One of the most common infections of viral etiology is rubella. This disease usually proceeds in a mild form, rarely accompanied by complications. On the other hand, infection of a pregnant woman poses a serious threat to the health of her unborn baby. In some cases, the disease causes malformations in the fetus and its intrauterine death.
Disease Description
Rubella is a viral etiology infection characterized by skin rashes and moderate intoxication. For the first time the disease was fully described by F. Hoffman in 1740. After only 140 years, a unanimous decision was made to isolate the pathology into a separate nosological group.
Today, the prevalence of the disease has declined significantly. Such results were achieved thanks to the vaccination policy of the population. Despite this, about 100 thousand new cases of infection are recorded annually. Every 3-4 years, the incidence rate rises, and then declines.
Sources of infection and transmission methods
Rubella is a disease of viral etiology. Most often it is diagnosed in children. The role of its causative agent is the RNA genomic virus with teratogenic activity. It is comfortable for him to exist only in the human body. In the external environment, he quickly dies under the influence of ultraviolet radiation, due to insufficient moisture 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 rashes and another five days after the ruby virus is released into the external environment. In the epidemiological plan, 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 confirming the diagnosis of rubella.
How is the infection carried? In total, there are two ways of transmitting the disease - airborne and transplacental. The mechanism of development of this ailment has not been thoroughly studied. Rubella virus enters the human body through the mucous membranes of the respiratory tract. Then it begins its activity, settling on the skin cells and in the lymph nodes. The body responds to the introduction of agents by the formation of specific antibodies. During the disease, their volumes in the bloodstream are constantly increasing. After recovery, a person remains immune against this virus for life.
What does rubella look like?
The incubation period is about 15 days. The next catarrhal period is 3 days. In young patients, symptoms of damage to 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 the disease, rashes appear in 90% of patients against skin itching. They look like small pink spots of regular shape that rise above the surface of the skin.
A rubella rash initially appears in 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. Other symptoms of this disease include a slight increase in temperature. 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, symptoms are completely absent, which complicates the diagnosis and contributes to the spread of the epidemic. The disease usually proceeds in a mild form, the 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 likely consequences can be noted a violation of the central nervous system, 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 face this ailment in childhood, and the resulting immunity persists for the rest of their lives. Currently, about 85% of women are immune to this infection at the time of reproductive age.
Medical examination of the patient
Confirmation of the diagnosis is usually straightforward. Initially, the doctor conducts a physical examination and draws attention to specific symptoms (a little higher, we already told you what rubella looks like). The next stage of the examination is laboratory testing:
- General blood analysis.
- Assessment of the concentration of immunoglobulins.
- Serological examination of mucus from the nasal cavity.
Differential diagnosis with measles, enterovirus infection, scarlet fever is mandatory.
The basic principles of treatment
A person who has already got rubella does not need emergency hospitalization. Special drugs against this ailment 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, a rubella rash remains only a few days. After recovery, the resulting immunity lasts for life. Sometimes the disease returns. Experts explain this phenomenon by the individual characteristics of the immune system.
Only in case of complications is shown treatment in a hospital. Patients are prescribed immunostimulating therapy ("Interferon", "Viferon"). To prevent the development of cerebral edema, hemostatics, diuretics and corticosteroids are used. In the stage of convalescence, patients are advised to take nootropic drugs to improve cognitive function.
What is the danger of 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, lesions from the central nervous system 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 the baby can affect his health. The virus penetrates the fetus through the placenta, affecting the endocardium and capillaries. Then the pathogen spreads to all the organs of the child, where it begins to multiply rapidly. Among the most common complications of rubella in pregnant women, there 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;
- lack of body weight ;
- jaundice;
- myocarditis;
- encephalitis;
- mental retardation;
- dystrophy.
Such complications lead to premature death of the baby in 30% of cases. In the first year of life, about 70% of children die. Individual manifestations of the disease make themselves felt only at puberty. These are autoimmune thyroiditis, diabetes, and growth hormone deficiency. Rubella can remain active in the blood of an infected child for several years. Modern medicine cannot offer a specific treatment for this ailment.
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 onset of its first symptoms. However, a sick person is isolated for 5-7 days from the time of the rash.
Specific prophylaxis implies vaccination against three diseases simultaneously: measles, rubella, and mumps. Vaccination at 6 years old is done a second time, and the first - at the age of one year. Among the contraindications for vaccination are the following:
- malignant neoplasms;
- pregnancy;
- negative reaction to the vaccine;
- exacerbation of diseases of infectious etiology.
Rubella vaccination can be combined with other mandatory vaccinations (against pertussis, hepatitis B, polio, diphtheria and tetanus). Various drugs are not allowed to be mixed in the same syringe. In addition, it is advisable to put the injections in different places. An exception is only a comprehensive (measles-rubella-mumps) vaccination. At 6 years old, many children do it again. Such revaccination contributes to the development of immunity immediately to three diseases. After it can be observed swelling of the skin and its slight redness. Adverse reactions from the body are enlarged lymph nodes, nausea, runny nose, and general malaise. In adolescence, after vaccination, the development of arthralgia and polyneuritis, which eventually pass on their own, is not excluded.