Rubella is an acute viral infection, predominantly found in children, and belonging to the category of childhood infections. It is manifested by respiratory manifestations, intoxication and a specific rash.
The disease is of particular importance, since during pregnancy it can cause severe multiple fetal malformations.
Rubella is a controlled infection, that is, a vaccine has been developed from it, which is included in the national calendar of many countries of the world.
Rubella is caused by a special small virus from the Togavirus family.Due to its structure, the virus is unstable in the external environment, therefore, infection is especially important with close contact and in organized groups. The susceptibility of non-vaccinated individuals reaches 90%, and therefore rubella is classified as a quarantine infection.
The rubella virus is sensitive to the action of disinfectants, to high temperature, to drying and ultraviolet, poorly preserved in the external environment.
Most often, the incidence occurs during the change of seasons. Children from 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.
Children with congenital forms of rubella are also dangerous in terms of infection from an adult or child, both with typical and erased forms. Contagiousness begins a week before the onset of the rash and the entire period of clinical manifestations, plus another 7 days from the moment the rubella signs disappear.
Infection occurs through airborne droplets when talking, crying, sneezing. Pregnant women are infected the same way, and the fetus is transplacental.
By origin, rubella is congenital (intrauterine infection of the fetus), and acquired.
The incubation period for rubella can last for 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 light cold and light redness of the throat, these phenomena persist for one day or several.
Fever gradually develops up to 37.5-38 ° C, lymph nodes are enlarged in the neck and neck, enlarged lymph nodes can then persist for up to 2 weeks.
Then there are small pink spots 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 for rubella rash is not characteristic.
The rash is abundant, in the form of small specks. In adults, rubella may cause swelling and painful joints.
In the early stages of pregnancy, rubella can cause miscarriages, embryo death, congenital deformities.
To read separate article about rubella during pregnancy.
Signs of Congenital Rubella
Congenital rubella is a severe combined lesion of the fetus, especially serious when the mother is infected in the first trimester of pregnancy with the laying of all organs and tissues. The manifestations are called the Gregg triad:
- double-sided cataract or clouding of the lens of the eyes, with a decrease in the size of the eyeball,
- heart defects with stenoses of large trunks, defects of valves and partitions of the heart,
Nervous tissue malformations with hydrocephalus, the defeat of the substance of the brain with a sharp delay of development, defects of the hard and soft palate.
The basis of the diagnosis is epidemiological data on the presence of rubella in the region, as well as indications of typical rash, an increase in lymph nodes.
To confirm the diagnosis, rubella virus isolation is necessary, but it will only be shown until a rash appears. At a later date, the diagnosis is made on the basis of data on antibody titer:
- IgM class antibodies are detected in patients with the presence of fresh infection and rubella activity,
- class antibodies IgG in the presence of previous rubella or chronic infection with intrauterine infection,
It is important to determine rubella antibodies during pregnancy planning, if a woman is not vaccinated against rubella and there is no indication in her rubella card. If there is no antibody to rubella, a woman’s vaccination is shown three months before the planned conception.
There are no specific antiviral drugs for rubella, treatment is carried out symptomatically.
Shows bed rest with full-age nutrition and abundant drink. Antiviral and immunomodulatory drugs are used – arbidol, viferon , influenza , anaferon.
The rest of the therapy is based on the symptoms – antitussive agents, remedies for the common cold, febrifugal. The rash does not need to be treated, as well as the use of antihistamines.
Developed specific prevention of rubella in the form of vaccination. It is carried out in conjunction with the mumps and measles, MMR triple vaccine in age 1 year and 6 years old, girls are also 14 if they have not been vaccinated before.
There are also rubella monovaccines ( Rudivax ), they are administered to women who do not have antibodies to rubella during pregnancy planning.
In case of detection of rubella cases, contacts are quarantined for 21 days, patients are isolated for a week after the appearance of the rash.