Is rubella dangerous? Symptoms of various forms of the disease. Signs of rubella in adults

Rubella is an acute viral disease, mainly diagnosed in children, due to which it is classified as a “childhood” infection. Rubella, the symptoms of which determine the name of this disease, manifests itself primarily in the form of a characteristic color of the rash; in addition, this disease is also quite dangerous for pregnant women, or rather for the fetus, due to its direct connection with the development of congenital deformities in children and with intrauterine mortality.

general description

The rubella virus belongs to the togaviruses; toga in translation means cloak, which determines its characteristic features: with the help of a double membrane it covers its own RNA molecule. The surface of such a membrane has spikes in the form of villi; they contain hemagglutinin, as well as neuraminidase. As for the infectiousness inherent in rubella, when compared with other droplet-type infections (whooping cough, measles, chickenpox) it is not so significant, which is determined by the general instability to environmental conditions, which, by the way, cannot be prevented even by such a double shell. Meanwhile, even in conditions in which the virus seems to be losing in all directions, the susceptibility of non-immunized patients is about 90%, which determines the virus is not so harmless.

We have already highlighted that the virus is unstable in relation to the conditions that it has external environment. However, it is important to consider that the room temperature in the room allows it to remain indoors for about several hours. The death of the virus occurs quite quickly if its inherent acid-base environment changes to acidic or, conversely, to alkaline favor. The instability of the virus is known in relation to changes in temperature, where death occurs at 56°C, as well as when exposed to UV radiation, drying, the use of disinfectants, formaldehyde and ether.

The risk of developing rubella is quite high for those patients who have never had this disease before, as well as for those who have excluded the need for vaccination against it. Outbreaks of morbidity are seasonal, occurring in winter/spring. As for epidemiological outbreaks, their recurrence is noted every ten years. After suffering from rubella, patients develop immunity to this disease, which is often determined to be lifelong, and, nevertheless, reinfection will also happen in the future.

A sick person who is diagnosed with acute course infections or a subclinical form of manifestation of the disease (this option eliminates the appearance of symptoms). In addition, children with diagnosed congenital form rubella, the transmission of which occurred from a mother exposed to infection during pregnancy. What is noteworthy is that congenital rubella makes children sources of the disease for up to three years, and in practice there are cases indicating an extension of the period of virus shedding, which is noted before reaching the age of 18.

A person who is ill with rubella is dangerous five to seven days before the rash appears, as well as for seven days after its disappearance.

Regarding the routes of infection, we have already noted that it is droplets, or rather airborne droplets (transmission occurs by coughing, talking, screaming, sneezing, and pronounced exhalation). In addition, infection also occurs through the transplacental route, which means infection of the pregnant woman while simultaneously infecting the fetus. As favorable conditions For possible infection places can be identified where the population is crowded in them, in other words, this determines the organized type of collectives, etc.

Rubella: symptoms

The duration of the incubation period (that is, the time between the introduction of the pathogen into the body’s environment with subsequent life activity and relevant processes and between the manifestation of the first symptoms) for the disease we are considering is from 13 to 23 days, and from these days a person can act as a source spread of the rubella pathogen. Its release occurs five days before the rash appears, and nothing specific may accompany this period; moreover, catarrhal discharge may not even appear (their appearance, like the appearance of other symptoms, can be noted already in combination with the rash ). Thus, infection often occurs from people who, by all visible signs, are “healthy.”

The incubation period is accompanied by the process of penetration and subsequent attachment of the virus to the mucous membranes (it is concentrated within the area of ​​the upper respiratory tract), gradually the picture of the disease indicates that the virus has penetrated into the submucosal area (which is ensured by neuraminidase), and this, in turn, leads to its spread through lymphatic system. Thus, from this point on it is advisable to consider next period the course of rubella, that is, the approach of its prodromal period.

It should be noted that the next period of the disease, which is the marked prodromal period , in some cases may be absent, therefore this implies a transition to a period of rash following the incubation period. If the prodromal period appears, then the duration of its course is on the order of several hours to two days.

The severity of catarrhal symptoms is not too significant; it manifests itself in malaise, as well as in temperature (up to 38 degrees). In addition, there is an increase in lymph nodes, which occurs 1-2 days before the rash appears; the duration of such a state during the disease ranges from 1 to 3 weeks. It should be noted that changes associated with the condition of the lymph nodes are the only indicator of the onset of the prodromal period. As a rule, the occipital and posterior cervical lymph nodes are subject to enlargement; they are characterized by painlessness, lack of adhesion to the tissues surrounding them, and also a soft consistency.

Next period period of rashes, lasts about 3-4 days. Before the rash itself appears, an enanthema often forms on the mucous membrane, which looks like pink spots concentrated in the area soft palate. These spots can subsequently merge with each other, spreading to the arches and the hard palate. After the appearance of a mucous rash, a small-spotted type of rash forms throughout the body, although for the most part its concentration is noted in the area of ​​​​the bends of the limbs, on the face and buttocks, but the rash due to rubella does not appear on the soles and palms. The nature of this rash, as noted, is small-spotted and quite abundant. It merges with each other extremely rarely, the brightness of the color is lost quickly - within a period of 1-3 days (the rash itself disappears by this time). Its diameter is about 2-5 mm.

The formation of a rash occurs due to the spread of the virus through the blood with simultaneous exposure to hemagglutinin, due to which red blood cells stick together, which, in turn, also occurs in combination with dermatotropism, in which the skin (dermis layer) is selectively affected. Ultimately, such processes lead to the fact that red blood cells in a glued state begin to “get stuck” directly in skin layer. Previously noted catarrhal manifestations may be absent.

Rubella, the symptoms of which in adults are also accompanied by arthralgia (otherwise known as joint pain), may also appear with some redness, combined with swelling. It should be noted that rubella in adults, similar to a number of other “childhood” diseases, is characterized by a more pronounced and acute form. Additionally, their symptoms include fever, high temperature, and chills. Often appears severe runny nose and sore throat, combined with sore throat and cough, photophobia and lacrimation are noted.

The rash, as the main symptom of the disease, appears in adults in a more pronounced and abundant form than in children, while the resulting spots often merge with each other, which forms entire erythematous areas, especially concentrated on the buttocks and on the back. Duration of retention within skin the rash lasts about 5 days, although more is possible long term for this. What is noteworthy is that rubella in children and its symptoms, accordingly, occurs in a more mild form than rubella in adults - in the latter case, moderate forms of the disease and severe forms are diagnosed up to 10 times more often.

Recovery ensures the complete disappearance of the listed symptoms.

Actually, recovery is such a period during the course of the disease as period of convalescence, within which all symptoms associated with rubella gradually disappear. Meanwhile, the patient still remains dangerous to others, because the possibility of infection is still relevant (in particular, this applies to those who have not been vaccinated against rubella and those who have not previously had it), the patient’s period of danger during this period is determined to be a week from the moment the rash disappears.

As for the atypical (or erased) form of the disease, it is somewhat more difficult to recognize. This form is characterized by an increase in temperature combined with a sore throat, but the symptoms of intoxication, as well as the main manifestation of the disease, which, as already noted, is a rash - all this this option absent.

The greatest share of the probability of infection occurs in the asymptomatic form of rubella in patients, because, as can be understood from the definition itself, it is not accompanied by any symptoms indicating the presence of rubella, however, the virus is still isolated. Considering that this form of the disease exists, testing for the presence of antibodies to it during pregnancy is extremely important.

Rubella during pregnancy: symptoms

For children, as well as for most adults, rubella is an almost harmless disease. However, infection of a pregnant woman with rubella can cause almost catastrophic consequences.

When infected during pregnancy, the virus, once in the mother’s blood, reaches the fetus through the placenta, thereby affecting its tissues. This, in turn, leads to infection of the fetus during the first three months of pregnancy, during which intrauterine development is disrupted.

In terms of considering the consequences, the most dangerous period for rubella is the first trimester of pregnancy, because it is during this period that all the systems and organs of the fetus are formed, and it is they that are hit by the virus of the disease we are considering.

What is noteworthy is that the lesions that the fetus directly encounters can be the most different character Moreover, the degree of such damage is not related to how severe the disease is in the pregnant woman herself. She may feel great at this time without noticing any changes in her own condition, while the virus has active influence on the fetus, causing miscarriage, frozen pregnancy or stillbirth. In addition, the development of severe forms of damage to systems and organs in the child’s body cannot be ruled out.

The characteristics of the lesion and its severity are determined in particular based on the specific period at which the pregnant woman was exposed to rubella. So, with rubella during pregnancy 3-4 weeks provokes the development of congenital deformities in about 60% total number cases of morbidity, period 10-12 weeks determines a similar probability in 15% of cases, the term 13-16 weeks - at 7%.

As critical periods in damage to the fetal nervous system, an interval of 3-11 weeks was determined, in damage to the heart and eyes - an interval of 4-7 weeks, and in damage to the hearing organs - an interval of 7-12 weeks of pregnancy.

Thus, the shorter the pregnancy period at the time a woman is diagnosed with rubella, the more often and in a more severe form certain defects in the development of the fetus subsequently occur.

The risk of developing defects is greatest for the fetus in pregnant women exposed to infection within the period of 9-12 weeks after conception. Within the specified period, rubella during pregnancy usually leads to miscarriage or intrauterine fetal death, which is otherwise defined as “frozen pregnancy.” Even if it was possible to save the fetus, its normal development is disrupted in almost the vast majority of cases, which also leads to the appearance various symptoms, characteristic of congenital rubella.

Mostly rubella in the mother, arising on early stages during pregnancy, leads to the development of the so-called “minor rubella syndrome”, it includes the Greta triad, which implies the following three main pathologies:

• cataract , manifested in the form - occurs in a unilateral or bilateral version, often microphthalmia (a significant degree of reduction of the eyeball/apples) acts as an accompanying factor;
• heart defects – may involve non-union ductus arteriosus, damage to one of the heart septa or valve apparatus, in stenosis pulmonary artery etc.;
• deafness.

Of these pathologies, in 98% of cases of child birth with congenital rubella certain heart defects are relevant, in 85% of cases vision pathologies are noted (mainly in the form of the indicated option, which we have identified as cataracts). In 22% of cases, deafness is diagnosed (to varying degrees of severity), and most of it manifests itself in combination with vestibular disorders.

In addition to those defects that we have already noted with congenital rubella, infection of the mother with this disease can provoke another type of pathology in the early stages, for example, malformations of organs genitourinary system, liver, spleen, skeleton, etc.

In approximately 72% of cases, children with a congenital form of the disease in question are diagnosed with lesions of one type or another associated with the activity of the nervous system, especially the brain. So, the most common options include lesions in the form of:

• hydrocephalus, otherwise - dropsy of the brain, which occurs excess accumulation V ventricular system brain cerebrospinal fluid, which leads, against the background of relevant processes, to an accelerated increase in head circumference and an increase in the shape of the skull;
• microcephaly, which implies a significant reduction in size of the skull and brain in accordance with normal sizes other parts of the body, while an actual concomitant of microcephaly is mental deficiency (it can manifest itself both in a mild form of imbecility and in complete idiopathy).

The neonatal period in an infant with a congenital form of rubella is accompanied by disorders associated with muscle tone, increased excitability, and movement disorders, convulsions, paralysis, etc. Over time, aggravation of the condition in terms of mental retardation in development (in comparison with peers) cannot be ruled out, and the possibility of a decrease in mental development cannot be ruled out.

If a pregnant woman is infected with rubella during the period 13-20 weeks of pregnancy, a slight reduction in the risks associated with developmental defects is determined, however high performance at the same time, everything is also determined for pathologies associated with hearing - this type of lesion is possible before the 16th week.

With rubella, the infection of which occurred in a pregnant woman after the 20th week of pregnancy (which, accordingly, determines the second half of pregnancy), the risks associated with malformations are significantly reduced. Meanwhile, the possibility of developing chronic form infections in the unborn child in the variant in which the central nervous system in combination with the sensory organs will be affected. Congenital rubella, which provokes such lesions of the central nervous system, does not always make it possible to determine the pathology at birth, because in any case it can appear much later after that. In particular, manifestations accompanying such a lesion include convulsions, mental illness, mental retardation.

In addition to the pathology that directly affects the fetus, rubella can also cause complications that arise during the process. labor activity. In particular, these are certain disorders, bleeding or blood poisoning (sepsis).

Considering the severity of the complications that are relevant for the fetus when infected with rubella, this disease is recognized in the world as an absolute medical indication to subsequent termination of pregnancy (abortion). Termination of pregnancy is carried out on the basis of data on rubella within the period before the 16th week of pregnancy, regardless of the current severity of the manifestation of this disease. Accordingly, even in the case of an asymptomatic course of rubella in a pregnant woman, it is necessary to terminate the pregnancy, because, like the latent course of this disease, it leads to destructive impact virus to the fetus.

If rubella is detected at a period exceeding 16 weeks, as well as if there is suspicion of infection of the fetus, termination of pregnancy is carried out before the 28th week of pregnancy. If the disease is detected in a woman for a period exceeding 28 weeks, she is registered and classified as a high-risk group. This option requires a series of preventive measures oriented towards ensuring fetal protection during simultaneous treatment placental insufficiency, prevention in combination with treatment related to miscarriage.

To summarize regarding rubella during pregnancy, let us recall that infection with this disease during this period is possible only if the woman does not have immunity to this infection. Accordingly, it is important to have a history of rubella in the past or to have been vaccinated against rubella before the pregnancy itself occurred.

Measles rubella in children: symptoms

In this statement, the disease is included in a separate section of our article, and is explained as follows. Doubts often arise regarding the characteristics of this diagnosis, and, accordingly, its symptoms, but even more often the question arises: what is the difference between measles and rubella and what is such a “hybrid”? Some equate both options; others believe that rubella measles in one way or another combines the symptoms of both diseases. So, let's figure out what rubella measles actually is.

Rubella is rubella, and measles is measles, and in principle there is no third option here. Nevertheless, to understand the essence of this third missing component, let’s delve a little into the history of the issue that interests us.

So, let's start with the fact that many childhood diseases that caused a rash Pink colour, at any time determined significant difficulties in diagnosing a specific and relevant option in each case. Roseola, scarlet fever, measles and rubella - these diseases still occur quite often, and what can we say about diseases that are less common. Moreover, now, when it would seem that almost everything is known for each of these diseases, or at least the facts that scarlet fever is a bacterial disease in nature, and rubella and measles are viral diseases, diagnosis still remains difficult, and let alone even talk about the recent past.

In a mild form, measles resembles rubella, and a severe form of rubella resembles measles, scarlet fever in a mild form resembles both rubella and measles, etc. It was precisely such a chain, which determined some visible connection between diseases, that led to the fact that in the 19th century N.F. Filatov, who, as you may know, is one of the founders of pediatrics on a domestic scale, isolated rubella in two forms, namely measles-like rubella and scarlet-like rubella.

Somewhat later, scarlet-like rubella was refuted in its existence, so in fact two diseases remained, namely measles rubella and, in fact, measles. After some time, it was determined that calling the disease measles rubella is somewhat illogical, because rubella does not exist in any other form. That is why in modern medicine Only one name is used for this disease, that is, the one in which we initially consider it - rubella. As for the disease “measles rubella,” although it appears periodically here and there, it is an outdated synonym for rubella, being the same disease as it. Therefore, the symptoms of rubella measles in children are the same as the symptoms of rubella in children, which we previously discussed in general flow diseases.

Diagnosis

The basis for making a diagnosis is the nature of the manifestation of the rash, the period during which it occurred, the simultaneity of the nature of the rash, as well as the features of their localization and the overall epidemiological situation. It makes no sense to make a diagnosis yourself, because there are many diseases characterized by similar symptoms. This could be scarlet fever, measles, chickenpox, enteroviral exanthema, pseudotuberculosis, and initial stages– meningococcal rashes, etc. It should be noted that it is unforgivable to make a mistake “by” these meningococcal rashes, because the risks are too high - the mortality rate for this disease is determined to be 30%.

So, to detect rubella, it is used, first of all, virological method , which is focused primarily on virus detection. The effectiveness of this method is determined based on the timing of the study of feces and blood - a virological method would be an appropriate solution within 7-14 days from the moment the patient is infected (that is, until he develops a rash). If there is a rash, it is necessary to remove discharge from the nasopharynx.

Also used serological methods , with the help of which it is determined whether there are virus-neutralizing and class-specific antibodies. These types of methods are used 1-2 days from the moment the patient develops a rash, as well as on the 20th day.

Indirect hemagglutination reaction method (IRHA) And neutralization reaction method (RN)– applied with an interval of 10 days after each other, they involve taking blood twice to study for changes that have occurred in it. In addition, it is used complement fixation reaction (CFR) method, in which a complement-binding type of antibody is searched (they can be detected within three years from the moment the patient suffered from the disease). Accordingly, RSK at positive result“findings” indicates that the patient has recently suffered from a disease or that the onset of a period of recovery is relevant for him.

And finally linked immunosorbent assay(abbr. ELISA)- with its help, it is possible to identify class-specific antibodies, on the basis of which it is possible to determine the specific stage of the disease and its features ( initial period, acute period, convalescence). This method is also used in determining the degree of immunity in the context of considering the need for vaccination or revaccination. This method can also be used to diagnose congenital rubella.

Treatment of rubella

There is no specific type of therapy aimed at treating rubella. The main measures considered are those that are aimed at eliminating cerebral edema and swelling (for which cryoplasma, Lasix and corticosteroids are used). During the convalescence period, nootropic drugs are used.

IN in general terms treatment consists of prescribing bed rest (for a period of 3-7 days), good nutrition(based on accounting age characteristics). As part of etiotropic therapy, virocide drugs (isoprinosine, arbidol), immunostimulants and immunomodulators are considered. As a measure of detoxification therapy, it is used drinking plenty of fluids. To eliminate the symptoms accompanying rubella, expectorants are used (taking into account the specific type of cough, with the exception of the option, for example, with the simultaneous use of antitussive and expectorant drugs), analgesics, and antipyretic drugs.

For rubella in a pregnant woman up to the 28th week of pregnancy - an indication for abortion; after the 28th week, as well as if it is impossible to perform an abortion, use intramuscular injections immunoglobulin (dosage - up to 30 ml) in combination with a number of preventive measures provided to protect the fetus, ensure pregnancy and eliminate placental insufficiency.

If symptoms indicating rubella appear, you should contact your primary care physician/pediatrician, as well as an infectious disease specialist. Pregnant women will need additional consultation with a gynecologist.

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Among viral infectious diseases, “childhood” diseases are well known to everyone. Rubella belongs to this group. This infection is much less common than other childhood diseases, such as chickenpox. Symptoms of rubella in children are general malaise, slight compaction lymph nodes, characteristic feature is a red rash.

What is rubella in children

The infection was known back in the Middle Ages, this is confirmed by the surviving records of doctors of that time. The first description of the disease belongs to the German physician F. Hofmann and dates back to 1740. In the 1930s, Japanese scientists proved the viral nature of this disease. In 1961, a group of scientists (Parkman P.D., Weller T.H., Neva F.A.) isolated and described the virus that causes the disease. Medical statistics show that children from 2 to 9 years old are more likely to get sick.

For children of any age, this disease does not pose a danger if proper treatment, is relatively easily tolerated, but in adults the disease is severe. Rubella is dangerous for pregnant women. Infection in the early stages of pregnancy is an indication for its termination. Australian scientist Gregg N. in 1941 described fetal pathologies that develop due to damage to the expectant mother’s body by a virus. Congenital pathologies heart disease, deafness, and cataracts are referred to as “classic congenital rubella syndrome.”

The virus enters the body in three ways:

• Airborne, which is the most common. Infection occurs through close contact (face to face), when a carrier of the virus sneezes, coughs, or cries. The pathogen enters the air with particles of saliva and penetrates the body of a healthy person. The risk of infection increases significantly in a confined space.
• Children who have developed the habit of touching everything become infected through contact and household methods. Infection occurs through shared toys, dishes, and clothing. In children's institutions, the risk of infection is high. Dirty hands can also become a source of infection. In this way, infection occurs much less frequently if you follow basic rules hygiene.
• From the mother through the placenta. If infected in the early stages of pregnancy, a miscarriage or stillbirth may occur if the woman carried the child to term. If infected for more than later During pregnancy, there is no complete guarantee that the baby will be born healthy.

Incubation period

There are several stages or periods of rubella:

• incubation;
• premonitory;
• spread of rash;
• recovery.

Begins incubation period when the virus enters the body. The causative agent of the infection affects the lymph nodes, into which it enters through the bloodstream. The incubation period lasts from 16 to 22 days (in some cases the duration can be from 10 to 24 days). During this period, when the virus actively multiplies and circulates through the bloodstream, the disease can only be diagnosed by enlarged lymph nodes behind the ears and on the neck. 5-8 days before the end of the incubation period, a person becomes infectious.

Symptoms of rubella in children

“Pre-disease” (the period before the appearance of the rash) lasts 1-2 days, in little patient Appetite disappears, malaise and fever appear. As a rule, the child does not express complaints during this period. Rubella in a child is diagnosed based on the following symptoms:

• characteristic rash;
• slight nasal congestion;
• temperature increase from 37.5 to 38.1.

Rash

Skin rashes last from 1 to 3 days. Because of the red color of the rash, the disease received its name. The first reddish dots (papules - fused dots) appear on the face, behind the ears, on the neck and then spread to the lower areas of the skin. The rash looks like red spots oval shape with well defined edges. It is impossible not to notice such a rash. The spots are not felt when touched, do not bleed, do not itch, they are located as if under the skin. When pressed, the rash turns pale, then turns red again.

The first signs of rubella

The initial manifestations of the disease can be noticed only at the end of the incubation period. Before this, the baby may be capricious, lethargic, sleepy, slow without obvious reasons. These manifestations are associated with the reaction immune system aimed at suppressing infection. The natural destruction of viruses by the body takes 1-2 days, but the structural features of the pathogen’s shell give it the opportunity to spread throughout the body during this time.

During airborne infection, the pathogen enters the upper respiratory tract, causing irritation, inflammation, and coughing. Inflamed lymph nodes can be easily felt behind the ears and on the neck. In the first stages of the development of the disease, the inguinal, axillary, and submandibular nodes become inflamed. The diameter of the nodes is about 10 millimeters.

Rubella in children under one year of age

Rubella is very rare in newborns. The infection is transmitted to the baby from the mother who became ill during pregnancy. Patients up to one year old can get rubella if they are not vaccinated in a timely manner. Preventive vaccinations against this infectious disease are provided starting from 12 months. Rubella in infants has the same symptoms as in older children. During the examination, the pediatrician recognizes the childhood infection or diagnoses rubella with the help of tests and additional examination.

Kinds

Congenital and acquired rubella is observed in newborns. Appearance congenital disease associated with infection of the fetus in the womb of an infected mother. The baby is born with the following symptoms:

• low body weight;
• characteristic rash on the baby’s skin;
• he is lethargic;
• epileptic seizures appear;
• nervous excitability;
• developmental delay is observed;
• lack of hearing;
• blurred vision due to corneal clouding;
• The head is small due to underdevelopment of the brain.

With congenital rubella, the child’s vital development is impaired. important systems organs. At intrauterine infection many pathologies are diagnosed from the nervous and of cardio-vascular system. Treatment methods for this type of infection have not been fully developed. Doctors use drugs whose therapeutic effect is aimed at identifying congenital defects, strengthening immune defense and restoring damaged organs and systems.

Acquired rubella is very rare in infants. In a mother who has had this disease, breast milk there are ready-made antibodies that protect the newborn. Infection infant may come from a sick person. In this case, the clinical picture is different:

• the appearance of a red rash on the face, which gradually spreads throughout the body;
• increased temperature (up to 38 degrees);
• swollen lymph nodes;
• inflammation of the mucous membrane oral cavity and tonsils;
• slight runny nose and cough;
• conjunctivitis, lacrimation;
• poor sleep and appetite.

If signs of rubella appear in an infant, you should call a doctor. At mild flow illness, the child must be provided with sufficient drinking regime, you can increase the number of feedings (with breastfeeding). At strong increase temperature, the baby is given an antipyretic. The main treatment is prescribed after deciphering the test results.

The difference between rubella and measles and scarlet fever

The outdated name for the disease is rubella measles; this infection was considered a mild form of measles. The symptoms of these acute infections are very similar and they are transmitted by airborne droplets. Marked characteristic rashes on the skin, fever, inflammation of the upper respiratory tract, cough, runny nose. The measles virus infects the central nervous system, respiratory and digestive system. The incubation period lasts at least 7 days. Followed by sharp increase temperatures up to 39. In addition to the symptoms already mentioned, measles is accompanied by conjunctivitis.

Gray-white spots with a characteristic red rim appear on the inside of the lips and cheeks. This sign indicates infection with the measles virus. The spots disappear with the appearance of a rash. First it appears behind the ears on the back of the skin, on the neck and face, and within 2-3 days it covers the entire body. The rash appears as small bright pink spots, then they merge and significantly increase in size. With measles, the immune system is greatly weakened, so the child is susceptible to other infections.

With scarlet fever, the temperature rises sharply, the throat is very sore, it is red, and there is purulent plaque on the tonsils. Symptoms characteristic of tonsillitis appear. Within a few hours a rash appears on the face: general background a small red rash appears on the reddened skin. It does not extend to the nasolabial triangle, but appears throughout the body. Most rashes appear on the sides and bends of the limbs. With scarlet fever, the tongue is bright crimson.

Scarlet fever is bacterial disease (streptococcal infection). The red rash looks similar to the rashes associated with rubella and measles (viral infections). A false diagnosis can be costly. Scarlet fever needs to be treated with antibiotics, which are not prescribed for viral diseases. A bunch of characteristic symptoms And typical manifestations Scarlet fever makes it possible to accurately recognize this dangerous disease.

Diagnostics

It is impossible to give recommendations on how to determine rubella in a child. To establish accurate diagnosis“Rubella”, even a doctor’s examination is not enough, especially if the disease is mild or there is suspicion of congenital rubella. For laboratory tests, a general blood test is prescribed, which is used to determine the number of lymphocytes and plasma cells, and determine the erythrocyte sedimentation rate (ESR). A hemagglutination inhibition reaction (HAI) is performed at the peak of the disease and after 10 days. An enzyme immunoassay is performed.

Treatment of rubella in children

This is a simple childhood infection that does not require special therapeutic measures. Most children tolerate this disease easily and without complications. In the normal course of the disease, hospitalization of the child is not required. Recommended bed rest and drinking plenty of fluids. It's important to organize proper nutrition, it should be light and necessarily include dairy products, vegetables and fruits.

Drug therapy

At high temperature Pediatricians recommend age-appropriate antipyretics (eg, paracetamol, ibuprofen, ibuclin). These antipyretics have an anti-inflammatory effect. At severe rashes reception recommended antihistamines(for example, fenkarol, suprastin, loratadine). Normally, the rash goes away within 3-4 days. As an additional therapeutic event Vitamin therapy is recommended to strengthen weakened immunity.

The occurrence of complications is indicated by severe headaches, temperature above 38, nausea, vomiting, and convulsions. In this case, the patient should be hospitalized. Against the background of rubella, other infections can enter the body. Among possible complications purulent otitis media, pneumonia, sore throat. Only upon diagnosis additional infection The doctor prescribes antibiotics.

Diuretics and some steroid drugs prescribed in a hospital setting. These medicines used to identify symptoms of intoxication and to prevent cerebral edema. In newborns, encephalitis has been described among severe complications. Children under one year old (especially in the absence breastfeeding) rubella is difficult to tolerate, and there is a high risk of contracting other infectious diseases.

Folk remedies

It is good to use in the treatment of rubella herbal teas, the action of which is aimed at increasing immunity and treating skin rash. Such recipes ethnoscience offers plenty. Several recipes vitamin tea, which is recommended to drink two to three times during the day:

• In a 1:1 ratio, brew rose hips and black currants;
• In a 1:1 ratio, brew lingonberries and rose hips;
• In a ratio of 3:1:3, brew rose hips, lingonberries, and nettle leaves.

At the pharmacy you can buy ready-made mixtures from which infusions are prepared, which should be drunk three to four times a day, 1/3 cup. The collection contains birch buds, string, clover flowers, dandelion root, wormwood herb, yarrow herb, mixed in equal parts. Birch buds relieve itching, inflammation, relieve pain, have a good effect on metabolic processes, accelerate the excretion of metabolites.

Is it possible to bathe a child with rubella?

With the doctor's permission, you can and should bathe your child during rubella. Hygiene procedure helps relieve itching, eliminates dust particles and pieces of dry skin. During illness, the immune system is very weakened, so to prevent dermatitis it is necessary to keep the child’s skin clean. When bathing, you can add a solution of potassium permanganate to the bath, recommended herbal infusions, which will have not only a calming effect on the skin, but also on the entire body.

Prevention

The World Health Organization has developed and is implementing a program for preventive vaccinations. One year old children do preventive vaccinations, at 6 years of age they are re-vaccinated. Vaccinations are given to women childbearing age if outbreaks of infection are registered. Girls aged 14 years who have not been vaccinated before must be given the vaccine unless there are contraindications.

Unvaccinated children suffer from the disease easily. Emergence serious complications observed in adults who are not vaccinated and in childhood did not have rubella. The virus spreads by airborne droplets, so only an already developed immunity can save you from infection. During disease outbreaks, it makes sense to ensure timely vaccination.

Not specific prevention limited to the isolation of the patient and people who came into contact with him. At the end of the incubation period, the patient is isolated for the entire period of appearance of the rash; at this time he is an active source of infection. We must not forget that the infection is transmitted by airborne droplets. When a pregnant woman comes into contact with a carrier of the disease, there is a high risk of infection if she does not have specific antibodies in the blood and stable immunity.

Rubella (rubeola) is a viral infectious diseases moderate type.For rubella characterized by mild lesions of the child's body - slightly enlarged lymph nodes and the appearance of fine-spotted exanthema. But in older children, the disease can be severe, involving purpura (capillary fine-spotted hemorrhages in the mucous membrane or skin) and joints.
Etiology of rubella :
The rubella virus is frost-resistant, but quickly dies under the influence of disinfectants and when exposed to ultraviolet rays and Stores at room temperature for 2-3 hours.
The man is the only source and the spreader of the virus rubella.The source of this viral infection may become infant with congenital rubella, spreading pathogen during the first 5-6 months from birth.
Distributed by rubella by airborne droplets from an infected person to a healthy person when talking, coughing or sneezing. A person with rubella is a source of infection a week before the first symptoms appear and a week after the end of the period of rash.
The contagiousness (the ability of an infection to be transmitted from sick people to healthy people) of rubella is low and therefore infection requires closer contact than with chickenpox or measles. In poorly ventilated areas and in places with large crowds of people, the risk of infection rubella increases. In addition, there is a transplacental (from mother to fetus) route of infection with rubella, which can lead to the formation of pathologies in the development of the fetus. Women who have not had rubella by the time of childbearing age and do not have antibodies remain at high risk of infection during pregnancy.
With absence immunity against rubella, susceptibility to infection is very high and does not depend on age. Children under 1 year old get rubella in rare cases, since they retain passive immunity acquired from their mother. The peak of infection activity occurs between March and June among younger children. age group(from 3 to 6 years).

Symptoms of rubella in children :
Usually rubella in children occurs at a low temperature with minor conjunctivitis and a runny nose. The incubation period for rubella is from two to three weeks. These days, the child develops mild symptoms of intoxication of the body: headache, malaise, lethargy, decreased appetite, enlarged and reddened throat, sometimes - pain in muscles and joints. The posterior cervical, parotid and occipital lymph nodes are often enlarged. Before the rash, an enanthema (rash on the mucous membranes) may appear on the child’s skin, which is small pink specks on the mucous membrane of the palate. A little later, these specks may merge and spread on the temples, acquiring a dark red color.
The lymph nodes become enlarged at least two days before the rash appears on the child's skin and remain enlarged for 7-9 days. Rash with rubella, it manifests itself in a much more varied manner than with chickenpox or measles. The rash covers a significant part of the child’s body for several days and is a maculopapular formation of a pale pink color. First, the rash appears on the face (where some of the spots often merge). Then it quickly spreads over the entire surface of the child’s skin - especially many spots appear on inside arms, back and buttocks. After 2-3 days, the rashes turn pale and gradually disappear, leaving no traces of pigmentation. Photophobia (unlike measles) is absent.

Diagnosis of rubella :
With characteristic clinical picture(especially during the spreading season) and the identified source of rubella infection, diagnosing this disease does not present any special difficulties. In some cases, diagnosis can be difficult due to the similarity of the course with some childhood diseases (scarlet fever, measles, allergic skin rashes). Therefore, when symptoms of the disease, contact your pediatrician or invite a doctor to your home.
Rubella poses a great danger to women who have not been vaccinated and were not ill before pregnancy and who have communicated with carriers of this infection.
Therefore, to confirm rubella infection, it is highly advisable to undergo a laboratory examination.

Treatment of rubella :
In the absence of any complications, rubella treatment does not require any special means. Only isolation of the sick child from other children and bed rest are indicated. If complications arise with rubella, the following are used: sulfonamide drugs; analgesics; in some cases - antibiotics; gargling with antiseptic solutions; hyposensitizing and detoxification therapy; multivitamins.

Possible complications with rubella :
The most dangerous complications of rubella in a child include meningoencephalitis(rubella encephalitis). The development period is from two to six weeks after the skin rash. The course of rubella encephalitis is quite long and severe. Over 60% of children who have had this form of encephalitis acquire serious changes in their psyche and motor function.
Also, serious diseases caused by rubella include viral meningitis.

Prevention:
General prevention in hotspots rubella is ineffective, since the activity of the virus begins long before the appearance visible symptoms diseases in infected children. In places where infection is spreading, frequent ventilation of the premises and wet cleaning are carried out. Strengthening the immune system reduces the likelihood of complications in the child. Many countries provide general vaccination preschool children(in some European countries, all children aged 1.5-2 years are vaccinated with the rubella vaccine. In others, only girls aged 9-13 years are vaccinated). After vaccination, approximately 98% of children develop antibodies, and stable immunity to the virus appears rubella. It is especially important that girls develop immunity to rubella before the onset of pregnancy - either as a result of an illness in childhood, or through vaccination. During pregnancy, vaccination with the rubella virus is strictly contraindicated.
Vaccination Rubella is also contraindicated in: development oncological diseases; immunodeficiency state body; allergic reaction for aminoglycosides. You should also not be vaccinated during treatment using blood products (vaccination in this case is indicated 3 months after or 3 weeks before the course).

Indications for termination of pregnancy in those who have not been vaccinated or have not had rubella in preschool age women:
Pregnant women without immunity to rubella Those who have visited the outbreak area or communicated with a rubella-infected person should mandatory pass the laboratory research to identify possible infection. If rubella disease is confirmed in the 1st trimester and even before 4-5 months of fetal development, an artificial termination of pregnancy is indicated. positive analysis it is indicated to terminate pregnancy even in the absence of visible rubella symptoms, taking into account the possibility of a hidden course of the disease.
When infected with rubella late stages pregnancy, the woman falls into a high-risk group and is placed on special registration. Treatment of placental insufficiency, prevention of miscarriage, and measures to protect the fetus are carried out.

Folk remedies for treating rubella :
For treatment of rubella You can recommend herbal preparations containing immunostimulating substances and facilitating expectoration.
- Prepare a mixture: elecampane root, marshmallow root, licorice root in equal proportions. Brew 2 teaspoons of the mixture per glass of boiling water (boil for 10 minutes) and then filter. Take 1/4 cup every 3 hours.
- Vitamin teas are very useful: lingonberries and rose hips 1:1 (brew in boiling water and drink 3 times a day); or black currant berries and rose hips 1:1 (brew in boiling water and drink 3 times a day); or take 1 part lingonberry berries, 3 parts rose hips, 3 parts nettle leaves (brew in boiling water and drink 3 times a day).

Symptoms of the disease may appear 2-3 weeks after infection. Manifestations of rubella last on average 2-3 days and may include fever (up to 38.9 ° C or lower), headache, nasal congestion, red eyes, inflammation of the lymph nodes at the base of the skull, on the back of the neck and behind the ears. The rash of the disease has a pinkish tint and begins on the face, spreading to the torso, arms and legs. In some cases, joint pain may appear (most often).

Possible risks

The most common complication of rubella is lung development forms of arthritis, which gradually disappears even in the absence of appropriate therapy. As with other viral infections, the disease can cause ear infection. However, in most cases, rubella in people does not cause more serious illnesses.

Rare, but dangerous complication, is thrombocytopenia, which occurs as a result of a drop in the number of platelets in the blood. The condition requires urgent treatment and consultation with a hematologist. The phenomenon is characterized by increased nosebleeds, the appearance of blood on the mucous membrane of the mouth and can cause bleeding in the brain. Also, infection in the brain can provoke viral encephalitis, which can be fatal.

Rubella poses a particular risk to pregnant women. When infected there is high probability the pathogen enters the fetus, but in most cases the virus is dangerous only during the first trimester. Children who have been infected with the virus may have developmental defects spinal cord, cataracts, deafness, slow growth, heart deformities, and problems in general development.

Diagnosis of the disease is complicated by the nonspecificity of its symptoms, and the existing rash may be similar in nature to others viral lesions. To make a diagnosis, your doctor may prescribe blood tests to determine the presence of antibodies, which are markers for rubella.

Usually no treatment is required for the disease. Infection during pregnancy requires consultation with a specialist who can report possible risks and appoint necessary medications to stimulate the immune system and get well soon. During the period of exacerbation, it is possible to carry out symptomatic treatment with the use of anti-inflammatory drugs.

Currently, not everyone realizes that rubella threatens both children and adults. Why is rubella dangerous? This viral disease, the pathogen of which quickly loses its danger when heated, dried or exposed to ultraviolet light. The peculiarity of the disease is that, having been ill once, it is impossible to become infected again, since the body develops a strong immunity to this type of virus. The disease is often seasonal; the number of cases increases in the winter-spring period; in addition, rubella epidemics usually occur no more than once every 9 years. Children are usually affected, but adults are also extremely susceptible. The first signs that you need to pay attention to are rashes on the face and body, increased temperature, emerging fever, and a noticeable enlargement of the lymph nodes.

Course and consequences of the disease

You can get rubella only through contact with an infected person (during the incubation period of the disease, as well as at the height of the disease).

In addition, the disease can be transmitted by airborne droplets from a pregnant woman to an unborn child.

can last from 10 days to 3 weeks; on average, the disease manifests itself already in the third week after infection. The first symptoms resemble signs common cold: elevated temperature, runny nose, headache. After this, you can notice a significant increase in lymph nodes in the area of ​​the back of the head and in the back of the neck. Next, a red rash appears. The rash begins on the face and neck and spreads over almost the entire body within a few hours. The rashes themselves are reddish, in the form of small round or oval spots, they are noticeable for about three days, after which they disappear, leaving no traces behind.

In children, in most cases, rubella passes easily and without consequences, but in adults, complications often arise after it, such as arthritis (most often found in women), otitis media, pneumonia, there are even cases of thrombocytopenia and hemorrhages caused by it due to increased permeability blood vessels. Hemorrhages can become a serious problem if they occur during internal organs, in the eyes or even in the brain, their effects are usually long-term and difficult to treat. But the most severe complication manifests itself with the development of encephalomyelitis: loss of consciousness, acute headache, vomiting, the appearance of convulsions, sometimes reaching paralysis. In this case, there is a risk of death in 20-50% of patients.

Why is rubella dangerous for pregnant women?

In the mid-20th century, it was found that the consequences of rubella for pregnant women can be the most severe, since after this disease children are born with severe birth defects. Especially dangerous disease occurs in the first trimester of pregnancy, when the fetus undergoes the process of formation of all organs. Irreversible damage is caused to the eyes, hearing organs, skull bones, nervous system, arms and legs. There is almost a 100% chance that a child will be born with hearing impairment, clouding of the eye crystals (cataracts), and severe heart defects, which together will lead to mental retardation.

If the disease affects the mother on recent months pregnancy, the child after birth may have an enlarged liver and/or spleen, pneumonia often develops or hemorrhages begin (immediately at birth or within two days after birth). Often hemorrhages are accompanied by organ damage, which in 30% of cases leads to fatal outcome. Pregnant women who have rubella before 12 weeks are strongly advised to have an abortion for medical reasons.

Treatment and prevention

As such, there is no treatment for rubella: prophylaxis is usually recommended to avoid possible complications. In the first 5 days after the onset of the disease, it is recommended to stay at home and drink more fluids. A sick child may not be isolated for a long time from other children, but a pregnant woman must be isolated from a person with rubella. In addition, you should see a doctor to prescribe gamma globulin.

Disease prevention is a whole complex of measures. Initially, you need to identify the sick person and isolate him from healthy people for at least 5 days from the moment the rash appeared. In the room where the sick person was, you should do wet cleaning. If unvaccinated children have been in contact with the patient, they should be monitored. The first is given at the age of 1 year, the next at 6 years, and at 12 years only girls are vaccinated to reduce the risk of infection during pregnancy to a minimum.