncommon. Sexual dimorphism has not been established for this disease - women and men are equally susceptible to infection and the course of the disease.

There are three possible ways for the transmission and penetration of ruvirus into the body:

1. Airborne (is the main one),
2. Transplacental (vertical),
3. Contact (through household items).

The gateway to infection is the upper respiratory tract:

• The mucous membrane of the nasal cavity,
• Ciliated epithelium of the respiratory part of the pharynx,
• The mucous membrane of the oropharynx.

Once on the surface of susceptible mucosal cells, the virus is sent to the blood or lymph and reaches the regional lymph nodes with the lymph flow:

1. Sheinykh,
2. BTE,
3. Occipital.

The epidemiological picture is characterized by periodic outbreaks of morbidity that occur at intervals of 6-9 years (MES, 1996), according to some authors, 10-20 years. In the period between the occurrence of outbreaks of infection, isolated cases of local increases in morbidity are recorded with a seasonal maximum in April-June.

The incubation of the virus takes 2-3 weeks after entering the blood, after which it begins to be released into environment even before the skin rash appears. The most dangerous period of contact with an infected person is one week before the clinical picture and typical signs of the disease appear. The ability of the virus to enter urine and feces has been established, which determines the contact route of spread of infection. However, due to the fact that the persistence of the virus indoors is short-lived, this method of transmission is ineffective and makes a minor contribution to the epidemiology of the disease. However, it is important to take into account the fact that in organized groups, for example, preschool and school groups, groups of military personnel, etc., the likelihood of infection increases. If a patient with rubella is identified in organized group she will be isolated from the rest of the team for 21 days from the moment the patient is identified. Daily monitoring is established, which should include measuring body temperature, examining the skin and mucous membranes of the oral cavity, and palpating the lymph nodes.

Clinical features in children and adults

There are differences in the clinical picture of the disease between children and adults. In particular, Children tolerate rubella much more easily than adults and without complications. The course of the disease in adults is moderate and severe, with possible complications such as inflammation of the joints, inflammation of the membranes and the brain itself, as well as a decrease in the content of platelets in the blood and, as a result, hemorrhages - petechiae.

The rubella virus is extremely dangerous for women planning to become pregnant or already in the early stages of pregnancy. The consequence of infection of such a group of women is CRS syndrome, or congenital rubella syndrome.

Forms of rubella can be divided into groups:

• Acquired rubella in children,
• Congenital rubella of newborns,
• Acquired rubella in adults.

Acquired rubella in children is characterized by the following manifestations:

There may be no catarrhal period at all, or it may last only a few hours and pass unnoticed in a couple of days. Inflammation may be accompanied by a set of nonspecific symptoms:

• Hyperthermia,
• Slight runny nose.

The appearance and spread of rashes has a certain sequence - at the beginning of the disease they appear on the face, then move to the neck, after which they move to the torso and limbs, but after a week they do not leave a trace behind. The rashes have the form of spots, not bubbles, so they can be easily distinguished from. The temperature of children with rubella can rise to 38 ºС (less often 38-39 ºС), lasting for 2 days. The general severity of symptoms lasts for one week and ends without complications with complete recovery. However, it is important to remember that the child retains the ability to infect others for the next 2 weeks. At this time, he develops lifelong immunity.

Intrauterine infection of the fetus with rubella leads to the development of congenital rubella syndrome. It is observed in 15-30% of pregnant women and poses a serious threat to the fetus. Rubivirus has an increased tropism for embryonic cells, which is due to the presence of surface receptors used by the virus to penetrate cells. As a result of transplacental infection of the fetus, rubivirus disrupts the mitotic activity of embryonic tissue and affects the blood vessels of the placenta. The result of the interaction between the virus and embryonic cells is a lethal and teratogenic effect. The teratogenic effect manifests itself in the form of congenital deformities (Gregg's anomalies):

1. Degeneration of the cochlea of ​​the inner ear,
2. Development of cataracts,
3. Heart defects:
4. Tetralogy of Fallot,
5. Open Botallov duct,
6. Narrowing of the pulmonary trunk,
7. Defects of the cardiac septum.

In addition to the classic Gregg triad, more extensive congenital anomalies are possible - “extended syndrome”:

• Malformations of regenerative organs,
• Organs of the gastrointestinal tract,
• Skeleton skull bones,
• Micro- and hydrocephalus.

Possible consequences of congenital rubella and other intrauterine infections (TORCH complex)

Children born with CRS syndrome differ from healthy newborns:

1. Low body weight,
2. Bilirubinemia (bilirubin content in the blood below 3.4 µmol/l),
3. Signs of jaundice.

In addition, diabetes mellitus and thyroiditis may subsequently develop.

The timing of pregnancy during which infection of the mother and fetus is possible is important. If the mother has rubella:

• In the early stages of pregnancy, 3-4 weeks - congenital deformities occur in 60% of cases,
• At 9-12 weeks - in 15% of cases,
• At 13-16 weeks at 7%.

A number of authors indicate the absence of any teratogenic effects in case of infection after the 20th week of pregnancy. Spontaneous abortions occur in 10-40% of cases of early maternal infection, stillbirth in 20% of cases, and neonatal mortality of newborns with CRS syndrome reaches 10-25% (overall infant mortality is below 6%).

In adults, the symptoms of rubella are accompanied by more severe intoxication, and are therefore accompanied by:

1. General weakness and malaise,
2. High hyperthermia,
3. Headache
4. Chills.

It has been established that the virus can penetrate the synovial fluid of the joints, which leads to inflammation (arthritis) and, as a result, joint pain in the knee, wrist and hand joints. In the case of acute arthritis, the virus is detected in the synovial fluid, in the chronic form - in the blood. Women are more sensitive to arthritis of rubella etiology. In rare cases in adults (0.03% of cases), rubella is accompanied by thrombocytopenia (a decrease in platelet count below 150 109 / l) and increased permeability of blood vessels. The consequence of increased vascular permeability may be hemorrhages in internal organs. Cases of encephalitis (inflammation of the brain) are extremely rare.

Methods for diagnosing the disease

Diagnosis of rubella is usually not difficult if the disease is accompanied by a typical pattern of clinical signs. Therefore, during the normal course of the disease, laboratory analysis is not performed. According to indications, a general blood and urine test is prescribed. The most likely result of a general blood and urine test for rubella:

In controversial cases, with an atypical clinical picture, the following analysis methods are used to make a diagnosis of rubella:

1. Virological method,
2. Serological method,
3. Molecular genetic method.

Virological method analysis includes the use of erythrocytes from birds and some mammalian species. These can be red blood cells from pigeons, chickens or geese; rabbit erythrocytes are often used. Rubivirus causes agglutination of red blood cells followed by hemolysis.

Serological method The analysis makes it possible to determine species-specific antibodies in the patient’s serum for the rubella virus. For serological analysis, paired sera are used, which make it possible to determine the increase in antibody titer. The diagnosis is confirmed by the detection of antibodies to the rubella virus of the IgM class or a fourfold increase in antibody titer. This type of analysis allows you to distinguish rubella from measles, with similar clinical signs.

Molecular genetic The analysis method involves the use of polymerase chain reaction (PCR), which allows the isolation of the viral genome. The PCR method is one of the most reliable and precise methods diagnostics of the infectious agent.

The object of study for each of the listed methods of analysis in the case of acquired rubella is nasopharyngeal discharge or blood before skin rashes, as well as blood and urine after the appearance of rashes. In the case of congenital rubella, urine and feces (meconium) of newborns are used for analysis.

Since there is a danger of teratogenic effects of the fetus, the diagnosis of rubella in pregnant women or women planning their pregnancy is of particular importance to determine the presence of acquired immunity to this infection. The external symptoms of rubella are non-specific and it is possible that the woman did not have this infection in childhood, but suffered from an illness with similar symptoms that were mistaken for rubella. In addition, rubella can be asymptomatic in a latent form. Positive result in the presence of acquired immunity, the presence of class G (IgG) antibodies in a woman’s blood is considered. The detection of class M antibodies (IgM) in the blood is an indicator of the presence of the disease or that the disease has recently been suffered.

Possible indicators and their interpretation when analyzing for the presence of antibodies to rubella

Treatment of the disease

The general nature of the treatment of rubella in children and adults is practically the same. All activities should be aimed at:

• Production of antibodies against viral infection,
• Maintaining the body's strength to fight infection,
• Strengthening resistance to other infections.

If children become ill, they are treated at home. Hospitalization is indicated only for epidemiological indications and in severe cases of the disease. The classic form of acquired rubella in children and adults does not require specific treatment, therefore, according to indications, symptomatic treatment is prescribed, which should include:

Regarding drinking and diet, the following recommendations should be followed:

• Drinking should be plentiful and warm, you can make rosehip decoction (rich in vitamin C), apple compote, fruit juice, still mineral water;
• Divide meals into 4-5 meals, in small portions, so as not to overload the stomach (stimulates physiological leukocytosis),
• Food should be easily digestible,
• The diet should include light vegetable soups, mashed potatoes, steamed meat dishes;

Antiviral treatment for rubella may include immunomodulatory drugs:

1. "Arbidol"
2. "Aflubin"
3. "Groprinosil"
4. "Anaferon"
5. "Viferon"
6. "Genferon."

The main effect of these drugs is aimed at suppressing the reproduction of the viral RNA molecule (groprinosil, ana-, vi- and genferon) or stimulating the synthesis of its own interferon, as well as enhancing the growth of the cell population of T-lymphocytes in the blood.

The following is used as symptomatic treatment:

• Antipyretic drugs,
• Antiallergic drugs.

As a rule, in children the actual treatment of cough with rubella is not required if the disease is not aggravated by a related infection. In case of dry cough, drugs are used that are aimed at the formation and discharge of sputum. Among such drugs for children after one year, syrups are used:

1. Gedelix syrup prepared from ivy leaf extract, it does not contain ethyl alcohol and is sold without a doctor's prescription. Belongs to the group of expectorants, helps to liquefy and separate viscous sputum, as well as reduce bronchospasm. The active ingredient of the drug includes saponin glycosides, which increase the secretion of the bronchial mucosa.
2. Linkas syrup often prescribed for the symptomatic treatment of upper respiratory tract diseases that can develop against the background of rubella, therefore it can also be used in the treatment of rubella. It should be remembered that the drug contains 8 components of plant origin, including licorice root, marshmallow, fragrant violet, and kolgan. Therefore, possible allergic effects should be taken into account.
3. Syrup "Sinekod" contains the active chemical butamirate, which has an effect on the respiratory center.

To treat cough in adults, the drugs Ambroxol, Bromhexine, Mucaltin, Pertusin, Lazolvan, Bronholitin, etc. are used.

When rhinitis develops, drops are prescribed:

• "Nasivin", "Noxivin" and "Nazol", contains oxymetazoline,
• "Sanorin" and "Naphthyzin", containing naphazoline,
• "Galazolin", "Otrivin", "Tizin" containing xylometazoline.

The group of these drugs differs in dosage and is sold in concentrations of 0.025% and 0.05% aqueous solution for children and 0.1% solution for adults. Preparations based on oxymetazoline dry out the nasal mucosa less. The duration of action of drugs may vary, on average it is from 4 to 6 hours.

The most commonly used antipyretic drugs are those containing paracetamol for children and aspirin for adults. Ibuprofen, which is included together with paracetamol in Ibuklin, as well as Eferalgan suppositories, is also used as an antipyretic. Ibuklin is sold in the form of syrup, paracetamol and aspirin in tablets. Various dosages of paracetamol tablets are possible, which is important to consider when calculating the child’s body weight.

The course of rubella is accompanied by a weakening of the immune system and can provoke allergic reactions. Therefore, in some cases, antihistamines are indicated, such as:

1. "Parlazin"
2. "Loratodine"
3. "Ketotifen"
4. "Vibrocil."

“Parlazine” and “Loratodine” do not have a sedative effect, “Ketotifen”, on the contrary, can cause drowsiness.

Disease prevention

Live or killed vaccines are used as specific rubella prevention. Mass vaccination programs in different countries were accepted into different time, and in some countries they are not accepted to this day, for example in the countries of South Asia, where 136 cases of congenital rubella of newborns regularly occur per 100,000 population. Since 1969, rubella vaccination has become mandatory for the countries of North America and Europe. In the USSR and subsequently in the Russian Federation, routine vaccination was not carried out until 1997, but information about the previous disease was included in the vaccination card, i.e. Naturally transmitted diseases were counted as vaccination. Since 2000, rubella vaccination has been included in the national vaccination schedule, according to which rubella vaccination is given at the age of 1 year and at 6-7 years. The result of routine vaccination was an almost exponential drop in incidence by 150 times: 152 cases per 200,000 people in 2005 and 1 case per 200,000 in 2015.

IN Russian Federation The following vaccines are registered and used:

• Live vaccine "MMPII", produced in the USA,
• Priorix vaccine, French-made,
• Live monovaccine "Rudivax"
• Attenuated vaccine for the prevention of rubella produced by Serum Institute, India.

Vaccines are made from attenuated strains of the virus. Attenuated strains are weakened versions of the virus that are completely devoid of the ability to cause disease (virulence). Such viruses are repeatedly cultivated in human embryonic lung tissue culture or in animals (green monkey kidneys) by repeated and sequential transfer of virus-containing material.

Immunization is carried out twice– the first vaccination is carried out at the age of 12 months, repeated revaccination at 6 years. Additional vaccination is carried out for girls aged 12-13 years, which prevents the risk of contracting viruses during pregnancy. Vaccination against rubella is strictly prohibited 3 months before a planned pregnancy. The most commonly used vaccine for immunization is the MMR vaccine - measles-rubella, which shows high efficiency and allows you to reduce the number of necessary injections to form stable immunity to three infections. The use of the three-component MMR vaccine at 12 months provides long-term immunity, which in some cases persists throughout life. Repeated vaccination (re-vaccination) at 6 years of age is aimed primarily at strengthening immunity and possible “reinsurance” in case 100% of vaccinated children lack total immunity.

After vaccination or as a result of contracting a disease, a person develops stable lifelong immunity, which is provided by IgG class immunoglobulins. Immunoglobulin IgG makes up the majority of globular proteins in blood serum. The structural features of the variable region in the IgG molecule provide the possibility of its binding to specific antigens, including those of a viral nature. Penetration of the rubella virus stimulates the proliferation (reproduction) and differentiation of B-lymphocytes, which in the early stages of the disease synthesize IgM class immunoglobulins, and at subsequent stages IgG class immunoglobulins that are species specific to this virus.

Video: rubella in the program “Live Healthy”

One of the most common viral infections, occurring mainly in childhood, is rubella. This viral disease, which in most cases is mild, is accompanied by a short-term increase in body temperature, a small rash, and enlargement of all lymph nodes. Rubella most often affects infants and children preschool age, the so-called risk group – from 1 year to 7 years. Older children get sick much less often. What are the first signs, what is the incubation period, as well as how to treat the disease - we will consider further.

What is rubella?

Rubella in children is a disease belonging to the group of infectious, viral in nature, the main symptoms of which are considered to be fever, a widespread pinpoint rash over the body and catarrhal phenomena on the respiratory organs.

The rubella virus tolerates freezing well, remains aggressive for several hours at room temperature, and quickly dies under the influence of ultraviolet radiation, heat and disinfectants.

Factors that destroy the rubella virus:

• drying;
• the effect of acids and alkalis (the virus is destroyed when the pH decreases below 6.8 and increases above 8.0);
• action of ultraviolet radiation;
• action of esters;
• effect of formalin;
• effect of disinfectants.

Transmission routes

A person can only become infected with rubella from another person. The infection is transmitted by airborne droplets (the virus enters the air from the mucous membrane of the respiratory organs of a sick person and is then inhaled by a healthy person). Most of cases of infection occur during the incubation period, when the virus has already settled in the body, but has not yet manifested itself with external signs.

Routes of transmission of rubella:

• Airborne;
• Transplacental (especially in the first trimester of pregnancy);
• In young children, the virus can be transmitted from mouth to mouth through toys.

A carrier of Rubella virus poses a danger to others from the second half of the incubation period: a week before the rash and a week after.

The risk of morbidity is high for those who have never been sick and have not been vaccinated; children 2-9 years old fall into this category of people. Outbreaks of morbidity are characterized by seasonality - winter-spring. Epidemic outbreaks recur every 10 years. After an illness, stable lifelong immunity is formed, but according to some data, re-infection is still possible.

When released into the external environment, the microorganism retains its aggressive properties for 5 - 8 hours, depending on the dryness and air temperature.

Incubation period

The incubation period for rubella is from 10 to 25 days. It is believed that children in whom the disease occurs without any manifestations or with mild symptoms are stronger sources of infection than children with obvious signs of infection.

Your baby can get rubella if he has been in contact with:

• infected people who exhibit all the characteristic symptoms;
• patients with an atypical form of the disease (with an uncharacteristic course of rubella, the rash and many other signs may be completely absent);
• infants who are diagnosed with a congenital form of the disease (in such children, the virus can multiply in the body for 1.5 years).

Typical symptoms of the disease are noticeable at the end of the incubation period.

How rubella begins: the first signs in a child

Signs of rubella in children are often similar and largely due to the nature of the rash. Red spots appear rapidly, quickly covering the entire surface of the body. The first are localized on the neck, face, head, and later spread to the back, buttocks, and the surface of the limbs.

How rubella begins:

• First, the following symptoms appear: nasal congestion, sore throat, weakness, drowsiness, fever.
• Next, enlarged lymph nodes and their swelling become noticeable. Pain is noted on palpation.
• The most characteristic symptom during diagnosis is red spots.

The course of the infectious process with rubella in children is divided into several periods:

• incubation (from the moment the infection enters the human body until the development of the initial symptoms of the disease);
• period of precursors (prodromal);
• rash period;
• convalescence (recovery).

What rubella looks like: photos of children with a rash

Not all parents know how rubella manifests and looks like and often confuse this disease with a typical cold or acute respiratory infection. But it is necessary to carefully diagnose each similar case and take measures to prevent complications of infection that can affect brain structures, nerve fibers, spinal cord and connective tissue. The walls of small blood vessels are especially often affected.

The rash associated with rubella in children is localized around the ears, on the cheeks, in the area of ​​the nasolabial triangle, and on the neck. After 1–2 days, the elements spread throughout the body from top to bottom, and after 3 days they turn pale and begin to disappear. The rashes never affect the skin of the palms and soles, but are most disturbing on the inner thighs, outer forearms, and buttocks.

Symptoms of rubella in children

From the moment of infection with rubella until the appearance of the first symptoms, there is an incubation period that lasts 11–24 days (in most patients - 16–20 days). At this time, the virus penetrates the cells of the mucous membrane of the respiratory organs, and from there into the bloodstream, spreads with the bloodstream throughout the body, multiplies and accumulates.

During the incubation period, rubella manifests itself as follows:

• the temperature rises (slightly);
• weakness;
• conjunctivitis;
• pain in the throat;
• runny nose;
• lymph nodes enlarge;
• the final symptom is the appearance of a rash.

After 1–1.5 days, sharp pain occurs in the occipital part of the neck, the lymph nodes in this area become motionless and dense, up to 1 cm in diameter. May be observed:

Children experience the following symptoms:

• body temperature rises to 38°C and lasts for 2 days;
• slight enlargement and mild tenderness of the cervical and submandibular lymph nodes;
• redness of the throat;
• slight runny nose;
• conjunctivitis.

Skin rashes due to rubella (exanthema) appear first on the face, neck and behind the ear area, after which it quickly spreads down the body. This process goes quickly, so sometimes it seems that the rash appears all over the body at the same time.

The highest concentration of elements is observed on the back, buttocks and extensor surfaces of the limbs. The rash can be all over the body, but in other locations it is more sparse. The rash usually does not itch.

If children have reached an older age, parents may receive complaints about pain in the muscles and joints; rashes initially appear in the face, but then a rash starts on the body, spreading over the limbs, torso, and scalp.

The period of rash lasts on average from 3 to 7 days. Then the child’s condition noticeably improves, appetite returns, cough and sore throat disappear, and nasal breathing becomes easier. The size and density of the lymph nodes return to normal 14–18 days after the rash disappears.

Complications

Complications of rubella, as a rule, are detected when it is severe and are most often represented by the following pathologies:

• Attachment of a secondary bacterial infection (pneumonia, otitis media);
• Serous meningitis or encephalitis, characterized by a relatively favorable course (this complication can develop on days 4-7 of illness);
• Thrombocytopenic purpura;
• Intrauterine fetal death;
• Congenital malformations.

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

Diagnostics

If you develop or only suspect rubella infection, you should immediately contact a doctor such as an infectious disease specialist.

Even knowing how rubella manifests itself in children, it is not always possible to unambiguously identify this infection. Considering that the most telling sign - the rash - appears towards the end of the disease, the diagnosis must be made on the basis of anamnesis, data on the epidemiological situation and laboratory tests.

Diagnostic testing includes the following laboratory tests:

• Complete blood count (increased ESR, lymphocytosis, leukopenia, possible detection of plasma cells).
• Serological examination of nasal mucus (RSC, RIA, ELISA, RTGA).
• Determination of the concentration of antiviral immunoglobulins.

Diseases similar in symptoms to rubella:

• adenovirus infection - a cold that causes enlarged lymph nodes;
• enterovirus infection: enteroviruses can affect the intestines (acute intestinal infection), respiratory system (pneumonia, colds), skin and lymph nodes;
• measles is a viral disease that also manifests itself as a rash on the skin;
• infectious - a viral disease in which signs of a cold appear and enlarge in the lymph nodes, liver, spleen;
• - a fungal disease that causes spots on the skin;
• urticaria - an allergic reaction in which red spots appear on the skin;
• Erythema infectiosum is a red skin rash that can occur in some patients with any infectious disease.

Treatment of rubella

No special medications have been developed that could directly affect the virus, namely rubella. Usually the disease occurs in a mild form and the child’s body, in the absence of complications, copes well with the disease.

The only important aspect is maintaining bed rest, drinking plenty of fluids, to quickly remove pathogen toxins from the body, as well as prescribing medications that help eliminate the symptoms that arise.

No specific treatment has been developed, so they use:

1. bed rest for 3-7 days;
2. nutritious nutrition, taking into account age characteristics;
3. Etiotropic therapy with the use of viracids (arbidol, isoprinosine), immunomodulators (interferon, viferon) and immunostimulants (cycloferon, anaferon).
4. detoxification therapy - drinking plenty of fluids;
5. Ascorutin 500 mg three times a day (replenishes vitamin deficiency).
6. Temperature, headache, body aches are relieved by antispasmodics and children's anti-inflammatory drugs: Paracetamol, No-shpa, Nurofen.
7. symptomatic therapy (expectorants - a certain group is used for a certain type of cough, i.e. expectorants and antitussives cannot be used simultaneously), mucolytics, antipyretics, analgesics).

Medicines are prescribed to prevent complications and relieve symptoms

Treatment of rubella disease in a hospital is required if a child develops a convulsive syndrome and there are signs of infection spreading through the blood-brain barrier. In this case, the disease poses a threat to the health and life of the child.

Principles of treatment of rubella in children under 1 year of age:

• treatment only in an infectious diseases department for the entire period of rashes and infectivity, for constant monitoring of the child by medical personnel;
• in some cases, detoxification therapy is recommended by prescribing droppers with various infusion solutions;
• antihistamines are prescribed in all cases;
• symptomatic drugs (anti-fever, vomiting, other drugs when signs of complications develop);
• vitamins, especially C and A;
• correct diet.

Rubella in children under one year of age provides stable lifelong immunity, which allows you to refuse vaccination within the prescribed period.

For congenital rubella, a child is treated by several specialists, depending on the affected organs: dermatologist, neurologist, endocrinologist, ophthalmologist, ENT doctor and others.

Even if the child feels well, he should not visit kindergarten, school or others public places. It is best to stay at home for at least a week. At the same time, it is important to ensure that the child takes vitamins and products that strengthen the immune system. It is also advisable for the child to drink as much liquid as possible.

Prevention

The main prevention of rubella is timely vaccination. It is carried out according to the following scheme: at the age of 1–1.5 years, the child is vaccinated, and then at 5–7 years – revaccination. After revaccination, lasting immunity is developed to the virus.

Basic methods of prevention:

1. A sick baby is isolated from other children until complete recovery. Usually, from the onset of the rash, the sick person is isolated for 10 days. Sometimes (if there are pregnant women in the family or team) the quarantine period is extended to 3 weeks.
2. Complete exclusion of contact between pregnant women and a sick person. If contact occurs, repeat serology is performed on days 10-20 (detection of asymptomatic course). The administration of immunoglobulin does not prevent the development of rubella during pregnancy.
3. All children are vaccinated against rubella according to the vaccination schedule. It is given as an intramuscular or subcutaneous injection. Vaccination after 15-20 days forms a strong immunity in the child, which remains active for more than 20 years.

Rubella is an acute viral disease that manifests itself as reddening of the skin. At the same time, the general condition of the patient suffers. The main symptom of the disease is a rash. Many people have a question about whether the disease rubella consequences in girls what it can cause and why it is dangerous.

Consequences of rubella in girls

During pregnancy

If the risk virus appears at week 28, then she is placed at risk. In this case, preventive measures should be aimed at protecting the fetus. Pathologies that arise in a baby will not appear immediately, but only after a while. To avoid infection, vaccination is necessary.

Efficiency

The consequences of rubella in children can be very diverse. The nature of complications depends on the age of the child and the characteristics of the pathology.

The most serious consequences of rubella in children

If the disease proceeds without any manifestations, then it does not cause any consequences in a child who has had rubella measles. The most serious complication of rubella is encephalitis. A similar consequence of the disease occurs only among adolescents and adult patients. Inflammation of the membranes of the brain develops in one case out of 10 thousand. Most often, the complication occurs very quickly and appears before the rash appears. Very rarely, rashes appear all over the patient’s body before the onset of autoimmune encephalitis.

Encephalitis is accompanied sharp deterioration general condition and confusion. Very soon, patients develop meningeal symptoms; in the most severe cases, convulsive syndrome occurs, which can result in respiratory arrest and depression of the cardiovascular system. Lack of medical care can cost a child his life.

Another serious complication of rubella can be damage to the central nervous system, which can be expressed in the form of paresis and paralysis. The probability of developing such diseases is approximately 25% of all diagnosed cases of the disease, and child mortality with a similar course of rubella reaches 30% or more.

Congenital rubella in children can also cause serious consequences. which appear several years after the infectious process. Intrauterine infection of the fetus by a virus sometimes results in impaired brain activity, impaired mental development, mental disability, impaired speech and the ability to write. In addition, over time, children may develop a persistent decline in intelligence, accompanied by impaired motor coordination, which is associated with uncoordinated work of individual parts of the brain. Such long-term consequences of rubella cannot be treated.

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Vaccination against rubella

The only reliable way to prevent outbreaks of rubella is vaccination against this infectious disease. The first time it is given at 12 months of a child’s life, repeated vaccination is carried out at 6 and 12 years. In adolescence, the drug is administered mainly to girls; for adolescent boys, rubella no longer poses any danger.

Modern medicine suggests using a combination vaccine containing, in addition to rubella titers, weakened pathogens of smallpox, measles and mumps. Persistent immunity, according to studies, provided that all requirements of the vaccination calendar are met, is developed in 95% of cases.

Before planning to conceive a child, a woman is recommended to take a blood test for rubella. If antibodies are absent, your doctor may recommend a booster vaccination. It is important to remember that vaccination is not carried out during pregnancy in order to prevent serious complications in the fetus. At least 90 days must pass from the moment the drug is administered to a woman until the child is conceived; breastfeeding is also not allowed during these days.

Rubella: symptoms, consequences and treatment

Continuing to tell you, our dear readers, about “childhood” diseases, in this article we would like to touch upon such a disease as rubella. Rubella itself is a harmless disease that occurs in a rather mild form - in children and, in principle, in adults. In pregnant girls, the course of the disease can cause very serious negative consequences, but not for the expectant mother herself, but for the fetus. It is for this reason that we want to draw your attention to the seriousness this issue and warn you against negative consequences.

What is rubella and what are its features?

Rubella is a viral infectious disease that appears as a red rash on the body. Rubella is most easily tolerated by children, and more difficult by adults, but for pregnant girls, rubella can end quite badly.

A person who has been vaccinated against rubella or has had it has a strong immunity to the disease, that is, it is impossible to become infected with rubella again.

Rubella during pregnancy

If a girl falls ill with rubella in the first months of pregnancy, and the presence of this infectious disease is confirmed, the doctor may suggest terminating the pregnancy. having an abortion.

Consequences of rubella for pregnant women

There are no negative consequences from rubella for a person suffering from it. That is, after infection, approximately 7 days later, the sick person fully recovers and not a single complication was noticed. The main thing is to follow a few rules, then the disease will go away much faster.

Now as for pregnant girls. As was said earlier, there is no danger or negative consequences for the mother herself, but for the child there is. In 50% of cases of rubella infection, it exposes the fetus to the risk of developing:

It is for these reasons that in order not to endanger the unborn child, it is recommended to have an abortion. If you contract rubella in late pregnancy, a decision regarding the life of the unborn child is made on the basis of tests and an ultrasound examination. As a rule, in the late stages of pregnancy, all organs of the child have already formed, so the risk of negative consequences is much less.

Symptoms of rubella

The signs of rubella are as follows: first, the patient’s body temperature rises and a headache begins, then a feeling of general malaise appears, after which characteristic red rashes begin to appear in the neck and head, which spread throughout the body. The rash is more common on the face, back and buttocks. It is impossible not to note the positive fact that the rash on the face and other areas of the skin with rubella does not itch, and this is good, not like with chickenpox.

After the first symptoms appear: malaise and fever, the first rashes appear, as a rule, after 48 hours and within a few hours cover the entire body. The rash lasts on the body for about three, sometimes up to seven days. There is no need to smear it or treat it with anything - it will go away on its own.

Interesting to know:

If parents notice such symptoms, the child urgently needs qualified medical care. Even with acute orchitis, if the pathogen is identified in time and adequate treatment is prescribed, the most terrible consequences can be avoided.

Question: Can rubella cause infertility in boys or men?

The Medical College www.tiensmed.ru answers:

Rubella is an acute viral infection. which mainly affects children aged 3 to 9 years. This pathology is characterized by a mild course, however, in rare cases, complications may develop, including male infertility .

Male infertility can be due to many reasons. It is based on a violation of the function of sperm synthesis by the epithelium of the convoluted tubules of the testicle, or a violation of their maturation in the epididymis.

There may be a decrease in the number of sperm produced, as well as disruption of their function. Sometimes there are changes in their structure - the germ cells become abnormal and are not capable of fertilizing an egg.

Reasons that can cause male infertility include a number of infectious and inflammatory diseases, among which rubella is noted. It should be said that such a complication occurs only in the case of infection of boys during puberty and when the testicles are affected with their inflammation ( orchitis), which happens extremely rarely. If rubella was contracted by a child under the age of 5 years, there is practically no risk of infertility in the future.

The occurrence of infertility due to rubella in men is an extremely rare occurrence, which, however, is not excluded in the event of severe orchitis. Relatively more often, measles, which can sometimes be confused with rubella, leads to similar consequences.

The occurrence of orchitis is a key moment for the development male infertility. This pathology has a clear clinical picture and is usually easy to diagnose.

Signs of orchitis are:

This pathology requires urgent medical attention. Identification of the pathogen and correct, timely treatment can prevent the development of male infertility.

Signs of infertility are:

The main criterion for male infertility is the inability to conceive a child through regular sexual intercourse with one healthy woman without using any method of contraception. Making this diagnosis requires a comprehensive examination, semen and blood analysis, and checking hormone levels. Often, a decrease in sperm quantity or quality can be treated. In some cases, it is possible to use artificial insemination.

Rubella

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

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 progressed 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 the viral nature of the disease. And in 1961, the causative agent of rubella was isolated.

The disease haunted all pediatricians. Several decades ago, the infection ranked third in the ranking of diseases that cause rashes in children. It was widespread and it was considered normal to get it in childhood. And since a full-fledged treatment has not yet been invented, complications were observed in almost every sick child.

In the middle of the 20th century, it was proven that the rubella virus leads to disruption of the proper development of children when the mother is 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 from the 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 most acute infection. Congenital rubella and complications of 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, a congenital disease is considered as a slow-acting infection, because often the child after birth experiences suppressed development of organ systems.

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

Symptoms

How does rubella manifest? During the incubation period, the disease will not manifest itself in any way, and it can sometimes last about three weeks or 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:

headache, dizziness

Rubella symptoms change in stages.

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?

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, the typical symptom of 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 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 making a correct diagnosis?

In most cases, special research methods are rarely resorted to, since many of them are expensive or require a long time for the pathogen to grow. 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.

Apart from the enlargement of peripheral lymph nodes and the appearance of a rash, there are no clear external signs of the 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 herpes virus types 6 and 7. In adults, this microorganism causes chronic fatigue syndrome, 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:

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.

bed rest

Bed rest is a prerequisite during intoxication, when the child has a headache and severe weakness, the body must rest more.

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 only the prescription of symptomatic medications.

Symptomatic treatment of rubella

What medications are prescribed to treat rubella?

Severe course of the disease or development serious complications, such as panencephalitis, are an indication for hospitalization in the infectious diseases department or intensive care unit. In these cases, you should not wait for a doctor, you need to call ambulance, because the number of deaths from rubeolar encephalitis 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 preventive measure, outbreaks of the disease occur every 10 years in various regions.

What anti-epidemic measures are taken for rubella?

Prevention of rubella

Today, the only effective way to prevent rubella is vaccination. Almost from the first days of vaccine development, it was included in the National Vaccination Calendar. 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 takes place 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 do not play a role in this last role. But still, the main function in the fight against rubella belongs to immunization through vaccinations.

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 poses a serious threat to 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 was first fully described by 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 the human body. In the external environment, it quickly dies under the influence of ultraviolet radiation, due to insufficient humidity or changes in pressure. At 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, the rubivirus is released into the 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 for infection are organized groups (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 the mucous membranes of the 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 to this virus for life.

What does rubella look like?

The duration of the incubation period is about 15 days. The next catarrhal period is 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, rashes appear in 90% of patients against the background of itchy skin. They look like small pink spots of regular shape 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 a slight increase in 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 a very dangerous form of the disease. In most cases, it is characterized by a complicated course. Possible consequences include disruption of the central nervous system, hearing and vision.

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 have already described what rubella looks like a little higher). The next stage of the examination is laboratory testing:

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

Differential diagnosis with measles, enterovirus infection, and scarlet fever is mandatory.

Basic principles of treatment

A person who already has rubella does not need emergency hospitalization. No special drugs have been developed against this disease; only symptomatic therapy is used. It is important for the patient to adhere to bed rest, eat right and drink 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, damage to 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 of the baby in 30% of cases. About 70% of children die in the first year of life. Certain manifestations of the disease make themselves felt only at puberty. These are autoimmune thyroiditis, diabetes, and growth hormone deficiency. In the blood of an infected child, the rubella pathogen can remain active for several years. Modern medicine cannot offer a specific treatment for this disease.

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). It is forbidden to mix different drugs 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.