Rubella (or measles rubella) is an epidemic viral disease. However, during pregnancy, measles rubella can have an adverse effect on the fetus.
The characteristic features of the disease are the presence of a skin rash and an increase in the size of the lymph nodes. Basically, rubella affects children (whose age is from five to fifteen years); rubella affects women and men equally. After the disease, a strong immunity is developed to it.
Rubella more clearly manifests itself in the form of epidemic waves. The most pronounced epidemics occur in the world with an interval of ten to twenty years. The rubella vaccination is mandatory - it is carried out at the age of 12 months and 6 years and is included in the calendar of mandatory preventive vaccinations in Russia. Vaccination rarely causes complications and is easily tolerated in most cases.
Rubella is the third disease. This name was stuck for measles rubella for the following reason. It has been holding onto rubella ever since a list of all the diseases that cause rashes in children appeared. In this list, as you might guess, rubella was the third in a row.
Rubella is not a dangerous disease. This can be judged on the basis of the fact that rubella is most often mild. The duration of its course is also short. The disease most often develops in children.
Rubella is a dangerous disease. This is indeed the case during pregnancy. If a pregnant woman becomes sick with rubella, then there is a potential danger to the baby - it is especially great in the case when the mother became infected in the first months of pregnancy. In this case (infection in the first month of pregnancy), the probability of miscarriage is very high. Rubella can provoke serious congenital defects in a child, which include deafness, blindness, pathologies of the development of the brain and heart. According to scientists, the risk of complications of the normal course of pregnancy with rubella infection in the first month is approximately 50%, in the second month it is about 25%, in the third month - 15%.
Rubella was recognized as an independent disease only at the end of the nineteenth century. This disease was described as early as 1740 (F. Hoffmann - a German physician). But despite this, rubella was recognized as an independent disease only in 1881. Until this year, rubella, along with scarlet fever and measles, were considered by scientists and doctors as one disease. The reason for this is that all of the above diseases have similar external signs, that is, they manifest themselves in almost the same way.
An RNA virus is the causative agent of rubella. This virus belongs to the togavirus family. The virus contains two antigens - internal and external. The virus rapidly degrades when exposed to organic solvents, UV rays, formalin, and chloroactive compounds. Also, the virus cannot exist for a long time under conditions in which the pH is above 8.0 and below 6.8. The infection can spread in two ways. The first method is airborne. The second is associated with contact with the discharge of a patient with measles rubella. During pregnancy, the disease is transmitted to the fetus through the mother's placenta.
Rubella is a worldwide disease. In America, the incidence of measles is seasonal. The peak incidence occurs in May-June. It should be noted that rubella is less infectious than measles. As a result of contact with a sick person, the likelihood of developing rubella in a healthy person varies from 30% to 60% of all cases.
Babies are not prone to rubella. Such cases are extremely rare. Rubella most often develops in children between the ages of five and fifteen. It is not uncommon for adults to get sick with rubella. However, after forty years of age, the likelihood of contracting rubella is almost zero.
Once you have had rubella, you can forget about it for the rest of your life. This is indeed the case. After a person gets sick with rubella, he develops a strong immunity to this disease. Re-infection with rubella is very rare worldwide. You need to know that rubella immunity does not protect a person from measles at all.
A rash is the first symptom of rubella. He is often the only one. The rash is most likely to appear first on the extensor surfaces of the limbs, as well as on the face and neck. However, the rash quickly spreads throughout the body. It remains unchanged for about three days. A rubella rash is similar to a scarlet fever rash, and, above all, it is expressed in the fact that the appearance of a rash with scarlet fever is often combined with a general redness of the skin around it.
Rubella symptoms are mild. If we count all the other symptoms of rubella, except for the rash, then this is indeed the case. An increase in body temperature above 38 ° is quite rare. The temperature is only elevated for a few days (usually three to four days). After this period, the patient begins to recover quickly. The patient is contagious on average two weeks (that is, a week before the first rash is detected, and a week after the first rash). However, those children who contracted rubella from the mother (meaning cases of intrauterine infection) remain infectious for several months (there are cases even up to two years).
Rubella is characterized by a pronounced prodromal period. The prodromal period, in simple terms, is associated with the appearance of signs-precursors of the disease. The prodromal period is typical for infectious diseases. One and a half days before the onset of the disease (that is, the appearance of a rash), there is a slight increase in body temperature, headaches, an increase in lymph nodes - posterior and occipital. Puffiness and a slight runny nose may also occur.
Rubella treatment is only symptomatic. There are no drugs against the causative agent of the disease. At elevated body temperature, bed rest is necessary (including for the purpose of isolating the patient from others). The duration of isolation should be at least seven to ten days, that is, it covers the period when the patient poses a danger of infecting others. Light meals are also recommended. Patients are allowed to take paracetamol. Most people with rubella do not even need any specific treatment. It is only possible to take funds that are aimed at treating complications or alleviating the general well-being of the patient.
Rubella rarely causes complications. Basically, the development of complications occurs only during the period of intrauterine development of a person. Congenital rubella has the following clinical picture. Most often it is defined by the Gregg triad. The latter includes: first, damage to the organs of vision - most often it is a cataract (develops in 84.5% of cases); secondly, pathology of the hearing organs (in 21.9% of cases) and, thirdly, congenital heart defects (found in 98% of cases of congenital rubella). Complicated rubella in childhood is largely associated with the presence of a secondary viral infection or bacterial infection.
Joint damage is a specific complication of rubella. Adolescent girls and women are most susceptible to this complication. Moreover, the incidence of this complication directly depends on the age of the patient with rubella. The older the patient, the higher the likelihood of joint damage. As a rule, this complication manifests itself approximately seven days after the first skin rash. It is clinically associated with pain, redness and, quite often, joint swelling. Pleural effusion often occurs. The most affected are the metacarpophalangeal joints. Elbow and knee joints are often affected. The symptoms of this complication persist for one week.
Damage to the nervous system in rubella is rare. The incidence of this rubella complication is one in five (or even six) thousand cases. Complications develop about the fourth or fifth after the first signs of the disease appear and can proceed in the form of meningitis, encephalitis, meningoielitis, etc. Acute encephalitis usually reveals itself as a new significant rise in the patient's body temperature. It is characterized by severe cerebral symptoms, which are determined by a disorder of consciousness and the appearance of seizures. Meningitis can develop on its own, but it often accompanies encephalitis.
Thrombocytopenic purpura is a specific complication of rubella. This complication is most often expressed in girls. It manifests itself a few days after the rash is detected (sometimes a week). The characteristic features of this complication are the appearance of a hemorrhagic rash, the presence of hematuria (that is, blood in the urine), and bleeding from the gums.
Rubella preventive vaccination is mandatory. Its main goal is to prevent the rubella virus from entering the body of a pregnant woman. The most important task has been identified, which is to reduce the level of congenital rubella to the level of 0.01 per 1000 births (and less) - we are talking about 2010. That is why rubella vaccination is mandatory and is part of the Russian vaccination calendar.
The vaccination itself is carried out either deeply subcutaneously or intramuscularly. Vaccination is carried out at the age of one year and six years, in addition, thirteen-year-old girls are also subject to vaccination if they have received less than two doses of this vaccine before. At the same time, the presence of a history of rubella disease is not taken into account (that is, the vaccination is done regardless of whether the person had rubella before).
Any vaccine against rubella is used from those that are approved for use in the Russian Federation - a domestic vaccine against rubella has not yet been developed.
Vaccines are often used against several diseases at once (three in one) - when they are introduced, the child is vaccinated against rubella, measles and mumps. With this increase in the risk for this vaccine, as well as the development of complications, is not observed. It is recommended that the mother-to-be vaccinated against rubella should be scheduled several months (two or three months is enough) before pregnancy.
Rubella vaccination during pregnancy will not only be of no benefit, but may also be harmful to the fetus, since the vaccine contains a live, but weakened, virus. Its meaning is precisely that rubella should pass in a very mild form. However, such a virus is dangerous for the fetus. In addition, a pregnant woman should never come into contact with people who have been vaccinated for four weeks after it.
The rubella vaccine is easily tolerated. Reactions to rubella vaccine are common. As a rule, this is redness of the injection site and some soreness. Quite often, subfebrile condition (fever) is observed, which, nevertheless, is of a short-term nature. Lymph node enlargement may occur infrequently. All of the above reactions are observed only in two to three percent of vaccinated from their total number. They occur within the first two or three days. A small number of people vaccinated between the fifth and twelfth days after vaccination may have some measles-specific reactions. We are talking about the appearance of rashes characteristic of the disease, an increase in the size of the occipital, behind the ear, cervical lymph nodes, and possible pain in the joints. All of these signs can occur (rarely) for two to four weeks after vaccination. The reason is that the vaccine causes mild measles rubella.
The rubella vaccine is not difficult. It would be more correct to say gives, but extremely rarely. Complications can occur with a frequency of 1 person with complications to 200,000 vaccinated. Complications include meningitis and meningoencephalitis. In any case, complications are mild. As a rule, there are no residual effects.