Rubella consequences for men. Rubella in children: symptoms, how to distinguish, treatment, forms of the disease, complications. Frequently asked questions about rubella

Acquired rubella in children is much more common than congenital forms of the disease. This is facilitated by specific routes of infection transmission. Most often, acquired rubella is spread by airborne droplets among groups of children from a sick child. a sick person begins to secrete the active form of the rubella virus already on the 7th day from infection. Viral shedding 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 through direct contact with a sick person. The virus is not stable in the external environment and spreads easily only where there is a large crowd of people and there is a shortage of fresh air. Therefore, periodic ventilation of premises and compliance with sanitary standards for the stay of children in children's institutions are effective preventive measures against rubella and many others that are transmitted by airborne droplets.

How rubella manifests itself: symptoms do not appear immediately

Rubella does not produce 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. Typically, the incubation period for acquired rubella is from 10 to 21 days. The average duration of the incubation period in infants and toddlers is 18 days. While the incubation period of rubella lasts, children do not show any external symptoms or signs.

But even after the end of the incubation period, rubella does not always give symptoms. According to clinical observations in recent years, it more than occurs in a latent form. It is also called subclinical. At this time, the symptoms of rubella are either very weak or not detectable at all. The normal course of rubella in children begins acutely, with a prodromal period, which on average lasts 2 to 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 pain in the occipital, submandibular, and postauricular lymph nodes. Their density increases and sensitivity to palpation increases. With the acute onset of the disease, the lymph nodes are visible, they appear above the skin of the neck. rubella can also produce symptoms in the form of catarrhal symptoms. Among them are redness of the mucous membranes of the oropharynx, congestion of the nasal passages, and a dry cough caused by inflammation of the 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 causes minor symptoms and is more mild. At older ages, during the prodromal period of rubella, a sharp increase in body temperature is observed. Typically, the thermometer readings are fixed at 38 degrees Celsius. After the appearance of skin rashes, body temperature returns to normal. If a third-party infection does not occur during the course of the disease, then an increase in 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 symptoms. Determining rubella becomes quite simple 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, the rash from rubella can become weeping. However, the classic form of skin rashes is much more common. These are small pinkish dots scattered throughout the body. In some places there is a merging of individual elements. The gluteal areas, the anterior surface of the abdominal wall, the bends of the limbs, the outer surfaces of the thighs, and the back are most affected.

The rash lasts approximately 3 to 5 days. Then it begins to quickly fade and after a few hours disappears without any consequences. The rash from rubella 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 already in the first hours of the disease to differentiate it from colds, which are also accompanied by a sore throat and increased body temperature. The enlargement of the lymph nodes is not accompanied by their adhesion to the surrounding tissues. Palpation is slightly painful. Hypertrophy of the lymph nodes is detected several days before the appearance of skin rashes and continues for 2 weeks after the rash disappears. In the practice of pediatricians, there are also cases where enlargement of the lymph nodes persisted for several years after rubella. This is a normal phenomenon, which indicates that the child’s body is actively fighting against the rubella virus. Sore throat and fever also disappear along with the rash. Catarrhal phenomena do not occur in the future

What are the symptoms of rubella in older children?

If in infancy and toddlerhood parents may not even notice that their baby has had rubella, then at an older age it is difficult not to notice this disease. the acute onset and rapid course are accompanied by a number of unpleasant symptoms. we should start with the fact that increased body temperature and sore throat with rubella are observed only in older children, adolescents and adults. Skin rashes in older age are more severe and have a high tendency to merge. They are accompanied by severe skin 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 very quickly joined by the phenomena of rhinitis in the form of a runny nose and nasal congestion. After the rash appears, older children may begin to experience intermittent pain in large joints and muscle tissue. Upon examination, redness of the skin over the surface of the joints can be detected. Pain on palpation. With the wrong treatment approach, arthritis and myositis in adolescents can develop into chronic forms of the disease.

Very often in children with rubella, small joints of the hands and feet are affected. In the future, the inflammatory process can spread to large ankle, knee, shoulder and elbow joints. With proper rubella treatment, joint pain goes away completely within 2 weeks after the skin rash disappears. In teenage boys, rubella can also cause testicular infections. In teenage girls, adnexitis associated with rubella is not common.

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 disease. As a rule, mild, subclinical forms of rubella leave absolutely no consequences. The most dangerous consequence of rubella is encephalitis. This complication occurs exclusively in adolescence and adulthood. The incidence of damage to the membranes of the brain after rubella is negligible, approximately 1 case per 10,000 diagnosed cases of infection. Encephalitis usually develops very quickly, before the onset of skin rashes. In rare cases, autoimmune encephalitis occurs after a generalized rash appears on the patient's skin.

The first manifestations of encephalitis in a sick child are a sharp deterioration in condition, which is accompanied by frustration and confusion. This is very quickly accompanied by meningeal symptoms. In severe cases, convulsive syndrome develops, which can lead to respiratory arrest and cardiac depression. Without timely medical care, all this can lead to the death of the child.

The second serious consequence of rubella in children is damage to the central nervous system. This can manifest itself in the form of paresis and paralysis, decreased sensitivity of certain areas of the skin, deterioration of vision and hearing. The frequency of such consequences of rubella is about 25 percent of the total number of diseases. More than 30 percent of children with damage to the central nervous system due to rubella die.

Congenital rubella can also have long-term consequences. Back in 1975, a brain disorder was first diagnosed in a teenager who had rubella in utero. Currently, doctors know for sure that rubella can have consequences even after several years. This can manifest itself in the form of a violation of the child’s mental development, mental disability, and writing. A decrease in the level of intellectual abilities is often accompanied by impaired coordination of movements and inconsistency in the functioning of individual parts of the brain. Unfortunately, such consequences of rubella are not treated and are not compensated for by additional pharmacological influence factors.

Rubella: treatment and symptomatic therapy

If a child is diagnosed with 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 a local pediatrician is to organize sufficient measures to prevent the spread of infection among children and adults. A sick child is extremely dangerous.

For children with weakened immune systems, the use of interferon is recommended to enhance the immune response to the virus. Typically, such children and toddlers with severe forms are hospitalized in infectious diseases departments. there they are under 24-hour medical supervision.
Mild forms of rubella can be treated at home. For adequate therapy the following are prescribed:

strict bed rest during periods of increased body temperature;
treatment of skin surfaces in the area of rashes;
symptomatic treatment in the form of antipyretic drugs, restorative and vitamin complexes;
taking medications that stimulate the production of immune bodies.

Constant ventilation of the rooms where the sick child is located is required. In the morning and evening, wet cleaning is carried out 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 surrounding people. Family members should adhere to the rules of personal hygiene and enter the room of a sick child only wearing a gauze bandage.

Prevention and vaccination against rubella

Vaccination against rubella is the only effective way to prevent outbreaks of this infectious disease. The rubella vaccine is first administered to a baby at the age of 1 year. Repeated rubella vaccination is then required throughout life at ages 6 and 15 years. Girls are usually vaccinated during adolescence. For boys at this age, rubella is no longer scary. Teenage girls are vaccinated to develop immunity during future pregnancies. In modern practice, a combined composition of the rubella vaccine is used. It also includes attenuated titers of smallpox, measles and mumps. According to research, stable immunity to rubella is formed in approximately 95% of cases of strict adherence to the vaccination schedule.

Infectious disease specialists recommend testing for carriage of the rubella virus and the presence of antibodies to it in the woman’s body during pregnancy planning. If a woman gives a serological positive reaction, then repeated vaccination is necessary. It should be remembered that during pregnancy, rubella vaccination is contraindicated. This can cause significant harm to the fetus. After the rubella vaccine is administered, fertilization is not recommended for 90 days. Breastfeeding is not allowed during this period.

Prevention of rubella also involves carrying out sanitary epidemiological measures at the source of infection. Children with suspected rubella are not allowed into the children's group. In rooms where children are kept, it is necessary to carry out wet cleaning twice a day; it is advisable to quartz the air in the premises of kindergartens and nurseries.

Particular caution should be exercised in relation to children who have been diagnosed with congenital rubella. They can be active carriers of the virus during the first 3 years of their life. Before these children attend preschool institutions, it is recommended to conduct serological tests. If the rubella virus is isolated, children are not allowed into kindergartens. They are prescribed treatment and vaccination. For the adult population, prevention of rubella should consist of observing rules of personal hygiene. Monitoring the level of antibodies and immune responses is a radical way to prevent intrauterine infection of the fetus with rubella.

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

What is rubella?

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

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

Factors that destroy the rubella virus:

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

Transmission routes

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

Routes of transmission of rubella:

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

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

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

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

Incubation period

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

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

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

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

How rubella begins: the first signs in a child

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

How rubella begins:

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

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

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

What rubella looks like: photos of children with a rash

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

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

Symptoms of rubella in children

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

During the incubation period, rubella manifests itself as follows:

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

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

Children experience the following symptoms:

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

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

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

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

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

Complications

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

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

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

Diagnostics

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

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

Diagnostic testing includes the following laboratory tests:

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

Diseases similar in symptoms to rubella:

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

Treatment of rubella

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

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

No specific treatment has been developed, so they use:

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

Medicines are prescribed to prevent complications and relieve symptoms

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

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

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

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

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

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

Prevention

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

Basic methods of prevention:

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

Rubella is an acute viral infection, mainly observed in children, and belongs to the category of childhood infections. Manifested by respiratory manifestations, intoxication and a specific rash.

The disease is of particular importance, since during pregnancy it can cause severe multiple malformations of the fetus.

Rubella is a controlled infection, that is, a vaccine has been developed against it and is included in the national calendar of many countries around the world.

Causes

Rubella is caused by a special small virus from the togavirus family. Due to its structure, the virus is unstable in the external environment, so infection in close contact and in organized groups is especially important. Susceptibility in unvaccinated individuals reaches 90%; therefore, rubella is classified as a quarantine infection.

The rubella virus is sensitive to the action of disinfectants, high temperature, drying and ultraviolet radiation, and does not survive well in the external environment.

Most often, the incidence occurs during the changing seasons. Children aged 2 to 10 years are most susceptible; epidemic outbreaks are recorded every 10 years.

Immunity after rubella is lifelong and persistent; antibodies remain in the blood for life.

You can get sick from an adult or a child, both with a typical and erased form; children with congenital forms of rubella are also dangerous in terms of infection. Contagiousness occurs a week before the onset of the rash and the entire period of clinical manifestations, plus another 7 days from the moment the signs of rubella disappear.

Infection occurs through airborne droplets when talking, crying, or sneezing. Pregnant women are infected in the same way, and the fetus is infected transplacentally.

By origin, rubella can be congenital (intrauterine infection of the fetus) or acquired.

Rubella symptoms

The incubation period for rubella can last 2-3 weeks, and in the last week of incubation the patient is contagious to others. At the end of the incubation period, there may be a slight runny nose and slight redness of the throat; these phenomena persist for one day or several.

Fever gradually develops to 37.5-38°C, the lymph nodes in the back of the head and neck become enlarged, and the enlarged lymph nodes can then persist for up to 2 weeks.

Then small pink spots appear on the face, extensor surfaces of the arms and legs, and on the buttocks. The rash lasts up to 4 days (less often - up to 7 days), itching is not typical for a rash with rubella.

The rash is abundant, in the form of small spots. In adults, rubella may cause joints to swell and become painful.

Complications during pregnancy

In the early stages of pregnancy, rubella can cause miscarriages, embryo death, and congenital deformities.

Read separate article about rubella during pregnancy.

Signs of congenital rubella

Congenital rubella is severe combined lesions of the fetus, especially serious when the mother is infected in the 1st trimester of pregnancy during the development of all organs and tissues. The manifestations are called Gregg's triad:

bilateral cataracts or clouding of the lenses of the eyes, with a decrease in the size of the eyeball,
heart defects with stenoses of large trunks, defects of valves and septa of the heart,
deafness.

Malformations of the nervous tissue with hydrocephalus, damage to the brain substance with a sharp delay in development, and defects of the hard and soft palate can also be identified.

Diagnostics

The basis of the diagnosis is epidemiological data on the presence of rubella in the region, as well as indications of typical rashes and enlarged lymph nodes.

Isolation of the rubella virus is necessary to confirm the diagnosis, but this will only be indicated before the rash appears. At a later date, the diagnosis is made based on data on the antibody titer:

IgM class antibodies are detected in patients with fresh infection and rubella activity,
IgG class antibodies - in the presence of previous rubella or chronic infection due to intrauterine infection,

It is important to determine antibodies to rubella during pregnancy planning, if the woman is not vaccinated against rubella and there is no indication in her card about having had rubella. If there are no antibodies to rubella, vaccination of the woman three months before the planned conception is indicated.

Treatment of rubella

There are no specific antiviral drugs for rubella; treatment is carried out symptomatically.

Bed rest with age-appropriate nutrition and plenty of fluids is recommended. Antiviral and immunomodulatory drugs are used - Arbidol, Viferon, Gripferon, Anaferon.

The rest of the therapy is based on symptoms - antitussives, cold remedies, antipyretics. There is no need to treat the rash with anything, nor do you need to use antihistamines for it.

Prevention

Specific prevention of rubella in the form of vaccination has been developed. It is carried out together with mumps and measles, the MMR trivaccine at the ages of 1 and 6 years, and for girls at 14, if they have not been vaccinated before.

There are also mono-vaccines against rubella (Rudivax), which are administered to women who do not have antibodies to rubella when planning pregnancy.

When cases of rubella are detected, contacts are quarantined for 21 days, patients are isolated for another week from the moment the rash appears.

Rubella, what kind of disease is it, how does it manifest itself and how is it dangerous? Perhaps all women have heard about this infection, because it is considered one of the most dangerous for expectant mothers. More precisely - for their unborn children.

Rubella is a contagious disease. Transmitted from person to person by airborne droplets. Moreover, it is mainly children who suffer from it. After this, lifelong immunity is formed.

The rubella virus has an incubation period of 2-3 weeks, after which symptoms of the disease appear. In general, patients feel well. Your throat may just hurt a little and your temperature may rise. Pain in muscles and joints appears less frequently, and lymph nodes become enlarged. But rubella in children and adults is always accompanied by a typical rash. For ordinary people, it may seem similar to what occurs with measles or scarlet fever. But there are differences, and the doctor will definitely notice them. With rubella, the rash first appears on the face, then spreads to the torso and limbs. The rash is abundant on the knees, elbows, back and buttocks. With measles, on the contrary, the rash is more noticeable on the face. The difference from scarlet fever is the skin, which is not hyperemic.

If you become infected with rubella, what should you do and how to treat it? First of all, you need to contact a dermatologist or infectious disease specialist to confirm the diagnosis. Otherwise, you can begin to receive incorrect treatment and harm your health. If the diagnosis is confirmed and the disease is mild, treatment is symptomatic. That is, at a temperature above 38.5 degrees - antipyretic and rest. If intoxication increases, and this is expressed by a deterioration in health, they may be admitted to a hospital to “remove toxins” from the blood. And if a bacterial infection occurs, prescribe antibiotics. At the same time, it is important to observe home quarantine so as not to infect other people.

Rubella is an infectious disease of viral origin, which has a very high level of contagiousness, that is, infectiousness. Its main signs are the appearance of elements typical of rubella on the skin, symptoms of moderate intoxication of the body, changes in the blood picture and enlargement of regional lymph nodes.

There are the following forms of rubella:

acquired– when a healthy child becomes infected from a sick person;
congenital– with it, a sick child receives the virus in utero from the mother and secretes it for 12-24 months after birth.

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Rubella in children can occur either in a mild form or with complications, most often of a neurological nature (rubella, arthritis, etc.). The disease is quite common, its outbreaks are recorded every 4-5 years in groups of children and adults. It is also characterized by seasonality, and the peak of activity occurs in winter. Children's bodies are very susceptible to the rubella virus, especially between the ages of 1 and 7-10 years. Infants up to 12 months have innate immunity. Those who have already had this disease have lasting immunity for the rest of their lives.

Rubella infection occurs from a sick person who is the source of the viral infection.

The disease is transmitted in the following ways:

airborne (kiss, conversation);
vertical route of infection (transplacental) - from the sick mother to the fetus;
contact – when using shared toys and personal hygiene items.

In total, the patient is contagious to others for 21-28 days.

note: It should be taken into account that a person with rubella is contagious both during the incubation period - 7-10 days before the rash, and after the onset of symptoms - about another 3 weeks.

Virus carriers who do not show signs of illness and are healthy can also be carriers of the disease.

Important: This disease is especially dangerous during pregnancy in the first trimester. Rubella causes severe congenital defects in the fetus during this period, including its death.

Pathogenesis

Rubella enters a healthy body through penetration through the respiratory tract and mucous membranes. The virus spreads hematogenously and also penetrates the lymphatic system, where it multiplies in the lymph nodes for about 7 days. Clinically, this manifests itself as a noticeable increase in the size of the nodes themselves. Catarrhal phenomena may also be observed - sore throat, dry unproductive cough, lacrimation. A rash begins to appear in the background, which looks like small oval or round spots of pink-red color. In childhood, this disease is much milder than in adults.

note: In laboratory tests of blood and nasopharyngeal swab, the virus can be detected 8 days before the appearance of the rash. After the rash, the virus is diagnostically confirmed by isolating it from a stool or urine test.

Rubella is caused by an RNA virus of the Rubivirus genus, which belongs to the Togaviridae family. Virus particles containing pathogenic RNA have very small sizes – 60-70 nm. The rubella pathogen dies at a temperature exceeding 56°C for 60 minutes, but in a frozen state it can live for many years. Once on mucous membranes or damaged skin, the virus begins to rapidly multiply under favorable conditions. It accumulates in the lymph nodes, spreads with the blood to all organs and systems, eventually settling in the skin.

Rubella in children is much easier than in adults. The disease occurs in 4 stages:

incubation period– takes on average from 7 to 21 days;
period of catarrhal phenomena– with it there are often no pronounced symptoms of rubella, but there may be a runny nose, redness of the nose, enlarged lymph nodes (this period lasts 1-3 days, no longer);
the height of the disease– at this time, exanthema and rash begin to appear (small, pink or red, with clear and smooth edges), in some cases it can merge, which often happens in children.
convalescence period(recovery).

It is worth separately clarifying the location and type of rubella rash, as these are its characteristic signs.

When differentiating the disease, pay attention to the following points:

with rubella, skin rashes are located in the back, face, buttocks, neck, scalp, inner flexor surface of the knees and elbows, behind the ears;
with rubella there is no rash on the feet and palms;
the rash looks like round elements with a diameter of up to 5 mm;
the body becomes covered with a rash within 24 hours;
elements on the oral mucosa are not excluded;
3-5 days after appearance, the rash disappears and leaves no marks on the skin;
There is no peeling or pigmentation left after rubella.

Upon examination, the doctor notices enlarged lymph nodes of the following groups: mid-cervical, occipital, posterior cervical. They are about the size of a large pea, and they remain that way even when the rash goes away.

The general condition of the child is slightly impaired, parents may observe lethargy and malaise. Body temperature usually does not exceed 38 °C and remains at 37-37.5 °C. Older children with rubella complain of pain in the joints, muscles, and headache. In parallel with the rash, mild conjunctivitis, rhinitis and cough may develop. Most often, when examining the oral cavity, looseness of the tonsils and exanthema on the mucous membrane of the soft palate (pale pink spots) are observed.

note: V In some cases, erased symptoms of rubella occur, when the signs of the disease are very mild. In this case, laboratory tests will help make a correct diagnosis.

Diagnostics

Sometimes confirming the diagnosis of rubella can be difficult. In some cases it is confused with scarlet fever or measles. That is why it is important to visit a doctor who will conduct an objective examination. If a pediatrician or infectious disease specialist doubts the correctness of the diagnosis, then additional tests are prescribed.

Examination for rubella consists of the following points:

Inspection. The doctor will notice a characteristic rubella rash on the child’s skin, which almost instantly spreads throughout the body, enlarged lymph nodes and catarrhal symptoms.
Laboratory research:

Analysis of urine. It contains a large number of leukocytes.
. With rubella, there is an increase in ESR, the level of monocytes and leukocytes, and sometimes the appearance of plasma cells is possible.
. Its task is to determine the stage of rubella and the presence of antibodies to it in the blood.

Important: Doctors prescribe additional tests to differentiate rubella from enterovirus and allergies to medications.

Complications of rubella

In fact, complications with rubella are quite rare, and they usually occur in children who suffer from immunodeficiency.

Possible manifestations include the following pathologies:

angina;
eustacheitis;
arthritis;
thrombocytopenic purpura;
meningoencephalitis;
orchitis

Complications of rubella during pregnancy are distinguished separately. The disease mainly affects the fetus, causing various malformations, sometimes incompatible with life. The mother’s body does not suffer, but the virus overcomes the placental barrier and provokes spontaneous abortion and fetal deformities.

Treatment for rubella is symptomatic, since there is no specific treatment. If there is no critical increase in body temperature, then hospitalization is not required, and the patient is treated at home with the permission of the doctor, but subject to bed rest.

Treatment for rubella includes:

when a secondary bacterial infection occurs;
vitamin and mineral complexes to support the body during illness;
are prescribed if the rash, itching and pain are severe;
for conjunctivitis, albucid is used;
physiotherapy in the form of UHF and dry heat is prescribed in the case of painful and enlarged lymph nodes;
it is important to limit the load on the child’s vision as much as possible, that is, to minimize staying in front of the monitor, watching TV, computer games, reading;
an antipyretic is required only if the temperature exceeds 38°C, which is extremely rare with rubella;
sprays are used locally for sore throat;
a stuffy nose is treated by rinsing with saline solutions and using nasal drops;
herbal medicine is recommended only with the permission of a doctor (raspberries for fever, rose hips and calendula for a general strengthening effect, etc.).

Treatment of congenital rubella in children involves the use of etiotropic drugs in the form of recombinant interferon. With it, Re-aferon, Viferon are usually prescribed. If meningoencephalitis develops in parallel, then corticosteroid hormones are also indicated. Interferon has a powerful antiviral effect and activates reduced. At the cellular level, it increases the phagocytosis of macrophages, which successfully fight the virus. Rubella is a systemic viral pathology, so it requires the administration of interferon both parenterally and orally up to 3 times a day. This is due to the fact that these drugs penetrate the body at the tissue level and are then quickly inactivated.

The main prevention of this disease is vaccination. It is definitely worth taking not only for children, but also for those women who have reached childbearing age but have not had rubella before. Especially if they are planning a pregnancy in the near future. To prevent the spread of the virus, a child with rubella should be isolated for up to 7 days after the rash appears. There is no quarantine in the children's group that the sick child attended. In this case, it is imperative to protect the patient’s contact with pregnant women.