One of the most common infections of viral etiology is rubella. This disease is usually mild, rarely accompanied by complications. On the other hand, infection of a pregnant woman poses a serious threat to the he alth of her unborn baby. In some cases, the disease causes malformations in the fetus and its intrauterine death.
Description of the disease
Rubella is an infection of viral etiology, characterized by the appearance of rashes on the skin and moderate intoxication. For the first time, the disease was fully described by F. Hoffmann in 1740. Only 140 years later, a unanimous decision was made to separate the pathology into a separate nosological group.
Today, the prevalence of the disease has declined significantly. Such results were achieved thanks to the policy of vaccination of the population. Despite this, about 100 thousand new cases of infection are recorded annually. Every 3-4 yearsthe incidence rate rises and then declines.
Sources of infection and modes of transmission
Rubella is a disease of viral etiology. Most often it is diagnosed in children. The causative agent is an RNA genomic virus with teratogenic activity. It is comfortable to exist only in the human body. In the external environment, it quickly dies under the influence of ultraviolet radiation, due to insufficient humidity or pressure changes. At low temperatures, the virus lives for a very long time and can retain the ability to reproduce.
The source of infection is usually a person with severe (rarely erased) signs of rubella. A week before the rash and for another five days after the rubivirus is released into the external environment. In epidemiological terms, children with a congenital variant of the disease are considered the most dangerous. In this case, the pathogen enters the external environment along with feces, saliva or urine for several months. Favorable conditions for infection are organized groups (kindergarten, school). Therefore, patients are isolated immediately after the diagnosis of rubella is confirmed.
How is the infection transmitted? In total, there are two ways of transmission of the disease - airborne and transplacental. The mechanism of development of this disease is not fully understood. The rubella virus enters the human body through the mucous membranes of the respiratory tract. Then he begins his activity, settling on the skin cells and in the lymph nodes. The body reacts to the introduction of agents by the formation of specific antibodies. During illness, their volumes in the bloodstream are constantly increasing. After recovery, a person remains immune to this virus for life.
What does rubella look like?
The duration of the incubation period is about 15 days. The catarrhal period following it is 3 days. In young patients, symptoms of lesions of the mucous membranes of the upper respiratory tract are very rare. Adults usually complain of photophobia, severe headaches, runny nose, cough, and lack of appetite. On the first day of illness, 90% of patients develop rashes against the background of pruritus. They look like small pink spots of the correct form that rise above the surface of the skin.
Rubella rash initially appears on the face, behind the ears and on the neck. During the day, it rapidly spreads to other parts of the body. It should be noted that exanthema never appears on the soles and palms. Sometimes single spots are found on the oral mucosa. In 30% of cases, rashes are absent, which significantly complicates the diagnosis. Among other symptoms of this disease, a slight increase in temperature can be noted. Rarely, patients complain of muscle pain, disruption of the digestive tract.
Types of rubella
Depending on the route of infection, it is customary to distinguish two types of this disease:
- Acquired rubella. This form of the disease is accompanied by multiple rashes throughout the body, but may have an atypical clinical picture. In 30% of cases, the symptomsare absent, which complicates diagnosis and contributes to the spread of the epidemic. The disease usually proceeds in a mild form, those infected are treated at home. Hospitalization is indicated only in case of complications.
- Congenital rubella. This is a very dangerous form of the disease. In most cases, it is characterized by a complicated course. Among the possible consequences, one can note a violation of the central nervous system, organs of hearing and vision.
Given the above facts, it is necessary to make one significant remark. Rubella disease in adults is extremely rare. The vast majority of people are faced with this disease in childhood, and the resulting immunity lasts the rest of their lives. Currently, about 85% of women are immune to this infection by the time they reach reproductive age.
Medical examination of a patient
Confirming the diagnosis is usually easy. Initially, the doctor conducts a physical examination and pays attention to specific symptoms (we have already described what rubella looks like a little higher). The next stage of the examination is laboratory testing:
- Complete blood count.
- Evaluation of the concentration of immunoglobulins.
- Serological examination of nasal mucus.
Differential diagnosis with measles, enterovirus infection, scarlet fever is mandatory.
Basic principles of treatment
A person who already has rubella does not need an emergencyhospitalizations. Special drugs against this disease have not been developed, only symptomatic therapy is used. It is important for the patient to adhere to bed rest, eat right and drink more water. In most cases, the rubella rash stays for only a few days. After recovery, the resulting immunity is maintained for life. Sometimes the disease returns. Experts explain this phenomenon by the individual characteristics of the immune system.
Only in the event of complications, treatment in a hospital is indicated. Patients are prescribed immunostimulating therapy ("Interferon", "Viferon"). To prevent the development of cerebral edema, hemostatics, diuretics and corticosteroids are used. In the convalescence stage, patients are advised to take nootropic drugs to improve cognitive functions.
How dangerous is rubella?
Complications of this disease are extremely rare. As a rule, they appear if a bacterial infection joins. Rubella in this case is complicated by secondary pneumonia, tonsillitis or otitis media. In adult patients, CNS lesions are not excluded. This disease poses the greatest threat to women during the period of bearing a baby. This will be discussed later in the article.
Pregnancy and rubella
The consequences of this disease during the bearing of a baby can affect his he alth. The virus enters the fetus through the placenta, affecting the endocardium and capillaries. Then the pathogen spreads to all organs of the child, where it beginsmultiply rapidly. Among the most common complications of rubella in pregnant women are intrauterine fetal death, stillbirth and spontaneous abortion.
If the baby is still born, he may develop the following disorders over time:
- heart defects;
- exanthema;
- underweight;
- jaundice;
- myocarditis;
- encephalitis;
- mental retardation;
- dystrophy.
Such complications lead to premature death of the baby in 30% of cases. About 70% of children die in the first year of life. Separate manifestations of the disease make themselves felt only at puberty. These are autoimmune thyroiditis, diabetes, and growth hormone deficiency. In the blood of an infected child, the rubella pathogen can remain active for several years. Modern medicine cannot offer a specific treatment for this disease.
Disease prevention
General preventive measures in foci of infection are ineffective. It is almost impossible to determine the presence of a virus in the body before the first symptoms appear. However, a sick person is isolated for 5-7 days from the moment the rash appears.
Specific prevention implies vaccination against three diseases at the same time: measles, rubella, mumps. Vaccination at 6 years old is done for the second time, and the first - at the age of one year. Among the contraindications for vaccination are the following:
- malignantneoplasms;
- pregnancy;
- negative reaction to the vaccine;
- exacerbation of diseases of infectious etiology.
Vaccination against rubella can be combined with other mandatory vaccinations (against whooping cough, hepatitis B, polio, diphtheria and tetanus). It is forbidden to mix different drugs in one syringe. In addition, it is desirable to put injections in different places. The only exception is the complex (measles-rubella-mumps) vaccination. At the age of 6, it is done to many children again. Such revaccination contributes to the development of immunity to three diseases at once. After it, swelling of the skin and its slight redness may be observed. Adverse reactions from the body are an increase in lymph nodes, nausea, runny nose, general malaise. In adolescence, after vaccination, the development of arthralgia and polyneuritis is not excluded, which eventually disappear on their own.
