rubella message. Treatment and complications after rubella in adults and children. What are the symptoms of rubella in older children?

is a viral infection that most often affects children 1-7 years old. The name of the disease was due to the fact that spots of bright red color appear on the human body. Other names for rubella: third disease, rubella, german measles, measles rubella. Despite such a variety of terms, they all mean the same infection.

Rubella in adults, unlike children, is quite rare, but, like most of"Children's" infections are more severe and often cause serious complications.

The disease got its name because of the main symptom of the disease - rubella rash. The source of infection in adults, as well as in children, is considered infected person, especially in the last two days of the incubation period and for another five days after the appearance of rashes.

The route of transmission of the disease is airborne. Rubella is a highly contagious infection, so the patient must be isolated, he is advised to comply with bed rest. If the pathology proceeds without complications, the necessary therapy is carried out at home.

Incubation period rubella lasts from 10 days to three weeks. The disease can be asymptomatic, manifesting itself on the fifth day - only after the appearance of rashes. After two days, fever may be observed with a rise in temperature to subfebrile values. In some cases, deterioration in well-being, headache, loss of appetite may occur two days before the onset of rashes.

It is not difficult for a doctor to make a correct diagnosis. It is enough for him to see a rash on his body to understand what kind of infection provoked it. If doubts remain, the doctor will refer the patient for testing. This will confirm the diagnosis. The patient will need to donate blood, which will be sent for ELISA.

The most characteristic symptom of rubella in adults - a rash - is usually more pronounced than in children, individual elements of the rash can merge with each other, forming larger erythematous spots.

Small pink spots first appear behind the ears and on the nose, after which they spread to the arms and torso, moving over time to lower limbs. When draining, the color of the spots becomes darker, which lasts 1.5 weeks. At the same time, adults have a general malaise, patients are worried about pain in the joints and muscles. In most cases, the disease is accompanied by profuse runny nose and sore throat.

In addition to the appearance of a rash, a person's lymph nodes increase in size. This is due to the accumulation of a large number of viruses in them. The nodes located on the back of the head swell especially intensively. This symptom helps confirm the diagnosis.

From the moment of infection to the moment the first symptoms appear, about 10-25 days pass. A person will begin to spread the infection 1 day before the first elements of the rash appear. It remains contagious for up to 7 days after its onset.

The consequences of rubella during pregnancy

Of even greater concern are the symptoms of rubella in pregnant women. If the infectious process begins in the first trimester, then the doctor advises the woman to have an abortion, since intrauterine infection of the fetus often causes serious complications that cannot be treated. Among the consequences transferred by a child in the womb of the disease, malformations of the brain can be observed, and a violation of the formation of some internal organs.

In the event that an abortion is contraindicated for a pregnant woman, and if rubella is infected on later dates the patient is injected with immunoglobulin, after which the condition of the mother and fetus is continuously monitored.

Babies under one year of age are rarely affected by the infection, as they receive protection from their mother. In addition, the contacts of babies with strangers are quite limited. If the infection still occurs, then the child suffers the disease severely. He has a high body temperature, develops vomiting and diarrhea. Self-treatment of a child with rubella is unacceptable. Be sure to call the doctor at home.

There are many diseases that are accompanied by the appearance of a rash on the body. Therefore, you need to know what features the rashes characteristic of rubella have.

A rash appears about 14 days after infection occurs. It remains on the skin for about 5 days. The exact timing depends on individual features immune system person. If a defensive forces fully activated, the rash may disappear in 2-3 days.

Distinctive characteristics of the rash with rubella:

The rash first appears in the mouth. It looks like pink spots.

Then rashes appear behind the ears, on the cheeks, near the lips, near the nose.

A few hours later, the rash spreads throughout the body. It captures the buttocks, shoulders, elbows, hips and knees.

On the body, the rash will have a more saturated color than on the face.

Sometimes there is no rash on the face at all, it appears only on the body.

Spot sizes are kept within 5 mm. At first, the spots will be flat, and then begin to rise above the surface of the skin.

The elements of the rash are single, they do not merge with each other.

If you press on the spot, and then remove your finger, the rash will disappear, after which it will appear again.

Rubella rashes do not affect the skin of the palms, feet, and groin.

The spots may itch, although some patients are not bothered by them.

When the rash passes, there are no traces of its presence on the skin.

Sometimes rubella is asymptomatic. In this case, the rash does not appear on the body. It will be possible to make a correct diagnosis only thanks to a blood test.

How to distinguish a rubella rash from a rash of other diseases?

There are many diseases that are accompanied by the appearance of a rash on the skin.

However, there are some distinctive features lesions of the dermis, which you need to focus on:

	It focuses on the elbows, knees, face, shoulders and buttocks. The rash has a pale pink hue.
	It covers the feet, face and upper part body. The rash is bright, has a rich red color, looks like tubercles.
	It is located on the scalp, distributed throughout the body. The rash looks like spots that transform into bubbles and are filled with fluid.
	Rashes appear on the body in the area of ​​the folds, on the face in the area of ​​the nasolabial triangle. The elements of the rash themselves are small and bright. The patient's tongue acquires a crimson color.
	Elements of the rash appear on the face, but they also appear on the torso. Sometimes the disease proceeds without a rash at all.
	She is focused on the body. The spots are small, have a pink color, protrude above the surface of the skin and quickly pass.

Most often, rubella is confused with measles. While scarlet fever with these diseases is easier to differentiate, since not only the skin, but also the tonsils suffer.

With rubella, the rash spreads quickly over the body. It can occupy the entire surface of the body in a few hours. With measles, this process is extended for 2-3 days. The measles rash tends to coalesce. This does not happen with rubella. The rash passes quickly and leaves no traces behind. The root elements first become pale, peel off, and dark areas may remain in their place.

With roseola, the rash looks like papules, that is, tubercles that rise above the skin. In addition, the body temperature rises greatly. There are no catarrhal phenomena.

In any case, the appearance of a rash on the skin is a reason to consult a doctor. Only a doctor can make a correct diagnosis and prescribe treatment.

Rubella treatment

rubella treatment in adults without fail carried out under the supervision of a specialist: you can not delay therapy and postpone the visit to the doctor. Serious consequences threaten patients in the absence of timely medical care.

Vaccination is considered the most effective preventive measure for people who did not tolerate rubella in childhood.

Education: Moscow medical institute them. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 " Occupational diseases", in 1996 "Therapy".

Rubella is one of the most severe childhood infections. Flowing, as a rule, benignly in children, rubella is very dangerous for expectant mothers, as it is the cause of the development severe pathologies in the developing embryo and fetus. To avoid this, it is important to timely prevent rubella by vaccination.

What are the symptoms of rubella? What tests for rubella help confirm or disprove this infection? How is rubella prevented in children and adults? What medications are used to treat rubella?

What is rubella

Rubella is an infectious disease caused by a member of the togavirus family. The leading signs of rubella are symptoms of intoxication, a characteristic rash, moderate catarrhal phenomena, as well as an increase individual groups lymph nodes.

Rubella infection affects people of any age and gender. In most, rubella proceeds without any special complications for the patient himself. But in case of illness of the future mother in the first trimester of bearing a baby, rubella behaves very insidiously, causing very serious complications in a developing fetus.

Rubella virus - the causative agent of the disease

The disease is caused by the rubella virus. It belongs to the Togavirus family. The rubella virus contains ribonucleic acid. Outside the human body, it quickly collapses. Antibiotics do not work on it, as well as on other viruses. However, he tolerates well. low temperatures and for a long time can retain the ability to live in a frozen state. But as soon as the rubella virus gets under the influence ultraviolet irradiation as soon as he dies.

It is possible to become infected with the rubella virus from someone who is sick with any of the forms of rubella, even from babies with a congenital form of the disease. A sick child or adult becomes contagious one to two days before the typical symptoms of rubella are visible, so they can come into wide contact with other people, infecting them at the same time. After severe symptoms of the disease appear, a patient with acquired rubella remains contagious for another five days.

Children who become infected with rubella in utero secrete a dangerous virus for a very long time. environment. This process lasts for one and a half to two years after the baby is born. The isolation of the virus itself in such children occurs with sputum, stool, urine.

There are two routes of transmission of rubella infection between people. The first way is airborne. It is characteristic of the acquired form of the disease. That is, a person becomes infected from a patient through close contact, when talking, coughing and sneezing, when using common utensils.

The second way is transplacental. It is realized in the case when the expectant mother fell ill with rubella during pregnancy, and transmitted the pathogen to the fetus (embryo) through the placental bloodstream.

After the rubella virus enters human body through the mucous membrane of the respiratory tract, it multiplies in cervical lymph nodes. A week later, togavirus is in the bloodstream. In response to this, lymphoid tissue is damaged. Antibodies begin to appear in the bloodstream, which neutralize the dangerous virus.

2 weeks after togavirus enters the human body, signs of rubella appear in the form of rashes. A week before this, the virus can be detected in the bloodstream and in the mucous discharge of the nasopharynx. In the very period of rashes, the virus is found in the urine and feces of the sick person. A week after the onset of rashes, the pathogen leaves the bloodstream.

Rubella prophylaxis in children begins at one year old. This occurs by vaccination followed by revaccination at the age of six. Not only is the rubella vaccine given a year, in parallel with it, the child is also vaccinated against two infections. Thus, at the age of 12 months, the child receives prophylaxis against the following infections: rubella, mumps, measles.

In addition, a preventive measure for rubella in children is to stop contact with the sick person. In the event that it is not possible to vaccinate against rubella for a child, then you should be careful when visiting educational institutions, public places as well as in travel.

Activities in the focus of infection

• As soon as the child (or adult) shows signs of rubella, parents (or the sick themselves) should call the local doctor or paramedic home. In some situations, parents call an ambulance team. In any case, it is not necessary to take a sick child to an appointment with a clinic. An ill adult also does not leave the house until it is clear whether he is contagious to others.
• The doctor or paramedic who made the diagnosis sends an emergency notice to the Center for Hygiene and Epidemiology.
• The patient is isolated at the initial stage of rubella. The period of this isolation is 7 days from the onset of the rash.
• The very first sick person is isolated from the team for 10 days from the appearance of the first rashes.
• If there are pregnant women in the team visited by the sick child or adult, then this isolation must be extended by 3 weeks. In the event that expectant mothers live with the sick person, they must be separated for a period of at least three weeks.
• medical worker daily examines contact children in the team to identify rubella at an early stage. Such observation continues for 21 days from the date of detection of the last case.
• During the entire quarantine period, new persons who have not been prevented by rubella by immunization before, and who have not had rubella, are not accepted into the team. If a child or adult has been ill with rubella or has been vaccinated against it, then he is allowed into the team.
• Identified contact seronegative persons under the age of 25 should be vaccinated against rubella (vaccinate or revaccinate). It is necessary to have time to carry out immunization no later than 72 hours from the moment the patient is identified.
• Pregnant women who have had contact with a sick person are subject to serological examination and observation by doctors. After that, the issue of terminating this pregnancy or further bearing a child is decided.

Rubella in children

Rubella is most common in children between the ages of two and nine. Susceptibility to disease is high. The infection is practically not registered in children under six months of age, which is explained by the presence of maternal antibodies to rubella. The only exceptions are children from mothers who did not have this infection and were not vaccinated against it.

An increase in the incidence in the cold months of the year is characteristic. Every 3-4 years there is a periodic increase in the incidence of rubella. After past infection a strong immunity is developed, which in most people turns out to be lifelong.

What does rubella look like in children? The symptoms of rubella in children are quite pronounced and include signs of intoxication, a characteristic rash, an increase in certain groups of lymph nodes, and catarrhal symptoms.

The incubation period for rubella is long, it lasts from 15 to 24 days, on average it lasts a little over two weeks.

Initial symptoms of rubella in children

The initial stage of rubella, in which there are clinical signs of infection, initiates a period of rashes. by the most significant symptom rubella in children is a rash.

In addition, the initial stage of rubella is accompanied intoxication symptoms. The general well-being of children is not disturbed much. Body temperature is usually not higher than 38 degrees, more often it stays in the range of 37.2-37.5 degrees. Sometimes the patient does not have a fever at all.

In rubella disease, symptoms in children are accompanied by conditions such as lethargy, drowsiness, malaise, headaches, and joint and muscle pain. They are already present at the initial stage of the disease.

Rubella rash

What do rubella rashes look like in children? The first elements of rashes appear on the skin of the face. The rash then spreads over the entire body. It's happening fast. Favorite localization of rubella rash: extensor surfaces of the arms and legs, skin around the joints, skin of the buttocks.

According to its characteristics, the rash is spotty, may be papular. The color of the rashes is pink. It is worth noting that the background of the skin is unchanged, the usual color.

Some people confuse the symptoms of rubella with the symptoms of measles. Rubella infection is not characterized by staging of rashes, rashes do not merge with each other, as with measles. In addition, rubella rash is smaller than measles. Sometimes with measles there are large elements of the rash, but they have the correct shape and differ in their uniform size.

Mostly rubella in children occurs with mild rashes. The duration of the rash period is 2-3 days, then the rash disappears. Pigmented spots after a rubella rash do not remain, peeling of the skin is also not typical.

With rubella disease, there are symptoms in children that are nonspecific and may accompany other infections. These symptoms include manifestations of catarrhal syndrome. A sick child is worried about a runny nose or nasal congestion, discomfort in the throat (itching, mild soreness), a dry cough.

Very rarely, with rubella infection, rashes appear on the mucous membranes in the oral cavity, rear wall throat, sky. These rashes are small-spotted, pass quickly enough.

An important symptom of rubella in children is an increase in certain groups lymph nodes. These include lymph nodes located on the back of the neck and neck. On palpation of these lymph nodes, the child feels pain. The lymph nodes themselves are enlarged, "juicy".

This symptom of rubella is one of the most pronounced, it persists for another week after the disappearance of the rash. This allows you not to miss rubella in a child if the rash was not severe, or it was mistaken for a rash of a different nature (for example, allergic).

Rubella tests in children

Rubella is usually diagnosed on the basis of clinical symptoms and history. Are there laboratory tests for rubella in children? Rubella can be confirmed in the laboratory in two ways.

• Virological diagnostic method - an analysis for rubella, which helps to isolate the pathogen directly from the blood, urine, feces, swabs from the nasopharynx.
• A serological diagnostic method is a rubella test, which reflects the presence or absence of antibodies to the rubella virus and their increase over time in the event of an infection. This examination is carried out twice with an interval of 7-10 days. The current infection is evidenced by an increase in the titer of antibodies to rubella by 4 times or more. In addition, specific rubella antibodies of classes M and G are determined. Their presence makes it possible to assess the severity of the process.

Usually reflects a decrease in the number of leukocytes, a relative increase in the number of lymphocytes and plasma cells.

Usually rubella treatment in children is carried out on an outpatient basis, that is, at home. It is necessary to hospitalize children with severe and complicated forms of infection, as well as children from closed groups.

For children diagnosed with rubella, treatment is selected by a pediatrician or paramedic. Sometimes consultation with an infectious disease specialist is required. It is important to stay in bed until the rash resolves. No special diet is required, but drinking plenty of fluids is recommended. You can take a shower with normal temperature body.

Rubella treatment in children is carried out only when the disease is severe or moderate forms. As antiviral agents use recombinant interferons (Viferon, Genferon, etc.). These funds are especially indicated for congenital rubella and complicated forms of infection.

In children, in the treatment of rubella, symptomatic agents are used according to indications. They are antipyretic drugs, expectorant drugs, vasoconstrictor drops, local preparations for the treatment of inflammatory processes in the throat, antihistamines.

Treatment of complications of rubella in children is carried out in a hospital. Medications are selected depending on the pathology and severity of the patient's condition.

Rubella in adults

It is generally accepted that rubella is not a severe infection. However, this statement is true only for the majority of children who become infected with rubella after birth. In adults diagnosed with rubella, the symptoms are very pronounced, and the disease itself is characterized by a rather severe course.

Signs of rubella in adults

Rubella in adults is accompanied by a longer fever. It may be accompanied by articular syndrome, when the patient is concerned about pain in the joints. A week after the disappearance of the rash, arthritis often occurs. This is more common in girls and women. AT pathological process internal organs may be involved.

Rubella rash in adults and adolescents is not only spotty and papular. Often there are hemorrhagic elements of rashes. Some elements of the rash merge. A common symptom of rubella infection in adults is severe conjunctivitis. Symptoms of intoxication correspond to those in childhood.

A similar course of rubella can be mistaken for measles. Therefore, it is very important to pay attention to the fact that with rubella the rash does not appear in stages, as with. It is also worth carefully examining the lymph nodes along the back of the neck and at the back of the head.

Diagnosis of rubella in adults is primarily based on history and symptoms of the disease. Laboratory diagnostics rubella in adults corresponds to that in children and includes virological and serological methods diagnostics. The greatest value belongs to the serological method.

Rubella treatment in adults

For sick adults diagnosed with rubella, treatment is prescribed by a therapist or paramedic. specific therapy against rubella has not been developed.

Treatment of rubella in adults with mild, moderate and uncomplicated infection is carried out on an outpatient basis. Antiviral drugs are usually not required. For mild rubella in adults, symptomatic treatment is prescribed, that is, drugs are selected depending on the severity of certain symptoms (runny nose, cough, fever).

In what cases is it necessary to hospitalize an adult for the treatment of rubella?

This applies to severe and complicated forms, as well as adults from closed institutions (for example, barracks) are hospitalized when there is a risk of infecting other people. Sometimes the treatment of rubella complications in adults is carried out even in the intensive care unit. These complications include encephalitis and meningitis.

Complications of rubella in children and adults

Most often, acquired rubella infection in children is benign. But some children still have complications. In adults, the adverse effects of rubella are frequently reported. These include inflammatory processes in the joints, thrombocytopenic purpura, inflammatory processes meninges and brain tissue, polyneuritis.

Among all viral encephalitis, which are registered in Russia, about a tenth of the encephalitis is rubella etiology.

Rubella during pregnancy in the first trimester threatens with very serious consequences for the baby. A pregnant woman is always warned about the risk of a child developing certain pathologies. She must undergo repeated serological survey, after which the issue of termination or prolongation of pregnancy is decided.

Transferred rubella infection in the first trimester of pregnancy is a medical indication for its termination. However, only the family makes a decision about this, doctors only warn the woman about the possible risks.

Why is rubella dangerous during pregnancy?

If the expectant mother gets sick with rubella while carrying a baby, the following will happen: the virus will penetrate the fetus along with maternal blood, infecting the smallest and larger vessels of the placenta, as well as the epithelium of the chorionic villi.

The rubella virus has an affinity for embryonic tissue, causing severe damage to the cells of the embryo, which subsequently develops severe malformations.

Sometimes these defects are incompatible with life: the fetus may stop developing and die in utero, or a child may be born with severe developmental anomalies.

Rubella symptoms during pregnancy

What does rubella look like during pregnancy? Rubella during pregnancy has the same clinical symptoms as any other patient. Considering that rubella in adults is more severe and often with complications, this is also common in pregnant women.

But do not forget that there are erased and asymptomatic forms of infection. Therefore, after any contact with a patient with rubella, the expectant mother should be examined. Even if obvious signs disease is not observed.

Rubella during pregnancy occurs symptomatic treatment illness. Infection in mild form treated at home. Medium and severe forms may require hospitalization. In addition, all complicated forms of infection are treated in the hospital.

Rubella antibody test for pregnancy planning

Modern women are increasingly trying to plan a pregnancy and are very responsible for this. Among the many examinations that a woman who is preparing to become a mother undergoes, it is recommended to donate blood for specific antibodies to rubella.

A high level of specific immunoglobulins (antibodies) of class G, the absence of class M immunoglobulins indicate that a woman has good immunity from rubella. It could have formed as a result of previous rubella (which the woman did not know or forgot about), or developed after vaccination.

If, during such an examination, specific antibodies to rubella are not detected, then this will indicate that the expectant mother is not sick with rubella at the moment, but can easily get sick with it if she encounters the virus.

Rubella testing for pregnant women

If a pregnant woman is at risk of infection, it is necessary to carry out her laboratory examination for rubella antibodies. For this, the enzyme immunoassay method is used.

• The detection of specific class G immunoglobulins (anti-rubella antibodies) in a protective titer in a pregnant woman in the absence of class M immunoglobulins indicates that the expectant mother is reliably protected from rubella (either after vaccination, or after past illness). She does not need further examination.
• In the absence of specific antibodies of both classes, it is necessary to repeat the examination again after two weeks. The expectant mother herself needs to exclude contact with a sick rubella.
• A negative result of the second study serves as an indication for another examination two weeks later (from the second analysis). The negative result of the third study suggests that at the moment the woman is healthy, but she is still at risk of contracting rubella at another time.
• If one of the examinations in the first trimester reveals the presence in the body of the future mother of specific class M immunoglobulins, then the woman is explained everything possible consequences current rubella infection in the fetus.

Specific rubella prophylaxis (vaccination) must be done at least 3 months before the desired pregnancy. If a woman becomes pregnant before the expiration of three months after vaccination, then the pregnancy is not interrupted, but is carried as usual. Rubella vaccine is not given during a known pregnancy.

During pregnancy, only non-specific prevention of rubella is possible: avoid contact with people who are not vaccinated against rubella (especially with children). It is worth trying not to visit children's institutions without urgent need, where there is a chance to meet the rubella virus. You should also stop contact with sick people of any age, whose infection is manifested by a rash on the body, and until the diagnosis of their illness has been made.

What does congenital rubella look like in newborns?

What does rubella look like in newborns? Newborns diagnosed with congenital rubella have different symptoms. They are conditionally divided into "large" and "small" rubella syndromes.

The "small" syndrome in congenital rubella is called the Gregg triad. It includes deafness, various congenital anomalies of the heart and cataracts.

The "big" syndrome in congenital rubella is characterized by even more serious damage. At the same time, there are deep lesions brain, such as complete or partial absence brain, microcephaly, hydrocephalus. Among the defects of the organ of vision, the most common are cataracts, glaucoma, retinal damage, microphthalmia and others.

In addition, serious anomalies of the heart and blood vessels are found in the fetus or newborn. In addition to the above defects, there are defects of the skeleton, organs of the urogenital, digestive systems, the organ of hearing.

inflammatory processes in internal organs manifested by symptoms of hepatitis, myocarditis, pneumonia. Thrombocytopenic purpura is common.

The most reliable way to prevent rubella in children and adults is active immunization. In other words, a rubella vaccine is given. The vaccine is administered subcutaneously.

Used to prevent rubella in children live vaccine. Rubella monovaccines have been developed that protect only against rubella. These include the following drugs: Erevax, Rudivax, rubella vaccine. There are also multicomponent vaccines that protect against the following infections: rubella, mumps and measles. Examples of such drugs that are registered in our country are Priorix, MMR II.

Often, young parents ask themselves the question: “Do I need to vaccinate boys against the rubella disease a year?” They motivate their doubts by the fact that rubella is quite easily tolerated. In addition, boys do not have to bear children. Therefore, vaccination is not necessary for them.

It should be noted that such conclusions are incorrect. A boy with rubella can infect this dangerous infection any pregnant woman who does not have rubella virus antibodies. It is likely that this will be a close family member. Therefore, when deciding on vaccination, it is worth thinking not only about the health of a particular child, but also about the health of society.

Rubella vaccination schedule

The first from the disease "rubella" is done in a year. In the absence of contraindications, the child is vaccinated a year against rubella, as well as against two more diseases (mumps and measles). Revaccination against all three infections is carried out at 6 years of age.

It often happens that a person's vaccination history is unknown. For example, this often happens with refugees and migrants, as well as with the loss of medical records. It also happens that for some reason the child received only one vaccination, and revaccination was not carried out.

For this category of citizens who did not have rubella infection, were not vaccinated against it, or were vaccinated once; and for those whose vaccination history is unknown, vaccination and revaccination against rubella is carried out up to and including 18 years of age. Between the ages of 18 and 25, only women are eligible for this immunization.

If it turns out that the rubella vaccination will be the third or even fourth in a row (for example, with an unknown vaccination history), then nothing bad will happen. With regard to rubella, it is better to play it safe and get vaccinated one more time than to meet this dangerous virus during pregnancy.

AT doubtful cases a blood test for rubella antibodies can be done to see if a woman is well protected against rubella and should be vaccinated.

Since the prevention of rubella in children is carried out with a live vaccine, the reaction to the vaccine does not happen immediately, but from 5 to 20 days. In the event that the child was vaccinated with a monovaccine, normal reactions are considered slight increase temperature, a slight runny nose and cough, an increase in the size of the lymph nodes on the back of the neck and on the back of the head. And adolescents often develop a rubella-type rash after vaccination.

If immunization was carried out with a vaccine against several diseases (rubella, mumps, measles), then a normal reaction to the vaccine may be due to the influence of all these components of the vaccine. That is, in addition to the above reactions, there is a slight increase salivary glands, conjunctivitis, morbilliform rash and others.

Vaccine complications rarely occur. The following complications of rubella vaccination have been reported: joint pain and arthritis, muscle pain, sensory disturbance.

In the case when the child was vaccinated against three infections at once (rubella, mumps, measles), there may be other complications associated with the remaining components of the vaccine. These include allergic reactions, serous meningitis, convulsions, swelling of the testicles, abdominal pain, thrombocytopenic purpura and some others. Such complications are very rare.

Unfortunately, it is impossible to predict in advance how a child will tolerate vaccination. As a result, many refuse to be vaccinated. How more cases unjustified refusals to vaccinate their children will be from their parents, the faster now rare childhood diseases will return to the masses. The adverse effects of these childhood infections are much more common than vaccine complications and are more severe, even fatal.

Acquired rubella in children is much more common than congenital forms of the disease. This is facilitated specific ways transmission of infection. Acquired rubella is most commonly 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 has 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. Average duration The 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 in various groups of 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, a sharp increase in body temperature is observed. 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 the prodromal period ends. 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. To a greater extent, the gluteal regions, the anterior surface of the abdominal wall, the folds of the limbs, the outer surfaces of the thighs, and the back are affected.

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. it 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 of 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 treatment approach, arthritis and myositis in adolescents can turn into chronic forms the course of the disease.

Very often in children with rubella are affected small joints hands and feet. In the future, the inflammatory process can spread to large ankle, knee, shoulder 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 is a sharp deterioration in the condition, which is accompanied by disorder and confusion. Meningeal symptoms quickly join this. AT severe cases develops convulsive syndrome, which can lead to respiratory arrest and cardiac depression. Without timely medical attention, 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.

Congenital rubella can also give long-term consequences. 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 does not yet know specific drugs that 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 of 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 using 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.

Rubella is a highly contagious infectious disease caused by Rubella virus (rubella virus). The infection is especially dangerous in the first trimester of pregnancy due to the risk of severe congenital anomalies in the development of the fetus or its death.

It is a fairly stable microorganism with a double membrane and a ribonucleic acid molecule. This structure of the virus allows it to survive for a long time in the external environment, even under adverse conditions.

Rubella: causes and development factors

The source of infection is a sick person. Rubella is transmitted by airborne droplets, contact (through common objects) or vertical (from mother to fetus) route. The patient sheds the virus as early as 6-8 days before the onset of the rash and remains contagious for a week after the onset of the rash. Children are most often ill.

In the absence of specific immunity in a person (against the rubella virus), the degree of contact with this disease is more than 90%. Typically, the spread of viral particles occurs in closed spaces where there are a lot of people. Usually, kindergartens, schools, orphanages and other institutions where there are many children. AT medical practice there are also cases of infection inside the hospital and in pediatric hospitals. For example, if a child with rubella is mistakenly referred to another department (due to the similarity of symptoms to influenza and lymphadenitis).

Types of disease: classification of rubella

Acquired rubella can occur in the following forms:

• Typical form (light, moderate, heavy).

• Atypical form (no rash).
• Inapparent form (subclinical).

As for congenital rubella, it comes in the following forms:

• Damage to the nervous system.
• Congenital heart defects.
• hearing loss form.
• Form with eye damage.
• mixed forms.
• Residual phenomena of congenital rubella.

Rubella symptoms: how the disease manifests itself

From infection to the first manifestations of the disease usually takes 11-24 days. The disease can begin with the appearance of a slight runny nose, a feeling of sore throat, lacrimation, dry cough. In adults, rubella is more severe: high body temperature (38-39 ° C), headache, muscle pain, weakness. On the first day there are rashes on the skin: round or oval red small spots. Initially, the rash occurs on the face, neck, scalp, during the day - on the trunk and limbs. A characteristic feature is the absence of elements of a rash on the palms and soles. Small single elements of the rash may appear on the oral mucosa. On average, the rash lasts 2-3 days.

After 6-8 days after infection in adults, rubella is usually accompanied by the following symptoms:

• Red rash. This is one of the first and main symptoms of rubella. If children have red spots, as a rule, of a small size, then in an adult the rash merges, forming massive spots. Initially, the rash appears as small pinkish spots in the ear and nose. Then the rash gradually passes to the arms and torso, and then - descends to lower part body. On average, rubella rashes last for 5-7 days.
• Temperature rise . Usually, the temperature with rubella rises before the rashes or during the appearance of spots. During the course of the disease, there are periods when the temperature can rise to 40 degrees Celsius. And if in a child the temperature with rubella is relatively easy to bring down, then in an adult it is quite difficult.
• Enlarged lymph nodes. And-for inflammatory process with rubella, already on the second day of the disease, the lymph nodes increase. In this case, the increase in lymph nodes occurs without any order. So, in some patients, lymph nodes are enlarged in armpit, for others - in inguinal region and other places. And sometimes an increase in lymph nodes occurs simultaneously in different places.
• Loss of appetite. Due to the infectious process, the patient has a loss of appetite, often accompanied by nausea. It's all the fault of intoxication with the waste products of the rubella virus and high fever, which is why appetite disappears.
• Headache. Frequent symptom infectious processes accompanied by intoxication and fever. With rubella, headaches, as a rule, are not passing and prolonged. Unfortunately, headache pills and migraine medications do not help with rubella.
• Symptoms of colds and flu. An adult with rubella can develop symptoms of colds and flu. So, sometimes rubella is accompanied by a runny nose, sore throat and sore throat, cough and other cold symptoms. In some cases, such a symptom occurs before the rash appears, and the patient does not even suspect that he is actually sick with rubella. At this stage, the disease is confused with acute respiratory diseases and carry out wrong treatment. In particular, doctors may prescribe to the patient antiviral drugs. However, it is worth noting that antiviral drugs for influenza do not work against the rubella virus.
• Pain in muscles and joints. Regardless of the temperature, with rubella, the patient develops palpable pain in the muscles and joints. AT this case this pain is very similar to the muscle and joint pain of the flu.
• Fear of the world. Often with rubella, the patient has discomfort in bright light, which lead to profuse lacrimation.
• Conjunctivitis. In some cases, photophobia with rubella occurs along with inflammation of the conjunctiva (conjunctivitis). As a rule, conjunctivitis develops 2-3 days after infection, and usually at night. That is, the first symptoms of conjunctivitis with rubella are felt in the morning, after waking up.

Patient response to rubella

Even with easy course diseases, you should contact your family doctor.

Rubella Diagnosis

The disease is diagnosed on the basis of a typical clinical picture, the presence of contact with the patient, the lack of vaccination. The diagnosis is confirmed by the determination of antibodies to the virus in the blood.

Treatment of standard cases of rubella is carried out at home. During the period of rashes adhere to bed rest. Special treatment is not required, but sometimes symptomatic agents are used (vasoconstrictor drops in the nose, antipyretic, antitussive drugs). With a complicated course of rubella, hospitalization is necessary.

In most cases, the complicated course of rubella is associated with the addition secondary infection(viral, bacterial). However, specific complications may occur among children and adults. The most common of these is joint damage, which develops a week after the rash period and is manifested by redness, pain, swelling of the joints.

Damage to the nervous system can be in the form of encephalitis, meningitis, meningoencephalitis, meningoielit, subacute progressive panencephalitis.

Against the background of encephalitis, myelitic disorders with pelvic or trophic disorders, lower flaccid paraplegia may develop.

Another specific complication diseases - thrombocytopenic purpura.

At intrauterine infection in the first trimester of pregnancy, violations of embryogenesis often occur, which leads to malformations, fetal death, and abortion. The classic rubella syndrome includes Greta's triad of heart defects, cataracts, and deafness.

Rubella in newborns is manifested by thrombocytopenic purpura, giant cell hepatitis with jaundice, hepatosplenomegaly, hemolytic anemia, enlarged fontanel, interstitial pneumonia, lesions of tubular bones.

For congenital rubella, heart defects are typical. Often there is a cleft of the arterial (Botallov) duct in combination with stenosis pulmonary artery or without it. It is also characterized by loss aortic valve, ventricular and atrial septal defect, aortic stenosis, transposition of large vessels.

Often, congenital rubella is accompanied by damage to the organs of vision - unilateral or bilateral cataract, microphthalmia, glaucoma.

Deafness varying degrees and severity is often found in combination with vestibular disorders.

Congenital rubella, as a rule, is accompanied by damage to the nervous system: microcephaly, chronic meningoencephalitis with long-term persistence of the virus in the cerebrospinal fluid.

Rubella prevention

To prevent the spread of rubella, patients are isolated for 5 days from the onset of the rash.

Rubella vaccination is provided by the vaccination schedule. Specific immunity after vaccination develops after 20 days and lasts for 20 years.

This is an acute illness caused by the rubella virus. It is characterized by the appearance small rashes, swollen lymph nodes and mild fever. If the infection occurs in a pregnant woman, intrauterine damage to the fetus is possible. In this case, it is necessary urgent help doctor.

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

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

Complications may develop:

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

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

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

Vaccination against the disease is included in the National calendar.

Causes and signs of the disease

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

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

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

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

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

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

Symptoms of the disease

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

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

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

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

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

Vaccination is used to prevent this infection.

Rubella during pregnancy

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

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

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

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

Rubella measles

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

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

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

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

Diagnosis of the disease

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

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

Held linked immunosorbent assay for antibodies. Detection of IgM confirms the diagnosis. Another laboratory analysis- detection of an increasing amount of antibodies using a direct hemagglutination reaction.

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

Differential diagnosis carried out with such diseases:

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

Rubella treatment

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

Rubella in adults is treated with symptomatic remedies- antipyretics and painkillers. In severe cases, with the development of encephalitis, the patient is hospitalized, detoxified, and symptomatic drugs are prescribed.

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

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

Children are vaccinated at 1 year of age. Revaccination ( reintroduction drug) is needed at the age of 6 years. If the girl has not been vaccinated, the vaccine against the disease is administered when she reaches fertile age (the time of the onset of menstruation). It is necessary to explain to the parents of the child possible dangers refusal to vaccinate.

The vaccine against the disease is safe, side effects after it are observed extremely rarely and do not pose a threat to health.

Disease prevention

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

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

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

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

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

Rubella video