How dangerous is the rubella virus. Signs of rubella in adults. Rubella symptoms in children

Rubella is a disease of viral etiology, which is mostly inherent in children of childhood. This togavirus infects children under 6-7 years of age and is not considered serious illness. Another thing is for adults. All signs, both primary and secondary, in people who fall ill in adulthood are much more pronounced, and the disease is much more severe.

This is a virus from the togavirus family, which can enter the patient's body in two ways.

1. Traditional airborne, that is, exclusively through the air or with microscopic particles of saliva, sputum, and so on from an infected person to an uninfected person.
2. Not so widespread transplacental transmission, which occurs from mother to fetus during pregnancy.

Important! This disease, harmless to children, moderate- for adults, especially dangerous for pregnant women. If the fetus being carried by the mother receives rubella transplacentally, this can lead to irreversible pathologies in his body.

When adults are infected with rubella (of course, by airborne droplets), the disease proceeds with specific long-term complications.

How rubella starts in adults

After a person has come into airborne contact with someone infected, the disease does not occur immediately, but only after two to three weeks. Moreover, at first the symptoms may not be fully expressed and resemble the manifestations of an ordinary SARS.

At the same time, already from the fifth day from the moment of infection, a person begins to spread pathological viruses around. That is why, even in past centuries, rubella was considered a highly contagious disease and was capable of causing extensive epidemics.

By the way! The rubella virus has a low resistance to environment and quickly dies under directed ultraviolet radiation.

Today, thanks to universal mandatory vaccination, mass outbreaks of the disease occur much less frequently. Besides, if earlier diagnosis"Rubella" was finally established, mainly, only after the appearance of a specific small red rash in the patient, now already at the beginning of the incubation period, if there is a possibility of infection, you can take a blood test for the presence of antibodies lg G, lg M.

The peak of infections is in cold period autumn-winter when protective functions of the body are reduced, and the person is more susceptible to different kind pathologies. It was in the cold season that it was statistically recorded maximum amount appeals of rubella patients to medical institutions.

How the disease manifests itself

The virus can take two different forms.

1. Atypical (implicit, erased) - this form is characterized by the course of the disease in a mild manner with implicit symptoms.
2. Typical (manifest) - with it, signs of the presence of the virus can be from medium to high severity.

Signs of rubella infection in adults

There are a number of symptoms that occur first and are considered the main ones. One of the acute signals of the onset of the disease is fever.

The first symptom is high fever.

An increase in temperature, accompanied by fever, is taken by one hundred percent of patients as the onset of an acute respiratory disease, simply - colds. And this is quite understandable - the patient's well-being is deteriorating in the same way as it happens with acute respiratory infections, only faster and stronger. The heat can reach up to forty degrees, and it is often difficult to bring it down.

The second symptom is an increase in lymph nodes.

The first day of the course of the pathology is accompanied by an increase lymph nodes. Doctors, of course, know about this, but the patients themselves rarely pay attention to the inflamed nodes. Nevertheless, this is a clear symptom of rubella, and any group of lymph nodes can become inflamed - from the cervical to the inguinal. The regularity of inflammation of one or another group from the patient's age, stage or strength of the disease has not been established by medicine.

The third symptom is a rash

The most recognizable main symptom by which the disease is diagnosed. Here, even non-specialists have no doubt that this is rubella, and not another infection with similar clinical manifestations.

The rash on the skin of adults is different from the one that occurs with rubella on the skin of children.

Rashes on children's skin resemble small red dots. Adults have dots on the skin that have merged into continuous spots that form erythema.

Moreover, there is a certain sequence of occurrence of these spots. They begin to form behind the ears, then gradually cover the upper and lower limbs. On the final stage rashes are formed on the back and in the buttocks area.

Important! In all cases of the disease, a rash also occurs in places where it is not immediately and not always detected - on the mucous membranes. In particular, it is possible to distinguish rashes on the surface of the sky, as well as on inside cheeks

Other symptoms appear later and are classified as minor. Among them, the first is an incessant migraine.

Headache

Headache can occur in the first few days of the disease and continue like a migraine, but not with attacks, but constantly. This rubella migraine is not relieved by medication and causes adult patients significant malaise. A headache can begin on any of the three days from the onset of the disease.

Joint and muscle pain

This sign of rubella is often mistaken for a manifestation of the flu. Painful sensations are exactly the same as those that occur when infected with the flu. There is aches in the muscles, "twists" the joints. General state pain in the whole body accompanied by lethargy and weakness.

watery eyes

Watery eyes are one of typical signs rubella

This is also one of the typical influenza manifestations, which is also characteristic of rubella. Tearing is especially enhanced if the patient is in a room with bright artificial lighting, but in daylight this symptom is also quite pronounced.

Advice! A rubella-infected adult should be kept at rest in a dimly lit room at night and with curtains closed during the day.

Conjunctivitis

Practically mandatory is for the flow adult disease a symptom of festering eyes. Somewhere on the fourth day after active start disease and manifestations of its first signs, pus begins to stand out from the eyes. Most of it is released at night and hours, so in the morning the patient hardly opens his eyes and needs to be washed.

Throat, cough, nose

This ARVI "trio" always occurs with rubella, in any adult. All symptoms of a respiratory viral infection appear very brightly, in full force, and linger in the patient for a long time.

Video - Rubella in adults: symptoms, consequences in men and women, treatment, prevention, vaccination

What to do with rubella

There are no medications to treat the rubella virus. If there is a risk of getting rubella (infected child in the family, visiting children's team or any contact with a possible carrier of the infection), one or more symptoms appear, the following steps should be taken immediately.

Step One - Seek Medical Care

It is imperative to contact medical institution to diagnose a disease. Further, if the disease proceeds without special pathologies, you can carry out home treatment.

Step two - isolation

In a home hospital setting, an adult with rubella is allocated a separate room in such a way as to minimize his contact with all relatives and family members.

By the way! In a room where a patient with rubella is kept, it is necessary to carry out full ventilation every four hours and do a deep wet cleaning.

Step Three - Medications

If there are no drugs directly for rubella, this does not mean that they should not be taken at all.

1. A sick adult should be given an antipyretic when the temperature rises above 38 degrees.
2. Immunomodulators are also prescribed, which will help increase the body's resistance to a viral attack.
3. From the manifestations of SARS, sprays, rinses, drops, suppositories, ointments, suppositories, expectorants are used.
4. At severe itching rashes are taking antihistamine tablets, as well as external ointments.

Step four - mode

Bed rest for an adult with rubella is mandatory, at least for the first few days.

It is important to follow a diet - eat not heavy, easily digestible foods, fruits.

It is necessary to constantly drink plenty of fluids, most of which should be herbal decoctions.

Complications and their consequences

This disease is characterized by a large number of subsequent and accompanying complications, many of which are so serious that they can lead to death.

Video - Rubella. How to avoid the consequences of the disease

Complications after rubella

How to protect yourself from rubella

Effective protection against rubella is vaccination

There is protection against this dangerous infection for adults. This is vaccination. If you had rubella in childhood, there are antibodies to the rubella virus in the body, which means that in adulthood, even when in contact with the patient, infection will not occur.

But if, as a child, you did not get rubella, the vaccine can be given to an adult, and doctors strongly recommend that everyone get vaccinated.

One of the most common viral infections, found predominantly in childhood, is rubella. it viral disease, which in most cases proceeds in a mild form, is accompanied by a short-term increase in body temperature, a small rash, an increase in all lymph nodes. Rubella most often affects children of early and before school 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, and how to treat the disease - we will consider further.

What is rubella?

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

The rubella virus tolerates freezing well, for several hours it retains its aggressiveness when room temperature, quickly perishes under the influence of ultraviolet radiation, heating and disinfectants.

Factors that destroy the rubella virus:

• drying;
• the action of acids and alkalis (the virus is destroyed when the pH decreases less than 6.8 and increases more than 8.0);
• action of ultraviolet radiation;
• the action of ethers;
• action of formalin;
• action disinfectants.

Transmission routes

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

Rubella transmission routes:

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

The 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 ill and have not been vaccinated; children 2-9 years old fall under this category of people. Outbreaks of morbidity are characterized by seasonality - winter-spring. Epidemic outbreaks recur every 10 years. After the disease, a stable lifelong immunity is formed, but according to some reports, 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 temperature of the air.

Incubation period

Incubation period with rubella - from 10 days to 25. It is believed that children in whom the disease occurs without any manifestations or with mild severe symptoms, are more powerful sources of infection than children with clear signs infections.

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

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

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

How does rubella begin: the first signs in a child

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

How rubella starts:

• First, the following symptoms appear: nasal congestion, sore throat, weakness, drowsiness, temperature.
• Further, enlarged lymph nodes and their swelling become noticeable. Pain is noted on palpation.
• Most characteristic symptom at diagnosis - red spots.

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

• incubation (from the moment the infection enters the human body to the development initial symptoms diseases);
• 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 itself and looks like, and they often confuse this disease with a typical cold or acute respiratory disease. But it is necessary to carefully diagnose each such case and take measures to prevent the complications of the infection, which may affect the structures of the brain, nerve fiber, back brain and connective tissue. Especially often the walls of small blood vessels are affected.

Rubella rash in children is localized around the ears, on the cheeks, in the region of the nasolabial triangle, 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. Rashes never capture the skin of the palms and feet, but are most disturbed on inner surface thighs, outer forearms, buttocks.

Rubella symptoms in children

From the moment of infection with rubella to the appearance of the first symptoms, an incubation period passes, which lasts 11-24 days (in most patients - 16-20 days). At this time, the virus enters the cells of the respiratory mucosa, and from there into the bloodstream, spreads with the bloodstream throughout the body, multiplies and accumulates.

In the incubation period, rubella manifests itself as follows:

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

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

Children have the following symptoms:

• body temperature rises to 38 ° C and lasts 2 days;
• a slight increase and slight soreness of the cervical and submandibular lymph nodes;
• redness of the throat;
• slight runny nose;
• conjunctivitis.

Skin rashes with rubella (exanthema) appear first on the face, neck and behind the ear, after which it quickly spreads down the body. This process goes quickly, so sometimes it seems that the rash appeared simultaneously on the whole body.

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 localizations it is more scarce. The rash usually does not itch.

If the children are older, there may be complaints to parents about pain in the area of ​​\u200b\u200bmuscles, joints, rashes initially manifest themselves in the face, but then a rash on the body starts, spreading over the limbs, trunk, and scalp.

The period of rashes lasts on average from 3 to 7 days. Then the child's condition noticeably improves, appetite returns, cough and sore throat disappear, relief nasal breathing. The size and density of the lymph nodes returns to normal 14-18 days after the disappearance of the rash.

Complications

Complications of rubella, as a rule, are detected in its severe course and are most often represented by the following pathologies:

• Connecting a secondary bacterial infection(pneumonia, otitis);
• Serous meningitis or encephalitis characterized by relatively favorable course(this complication may develop on the 4th-7th day of illness);
• thrombocytopenic purpura;
• Intrauterine fetal death;
• Congenital malformations.

The cause of complications is severe course rubella, lack of treatment, non-compliance medical appointments, accession of a secondary infection bacterial nature on the background of reduced immunity.

Diagnostics

With the development or only suspicion of infection with rubella, 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 determine this infection. Considering that the most "talking" symptom - a rash - appears towards the end of the disease, it is necessary to establish a diagnosis based on the anamnesis, data on the epidemiological situation and laboratory tests.

The diagnostic study includes the following laboratory tests:

• General blood analysis ( elevated ESR, lymphocytosis, leukopenia, possible detection of plasma cells).
• Serological examination of nasal mucus (RSK, RIA, ELISA, RTGA).
• Determination of the concentration of antiviral immunoglobulins.

Diseases similar in symptoms to rubella:

• adenovirus infection - a cold disease in which the lymph nodes increase;
• 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 in the form of a rash on the skin;
• infectious - a viral disease in which there are signs of a cold, increase in the lymph nodes, liver, spleen;
• - a fungal disease in which spots appear on the skin;
• urticaria - allergic reaction in which red spots appear on the skin;
• infectious erythema - red skin rash, which can occur in some patients with any infectious disease.

Rubella treatment

Special drugs that could directly affect the virus, namely rubella, have not been developed. The disease usually occurs in mild form and the child's body, in the absence of complications, copes well with the disease itself.

An important aspect is only the observance of bed rest, abundant drinking regime, for the speedy removal of pathogen toxins from the body, as well as the appointment of drugs that help eliminate the symptoms that occur.

Specific treatment has not been developed, so they use:

1. bed rest within 3-7 days;
2. full nutrition, taking into account age characteristics;
3. Etiotropic therapy with the use of viracides (arbidol, isoprinosine), immunomodulators (interferon, viferon) and immunostimulants (cycloferon, anaferon).
4. detoxification therapy - drinking plenty of water;
5. Askorutin 500 mg three times a day (replenishing 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 certain character cough, i.e. you can not use expectorants and antitussives at the same time), mucolytics, antipyretics, analgesics).

Medications are prescribed to prevent complications and relieve symptoms

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

Principles of rubella treatment in children under 1 year old:

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

Rubella in children under one year of age gives a stable lifelong immunity, which allows you to refuse vaccination in a timely manner.

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

Even if the child feels well, he should not visit Kindergarten, school or other 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 receives vitamins and means that strengthen the immune system. It is also desirable that the child drink as much liquid as possible.

Prevention

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

The main methods of prevention:

1. A sick baby is isolated from other children until complete recovery. Usually, the sick person, from the onset of the rash, is isolated for 10 days. Sometimes (if there are pregnant women in the family or group), the quarantine period is extended to 3 weeks.
2. Complete exclusion of contact between pregnant women and a sick person. In the event of contact - repeated serology for 10-20 days (identification of an asymptomatic course). The introduction of immunoglobulin does not prevent the development of rubella during the period of gestation.
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.

is an acute viral infection, manifested by characteristic rashes against the background of moderate intoxication, accompanied by regional lymphadenopathy and hematological reaction. The rubella virus enters the body through the mucosa respiratory tract where it enters with the inhaled air. The incubation period lasts from 10 to 25 days. Typical signs of rubella are the appearance of a rash on the face first, its rapid spread throughout the body and the absence of palms and soles on the skin. Rubella is diagnosed clinically.

The natural susceptibility of a person is high. Especially in women childbearing age, mostly 20-29 years old. The entrance gates of infection are the mucous membranes of the upper respiratory tract, sometimes damaged skin. Reproduction and accumulation of the virus occurs in the regional lymph nodes. The multiplied virus spreads through the bloodstream, affecting other lymph nodes and settling in the skin, while provoking an immune response. The formed antibodies attack the virus and cleanse the body. Post-infectious immunity is stable, lifelong.

Rubella symptoms

The incubation period for rubella is 10-25 days. The disease in adults usually begins with prodromal signs: fever (sometimes it can reach quite high values), malaise, weakness, headache. Often there is a moderate runny nose, dry cough, sore throat, lacrimation, photophobia. Examination may reveal mild hyperemia of the pharynx and rear wall pharynx, irritation of the conjunctiva. These symptoms usually persist for one to three days. In children catarrhal symptoms are most often absent.

AT initial period diseases both in adults and in children, lymphadenitis is noted mainly of the occipital and mid-cervical lymph nodes. Lymph nodes are enlarged, painful to the touch. Lymphadenitis can persist for up to 2-3 weeks. Eruptions appear after the catarrhal period. The rash is usually preceded by pruritus.

In 75-90% of cases, the rash appears on the first day of illness, first on the face and neck, behind the ears, under the hair. In some cases, the rash may spread from a different location. During the day, the rash covers various areas of the skin with the exception of the palms and soles. Especially characteristic are rashes on the buttocks, back, extensor surfaces of the limbs, in rare cases a small single enanthema of the oral mucosa (Foreheim's spots) is detected. The rash is small, spotty, not rising above the surface of the skin. The spots are red or pink, rounded, with smooth edges, the skin around the elements of the rash is not changed. In adults, the elements of the rash often merge; confluent exanthema is not typical for children.

During the rash, body temperature remains within the normal range, or rises to subfebrile figures, polylymphadenitis is noted. Sometimes there are myalgia and arthralgia, symptoms of dyspepsia, moderate hepatosplenomegaly may appear. Women often report symptoms of polyarthritis. The rash usually persists for about 4 days, after which it quickly disappears without leaving any consequences. In general, rubella in adults proceeds in much the same way as in children, but the severity and duration of the course are usually more significant, brighter catarrhal symptoms, abundant confluent rash, signs of lymphadenopathy are less pronounced, may not be noted by patients at all.

Complications of rubella

Complications of rubella are not frequent, as a rule, they arise as a result of the addition of a bacterial infection. Mostly among those there are secondary pneumonia, tonsillitis, otitis media. Sometimes rubella is complicated by arthritis, thrombocytopenic purpura. In adults, in rare cases, the development of complications from the nervous system is possible: encephalitis, meningoencephalitis, encephalomyelitis.

Rubella is more dangerous if it develops in pregnant women. The infection does not have a noticeable effect on the mother's body, but has an extremely adverse effects for the fetus: starting from birth defects development to intrauterine death. The likelihood of developing malformations directly depends on the gestational age at which rubella infection occurred. The same dependence can be traced in relation to the occurrence of congenital rubella: in mothers who fall ill at 3-4 weeks of pregnancy, the risk of infant pathology is 60%, if a woman is affected after 13-14 weeks, it is reduced to 7%.

Rubella Diagnosis

Methods specific serological diagnosis rubella has a retrospective diagnostic value, since a study of paired sera is performed with an interval of 10 days. An increase in the titers of immunoglobulins M and G is determined using RSK, ELISA, RTGA or RIA.

Besides, serological analysis and the setting of the reaction of blast transformation of lymphocytes is performed in pregnant women who have had contact with persons with rubella to identify infection and the likelihood of damage to the fetus. Analysis of the blood serum of a pregnant woman is carried out in the maximum early dates and no later than 12 days after contact with the patient. The detection of immunoglobulins G during these periods usually indicates the transfer of an earlier infection and the existing immunity to it, which allows you to fearlessly maintain pregnancy. The appearance of antibodies only in the second serum (mainly immunoglobulins M) indicates an active infectious process that could adversely affect fetal development.

To non-specific methods laboratory diagnostics rubella can be attributed general analysis blood. The blood picture usually shows lymphocytosis with generalized leukopenia, increase in ESR. In adults, plasma cells may be found in the blood. Additional diagnostic methods for rubella are needed mainly if complications are suspected. Diagnosis of pneumonia is carried out using x-ray of the lungs. At neurological disorders conduct an EEG of the brain, rheoencephalography, Echo-EG. The occurrence of otitis media requires consultation with an otolaryngologist.

Rubella treatment

As a rule, rubella is treated on an outpatient basis, hospitalization is carried out only in case of development dangerous complications. Etiotropic treatment of rubella has not been developed; in most cases, recovery occurs independently due to the elimination of the virus as a result of the formed immune response.

Therapy in cases of severe course consists in the appointment of symptomatic and pathogenetic drugs (detoxification therapy, antipyretics, sedatives, antihistamines). With the development of rubella arthritis, chloroquine is prescribed for 5-7 days. The development of neurological complications is an indication for the appointment of prednisolone, dehydration therapy. Congenital rubella is currently not treatable.

Forecast and prevention of rubella

In the vast majority of cases, the prognosis is favorable, the disease ends with a complete recovery without any consequences. The prognosis worsens in the case of the development of rubella encephalitis. Special meaning has rubella in obstetric practice. The transmission of infection by the mother can have extremely adverse consequences for the fetus. The variety of possible fetal malformations (congenital cataract, deafness, heart defects, microcephaly, etc.) with rubella pregnant women is the wider, the earlier infection occurred.

Specific prophylaxis of rubella in developed countries is carried out with the help of routine vaccination with a live associated vaccine against measles, mumps and rubella. In addition, there are monovaccines. Rubella vaccination is performed twice, the first time at the age of 12-16 months, then revaccination at 6 years of age. In addition, in the future, adolescent girls and young women are often revaccinated.

Emergency prophylaxis is carried out for contact children and pregnant women with the help of the introduction of anti-rubes immunoglobulin. Rubella patients are isolated until 5 days after the onset of the rash. There are no special quarantine measures for sick and contact persons.

Acquired rubella in children is much more common than congenital forms of the disease. This is facilitated specific ways transmission of infection. Most often, acquired rubella is spread by airborne droplets among groups of children from a sick child. sick person begins to secrete active form rubella virus already on the 7th day from infection. Isolation of the virus continues 21 days after the skin rash disappears. In the first 5 days after the appearance of a specific rash on the skin, the patient secretes the most dangerous strains of the rubella virus. During this period, the level of risk of infection increases many times over. Infection with acquired rubella is possible only when direct contact with a sick person. The virus is not stable in the external environment and spreads easily only where there is a large crowding of people and there is a shortage fresh air. Therefore, periodic ventilation of the premises and compliance with the sanitary standards for the stay of children in children's institutions are effective measures. preventive work against rubella and many others that are transmitted by airborne droplets.

How rubella manifests itself: symptoms do not appear immediately

Rubella does not give symptoms immediately after infection. This infectious disease There is a fairly long incubation period. At this time, the rubella virus adapts in the baby's body, actively multiplies and prepares for a centralized attack on various organs and systems. The usual incubation period for acquired rubella is 10 to 21 days. The median incubation period for infants and toddlers is 18 days. During the incubation period of rubella in children, no external symptoms and signs.

But even after the end of the incubation period, rubella does not always give symptoms. According to clinical observations recent years, more than leaks in a latent form. It is also called subclinical. At this time, the symptoms of rubella are expressed or very weakly or not defined at all. The normal course of rubella in children begins acutely, with a prodromal period, which lasts an average of 2-3 days. The main symptoms of rubella at this time are a significant increase various groups lymph nodes. In particular, there is hypertrophy and soreness of the occipital, submandibular, behind the ear lymph nodes. Their density increases and sensitivity to palpation increases. With an acute onset of the disease, the lymph nodes are visible, they appear above the skin of the neck. also rubella symptoms can give in the form of catarrhal phenomena. Among them are noted such as redness of the mucous membranes of the oropharynx, nasal congestion, dry cough caused by inflammation of the palatine tonsils.

Rubella symptoms also appear depending on the age of the baby. The most acute and severe course of the disease is observed in children of preschool and primary school age. In infants and toddlers, rubella symptoms are mild and more mild. At an older age, in the prodromal period of rubella, there is sharp rise body temperature. Usually the thermometer values ​​are fixed at around 38 degrees Celsius. After the appearance skin rashes body temperature returns to normal. If a third-party infection does not join during the course of the disease, then the child's body temperature is no longer observed.

Common signs of rubella in children

The most common signs of rubella in children include not only catarrhal phenomena. It becomes quite simple to determine rubella after it ends prodrome. At this time, a characteristic small red rash appears on the patient's body. Rashes appear simultaneously on all parts of the baby's body. In some cases, a rubella rash can become weepy. However, the classic form of skin rashes is much more common. These are small pinkish dots scattered throughout the body. In some places, there is a merging of individual elements. The gluteal regions, the anterior surface are more affected abdominal wall, bends of the limbs, outer thighs, back.

The rash lasts approximately 3-5 days. Then she begins to quickly turn pale and after a few hours disappears without any consequences. Rubella rash does not leave behind increased pigmentation, scarring of the skin and peeling of the stratum corneum of the epidermis.

Common signs of rubella include generalized inflammation of the posterior cervical lymph nodes. This sign of rubella allows in the first hours of the disease to differentiate it from colds, which are also accompanied by sore throat and fever. The enlargement of the lymph nodes is not accompanied by their cohesion with the surrounding tissues. Palpation is slightly painful. Hypertrophy of the lymph nodes is detected a few days before the appearance of skin rashes and continues for 2 weeks after the disappearance of the rash. In the practice of pediatricians, there are also cases when the enlargement of the lymph nodes persisted for several years after suffering rubella. This is a normal phenomenon, which indicates that the body baby is coming active fight against the rubella virus. Sore throat and fever also disappear with the rash. Catarrhal phenomena do not occur in the future

What are the symptoms of rubella in older children?

If in the chest and toddler parents may not even notice that their baby has been ill with rubella, then at an older age this disease is difficult not to notice. acute onset and rapid course are accompanied by a number of unpleasant symptoms. It should start with the fact that fever and sore throat with rubella are observed only in older children, adolescents and adults. Skin rashes at an older age are more severe and have a high tendency to merge. They are accompanied by severe itching.

Also, in older children, rubella can cause symptoms in the form of damage to the mucous membranes of the eyes. These are manifestations in the form of conjunctivitis, fear sunlight, lacrimation. These phenomena are quickly joined by the phenomena of rhinitis in the form of a runny nose and congestion of the nasal passages. After the appearance of a rash, older children may begin to worry about flying pains in large joints, muscle tissue. on examination, redness can be detected skin over the surface of the joints. Pain on palpation. With the wrong therapeutic approach, arthritis and myositis in adolescents can turn into chronic forms of the course of the disease.

Very often in children with rubella are affected small joints hands and feet. Further inflammatory process can spread to large ankles, knees, shoulders and elbow joints. With proper management of rubella treatment, joint pain disappears completely within 2 weeks after the disappearance of skin rashes. The boys in adolescence rubella can provoke and testicles. In girls in adolescence, the phenomena of adnexitis against the background of rubella are not common.

The consequences of rubella in children

The consequences of rubella in children can be very different. It all depends on the age of the baby and the form of the course of the disease. As a rule, mild, subclinical forms of rubella leave absolutely no consequences behind. Encephalitis is considered the most formidable consequence of rubella. This complication occurs exclusively in adolescence and adulthood. The frequency of lesions of the meninges after rubella is negligible, approximately 1 case per 10,000 diagnosed cases of infection. Usually encephalitis develops very quickly, before the onset of skin rashes. In rare cases, autoimmune encephalitis occurs after a generalized rash has appeared on the patient's skin.

The first manifestations of encephalitis in a sick child are sharp deterioration a condition that is accompanied by disorder and confusion. Meningeal symptoms quickly join this. AT severe cases a convulsive syndrome develops, which can lead to respiratory arrest and cardiac depression. Without a timely medical care All this can lead to the death of the child.

Second serious consequence rubella in children is a lesion of the central nervous system. This can manifest itself in the form of paresis and paralysis, a decrease in the sensitivity of certain areas of the skin, deterioration of vision and hearing. The frequency of such consequences of rubella is about 25 percent of total diseases. More than 30 percent of children with lesions of the central nervous system with rubella die.

Long-term effects can be congenital rubella. Back in 1975, a violation was first diagnosed brain activity in a teenager who had rubella in the prenatal period. Currently, doctors know for certain that rubella can have consequences even after a few years. This can manifest itself in the form of a violation of the child's mental development, his mental disability, and writing. A decrease in the level of intellectual abilities is often accompanied by impaired coordination of movements and inconsistency in the work of individual parts of the brain. Unfortunately, such consequences of rubella are not treated and are not compensated for by additional pharmacological factors of influence.

Rubella: treatment and symptomatic therapy

If a child has rubella, treatment should begin immediately. Science is not yet aware of specific medicines, which have a direct effect on the rubella virus. Therefore, treatment is mainly symptomatic. the main task of the local pediatrician is to organize sufficient measures to prevent the spread of infection among the child and adult population. A sick child is extremely dangerous.

For immunocompromised children, the use of interferon is recommended to enhance the immune response to the virus. Usually, such children and toddlers with severe forms are hospitalized in infectious diseases departments. there they are under round-the-clock supervision by a doctor.
mild forms of rubella can be treated at home. For adequate therapy appointed:

• strict bed rest during an increase in body temperature;
• treatment skin surfaces in the area of ​​​​rashes;
• symptomatic treatment in the form of antipyretic drugs, tonic and vitamin complexes;
• taking drugs that stimulate the production of immune bodies.

Constant ventilation of the premises where the sick child is located is required. Wet cleaning is carried out in the morning and evening with the use of disinfectants. at the first signs of rubella complications, the baby should be hospitalized in specialized departments. for the entire duration of treatment, the child is isolated from contact with peers and other people. Family members should adhere to the rules of personal hygiene, enter the room with a sick child only in a gauze bandage.

Prevention and vaccination against rubella

The rubella vaccine is the only effective way prevention of outbreaks of this infectious disease. The rubella vaccine is first given to a baby at 1 year of age. Then, throughout life, repeated vaccination against rubella is required at the age of 6 and 15 years. Girls are usually vaccinated during adolescence. For boys at this age, rubella is no longer terrible. Teenage girls are vaccinated in order to develop immunity for the period of future pregnancies. In modern practice, it is used combined composition rubella vaccines. It also includes attenuated titers of smallpox, measles and mumps. According to studies, stable immunity to rubella is formed in approximately 95% of cases of strict observance of the vaccination calendar.

Chickenpox and other viral infections transmitted by airborne droplets are not very stable in the external environment and mainly affect only people with weak immunity. That is why children are more likely to get sick than adults.

Rubella though rare disease, from which a vaccine was invented back in the 70s, but still very insidious and can have severe consequences. Therefore, everyone should know as much as possible about it in order to take timely and correct measures. In this article, we will talk about what is the rubella virus, what are the symptoms and treatments. this disease in children and adults, as well as methods of prevention in the form of rubella vaccination.

Rubella virus - description and methods of infection

The causative agent of this disease is the Rubella virus, which belongs to the Togavirus family. As mentioned at the beginning, this virus is not very resistant to the external environment - it quickly dies under UV rays, under the influence of disinfectants, elevated temperature(over 56 degrees), when drying, etc. In a room at room temperature, it dies after a few hours.

Rubella as individual disease was bred in 1881, but viral nature disease was proven by Japanese scientists only in 1938.

The disease is characterized by seasonality - spring-autumn. At risk are children from 2 to 9 years old, unvaccinated adults and pregnant women with weak immunity. After past illness or vaccination, a strong immunity to the strain of the virus is formed, although there are cases when the disease was recorded repeatedly.

How does rubella infection occur?

Rubella disease exists in two forms - congenital and acquired. The congenital form is when the rubella virus is transmitted to the child from a sick mother during pregnancy. The virus easily penetrates the placenta and infects the fetus, where it destroys the cells of the embryo, inhibits its development and growth, causes ischemia, etc. If a baby is infected with rubella during pregnancy, the likelihood that he will be born with a variety of defects (heart disease, glaucoma, brain development disorders, etc.) is very high. As a rule, if infection occurs in the first weeks of pregnancy, doctors strongly recommend interrupting it (we will talk about this in more detail later in the article). Rubella during pregnancy is extremely dangerous, therefore, if a woman was not vaccinated in childhood, it is necessary to be vaccinated even before conception. As a rule, when planning a pregnancy and during the first examinations during pregnancy, doctors first of all check the woman's immunity for antibodies to the rubella virus.

The acquired form of rubella means that the virus entered the human body through the mucous membranes of the nasopharynx after contact with a sick person. It quickly penetrates into the bloodstream and spreads throughout the body. The incubation period is 15-24 days. Then they appear obvious symptoms(Symptoms and treatment of rubella in children and adults will be described below.) A sick person poses a threat to others for 5-7 days before the appearance of a rash on the skin, and within 7 days after it disappears. A person with rubella is subject to isolation for this time.

Rubella symptoms in children and adults

It's no secret that adults endure "childhood" diseases much harder for the simple reason that an adult organism that is not protected by immunity is exposed to more aggressive effects of viruses. The rubella virus is no exception.

The symptoms of rubella vary depending on the period. There are only three of them:

• Premonitory;
• The period of rashes;
• Reconstruction period.

The first prodromal period is characterized by mild malaise in the first few hours or 2 days. it slight temperature within 37-38 degrees, an increase in the lymph nodes of the occipital and posterior cervical.

The period of rashes most often lasts 3-4 days, rarely 5-7 days. First, it appears on the face, then descends throughout the body. Mostly it is located on the lower back, buttocks and face. The rash looks like copious small pink spots. The reason for their appearance lies in the spread of the virus through the bloodstream. Under the influence of hemagglutenin, located on the membrane of the RNA of the virus, blood erythrocytes stick together - these glued erythrocytes seem to get stuck in the skin.

Rubella in children is accompanied by the following symptoms:

• a slight rise in body temperature, up to a maximum of 38 degrees;
• conjunctivitis;
• slight discharge from the nose;
• rash on the skin.

Rubella in adults is accompanied by more severe symptoms:

• a significant increase in body temperature;
• migraine;
• aches in muscles and joints;
• severe runny nose and lacrimation;
• cough;
• photophobia;
• severe rashes for at least 5 days.

The period of reconvolescence is a period of recovery, when all the rashes gradually disappear.

Rubella during pregnancy

Above, we have already said a few words about how important it is to get vaccinated before pregnancy, and how severe the consequences can be if the fetus is infected. We will tell you in more detail what the consequences of rubella during pregnancy can be.

AT best case it can be:

• cataract;
• heart disease;
• deafness;
• Adolescent Sclerosing Panencephalitis;
• neurological disorders, etc.

In the worst case, the pregnancy may end in stillbirth or spontaneous miscarriage. The earlier the infection of the fetus, the less likely it is that the child will be born alive. More details in the next video.

Rubella treatment in children and adults

There is no specific treatment for rubella in children or adults as such, unlike other viral infections. Here you need:

• Bed rest for 4-7 days;
• Immunostimulators and immunomodulators;
• Plentiful drink and good nutrition;
• Symptomatic treatment (antipyretics, analgesics, mucolytics, etc.).

Rubella vaccine

The disease is better to prevent than to cure. Therefore, it is imperative to get vaccinated. Rubella vaccination is, in fact, the transfer of the disease to mild form without consequences. But! Despite this, the person should still be isolated for 5-7 days before the onset of symptoms, and for 7 days after they disappear. After that, it is recommended to take a blood test for LgG antibodies, if they are - the person is considered immune, if not - re-vaccination is necessary after 5 weeks.

There is also a specific vaccination. It is carried out first at 12-15 months after birth, and then at 6 years of age it is revaccinated. If specific vaccination has not been performed, then the person must be vaccinated in puberty(14-15 years old).

When planning a pregnancy, unvaccinated women should be vaccinated 3 months before conception.

The rubella vaccine is valid for 10-20 years, after which it is necessary to re-vaccinate. This is especially true for women of childbearing age who have been vaccinated. last time at 14-16 years old.

From imported drugs In Russia, only the following are allowed to be vaccinated against rubella:

• Rudivaks (France);
• Errevax (England).