Rubella is an infectious disease caused by a virus. All viruses are characterized by the presence of a wavy appearance of outbreaks of the disease. This means that after an outbreak of a disease, when 2% or more of the country's population becomes ill, a sharp decline in the disease occurs, and only isolated cases of its manifestation appear. In rubella, this cycle is 8-12 years, which means that every 8-12 years there is a sharp rise in the incidence of rubella.
Causes of rubella infection in a child
The source of infection is only a sick person, while the virus is very unstable in the environment and quickly dies, so a single contact with a sick child is not always enough to infect a child. This feature of the virus causes its high prevalence among children in large cities, where the crowding of children is higher compared to the countryside. The transmission route of the virus is airborne (through the air when sneezing and coughing). Most often, children aged 3-4 years get sick, but the disease can be observed at an older age and in adults.
Rubella is characterized by the seasonality of occurrence: the winter-spring period.
Symptoms of rubella in a child
During the disease, three periods are distinguished: the incubation period, the periods of the height of the disease and recovery.
The incubation period begins from the moment the virus enters the child's body and continues until a skin rash appears. At this time, the rubella virus, having penetrated the child’s body, enters the lymph nodes (most often cervical, parotid, occipital). Here their rapid reproduction takes place.
Then this large number of viruses enters the bloodstream and spreads throughout the body with a blood stream. At the time of the appearance of viruses in the bloodstream, the child may experience a slight malaise, headache may bother, in very rare cases, the child’s body temperature rises. When viruses enter the bloodstream, they become available to the child’s immune system, and she begins to fight them, producing antibodies. The destruction of viruses in the bloodstream occurs in 1-2 days, but during this time they have already spread throughout the body and settled in tissues and organs.
The end of the circulation of viruses through the blood vessels is also the moment of the end of the incubation period. The total duration of the incubation period is 18-21 days, however, in some cases, it can increase to 24 days or decrease to 10. The main clinical manifestation of the disease at this moment is an increase in cervical, occipital, parotid lymph nodes.
A week before the appearance of the first rashes, the child becomes contagious to others, as it begins to secrete viruses into the environment. This property of rubella is responsible for the appearance of outbreaks of disease in children's groups.
The height of the disease begins from the moment a rash appears on the skin of the child. The rash is small rounded spots that are located separately from each other. This means that you can calculate exactly how many such spots are located, for example, on the arm. Most often, they first appear on the head and ears, and then spread to the whole body, however, it is not always possible to accurately distinguish the stages of the rash, sometimes it seems that the rash appeared simultaneously on the whole body of the child. The appearance of a rash is associated with the circulation in the child’s blood of antibodies and immune complexes, which causes the plethora of small vessels and the appearance of spots on the skin.
The height of the disease lasts 1-3 days and ends with the disappearance of the rash. During this period, usually nothing but a rash does not bother children, however, in some cases, general weakness is possible. In some cases, the disease can occur without the appearance of a rash (erased form). In this case, it is quite difficult to make an accurate diagnosis for the child and only a blood test for the presence of antibodies helps. Throughout this period, the child is contagious. Even if the child does not have rashes, it is still contagious to others.
During the recovery period, the rash disappears, however, the virus still remains in the body, which continues to be released into the environment, so the children are still contagious. This period lasts about two weeks and upon its completion a complete recovery occurs.
The total duration of the infectious period is two weeks: a week before the appearance of rashes and a week after the first rashes. At the end of the infectious period, the child can attend children's groups.
The long-term effects in children after recovery are usually not observed, in rare cases, slight arthropathy (soreness in the joints) can be observed. The small joints of the hands are usually affected, less often the elbow or knee joints. Usually, this pain passes soma and does not require any drug treatment. Arthropathy can be observed for 2-3 weeks after recovery.
The diagnosis is usually not difficult, since there is a characteristic rash, however, in its absence, the diagnosis of clinical manifestations is not possible and requires laboratory research methods.
For laboratory confirmation of the diagnosis, you can use the virological method (detection of rubella viruses in swabs from the mucous membranes of the mouth and nose) and immunological (determination of the presence of antibodies in the blood serum taken from a child’s vein). Antibody determinations are made twice: on the first day of the height of the disease (at this time the number of antibodies is minimal and may not even be determined) and on the 7th day, when the number of antibodies increases sharply. An increase in the number of antibodies in the blood serum is indicative and allows you to accurately diagnose, even in the absence of skin rashes.
It is also possible to conduct a general blood test in which changes characteristic of a viral infection will be detected: a decrease in the number of leukocytes (leukopenia), the appearance of plasma cells (10-20%), an increase in ESR, however, all these changes will not help to accurately diagnose, since are common to all viral infections.
There is no need for special treatment for rubella, since children tolerate this disease well, without complications. With an increase in body temperature, you can use any antipyretic for children: ibufen, ibuclin, paracetamol. If there are too many rashes, you can give your child antihistamines in the first three days: fencarol, suprastin, tavigil, and parliament. With an increase in body temperature, the child is shown bed rest, in her absence - at home.
After the illness, the child has a persistent lifelong immunity, which means that the child will no longer be ill with this disease. However, in very rare cases, if the child has not been exposed to the rubella virus for a long time, his immunity is somewhat weakened and re-infection may occur in adulthood. There are isolated cases of repeated rubella in one person with each epidemic rise in the disease.
For prophylaxis, prophylactic vaccinations are required at 12 months and 6 years, emergency vaccination of women of childbearing age (able to give birth) is also shown with an epidemiological increase in the incidence.
Rubella virus is particularly dangerous for pregnant women. If a woman develops rubella during pregnancy, this can lead to serious fetal development disorders and even cause premature birth (abortion). Rubella virus with blood flow passes through the placenta into the fetus. The virus has a very large affinity for embryonic tissues, where it begins to proliferate and disrupt organ formation. Antibodies of the mother are not able to penetrate the placenta, and the child’s body is not yet able to produce them on their own, so the virus multiplies freely and does not cure. Rubella virus causes malformations of the eyes, heart, spinal cord, brain, and hearing organs.
Malformations of the eyes: cataracts, retinopathy, underdevelopment of the eyelids.
Heart defects: open ductus arteriosus, stenosis of the pulmonary artery and its branches, interventricular septal defect, atrial septal defect, Fallot tetrad, aortic coarctation, transposition of large vessels.
Malformations of the spinal cord and brain: microcephaly, paralysis of the limbs, non-closure of the spinal canal.
Malformations of the hearing organs: deafness.
The likelihood of developing malformations increases inversely - in proportion to the gestational age: the shorter the gestational age for rubella in the mother, the greater the likelihood of developing severe malformations and the greater the number of organs involved in the process. With the development of rubella in the mother after the 16th week of pregnancy, the virus has practically no effect on the development of the fetus. If the mother is sick in the early stages of pregnancy, doctors recommend terminating the pregnancy.
Before pregnancy, it is recommended to donate blood from a vein to determine the TORCH complex. This is a complex of antibodies to viruses that most often cause impaired fetal development and can lead to miscarriage.
If a baby is born from a mother who has had rubella during pregnancy, he has congenital rubella. This condition is manifested by the presence of protracted jaundice, liver damage, the development of hemolytic anemia, poor bone development (on the roentgenogram of the bones you can see the alternation of light and dark areas), not overgrown fontanelles. A very characteristic sign of congenital rubella is the presence of thrombocytopenia (a decrease in the number of platelets in the blood), which disappears 2-3 weeks after birth. All manifestations of congenital rubella pass six months after birth. Another feature of congenital rubella is the prolonged release of the virus into the environment compared to children with acquired rubella. The detection of rubella virus in the mucous membranes of the mouth and nose can be observed for 20-30 months after birth, however, for the most part, the release of viruses into the environment ceases by the age of six months.
What is it?
Rubella has a viral cause; it is caused by the smallest Rubella virus, which survives extremely poorly in the environment. However, without a special disinfecting treatment, the virus can remain in the air for quite a long time. Under the influence of external factors, he dies very quickly. Destructive for him are: ultraviolet radiation, quartzization, exposure to high temperatures and aggressive chemical fluids (formalin or compounds containing chlorine).
The virus is well preserved at very low ambient temperatures. For this reason, in the cold season, more and more cases of rubella occur annually.
The virus is very volatile, quickly transmitted from a sick child to a healthy one. The child's body is very susceptible to this infection. According to statistics, the peak incidence of rubella occurs at the age of 2-10 years.
Stages of the disease
During the disease, several successive stages pass. After contact with a sick child, a large number of rubella pathogens enter the body of a healthy baby. In more crowded groups (kindergartens, schools, sports sections), the risk of infection increases several times.
You can get rubella in several ways:
- Airborne. In this case, viruses from a sick child to a healthy one are transmitted during communication or violations of personal hygiene rules. The susceptibility to the disease in babies is very high. A small amount of time and microorganisms are enough for infection to occur.
- Upright. In this case, a pregnant woman infects her unborn baby through the placenta. Rubella viruses penetrate perfectly through the placental barrier and reach the baby’s organs with blood flow. After birth, the baby may remain contagious for several months.
- Contact. Infection occurs when sharing common household items: bedding and towels, mugs and tableware, toys, toothbrushes. The contact method of rubella infection is most relevant for babies attending kindergarten. Insufficient disinfecting treatment of toys leads to massive outbreaks of the disease in preschool.
On average, the incubation period of the disease is 2-3 weeks. This is the time from the moment the virus first enters the body until the clinical symptoms of the disease develop. As a rule, after 7-10 days from the moment the pathogen enters the body, the child becomes infectious.
First, the virus invades the surface epithelial cells of the upper respiratory tract. There he begins to multiply actively. After a while, it already enters the lymph nodes and spreads throughout the body through the blood. At this time, the second week of the incubation period usually ends. If a diagnosis is made, it is during this period that it will still be possible to detect a large number of viral particles in the mucus of the nasopharynx and pharynx.
At the end of the incubation period, the amount of virus in the body already reaches a huge amount. With blood flow, the pathogen spreads throughout the body, penetrating almost all internal organs. At this time, the first symptoms of rubella infection appear in babies.
How to recognize: first signs
Making the correct diagnosis during the incubation period is often quite difficult. The child is practically not worried about anything. Skin manifestations are still absent. During the first three weeks after infection, the child may have a fever, a slight general weakness appears. Children at this time become more moody, their mood worsens. However, these signs are not specific and do not allow to suspect the disease in the early stages.
The first characteristic symptoms appear by the third week of the disease. At this time, many groups of lymph nodes are greatly enlarged. The lymph groups in the occiput are most affected. They become so large that they are even clearly visible and palpable. During the examination of the neck, the baby does not feel pain.
The lymphatic groups of nodes located in the axillary zone, in the groin and under the lower jaw increase. When feeling, they are quite large, dense. In some cases, you can even see some redness over damaged skin. By the end of the third week, the babies have a slight pain in the neck. It can be somewhat enhanced with sudden movements or turns of the head.
As a rule, a rash characteristic of rubella infection appears 2–3 days after the end of the incubation period. First, it appears on the scalp, neck, and also on the face. The rash consists of small red elements (from 2-4 mm). They can merge with each other, various patterns appear. The rash does not itch. It occurs due to the fact that the virus, when it multiplies, releases toxic products into the blood. They damage the blood capillaries and cause them to rupture.
After 3-4 hours, the rash begins to spread rapidly throughout the body. Red elements can be seen in all areas except the palms and soles. It is also one of the characteristic clinical signs of rubella infection. After 4 days, the elements of the rash gradually begin to turn white, decrease in diameter. After another 5-7 days, it completely disappears, leaving no ugly scars or scars on the body.
For the longest time, rubella rashes can persist on the skin of the buttocks, as well as the forearms on the inside. During the rash period, the baby's health often improves. Despite the creepy look, the baby feels much better already. At this time, body temperature normalizes, breathing improves, sleep and mood are restored.
During the period of skin manifestations, rubella infection is very similar to many other infectious skin diseases. The doctor must necessarily make a differential diagnosis. Other diseases can also be manifested by a rash. Any specialist knows how to distinguish a red infection from allergies or other childhood infections that can cause the appearance of red elements on the skin. Rubella rash has many distinctive features that allow you to accurately determine the correct diagnosis.
Forms of the disease
Rubella infection can occur in several forms.
With a typical or ordinary form of the disease, the child has all the classic symptoms of the disease (with the obligatory appearance of a rash). In some cases, an atypical variant occurs. With this option, there are no manifestations on the skin.
The diagnosis of the atypical variant is noticeably complicated. This requires the use of special laboratory tests that will help verify the result and identify the exact causative agent of the infection.
Rubella is often masked by many other childhood illnesses, which are manifested by the appearance of a rash. With measles rubella, for example, skin manifestations also appear. However, with measles, the child's well-being suffers to a greater extent. In babies, the temperature rises greatly, there is no appetite. Elements of the rash do not merge with each other. In order not to make a false diagnosis, the doctor must always observe the baby from the very first hours of the disease.
In order to quickly recover from rubella and restore strength, you need special medical nutrition. A diet for viral infection must necessarily include all the necessary substances (in sufficient quantity). Medical nutrition, which is prescribed for children in the acute period of the disease, includes:
- Separation of meals at regular intervals. Kids should eat every three to four hours. Breasts are applied to the breast every 2-2.5 hours. All servings should be approximately the same size.
- Gentle form of processing products. In the acute period, it is strictly forbidden to fry foods or bake them with the formation of a rough crust. All solid food particles can damage the inflamed mucous membrane of the mouth and increase soreness.
- Semi-fluid consistency. The more products are ground, the better for the baby. More liquid food is quickly absorbed and saturates the children's body with energy, without a feeling of heaviness.
- All dishes should be at a comfortable temperature. Too hot or cold food irritates the oropharynx and increases inflammation. Before serving soups and hot dishes it is better to cool to a temperature of 35-40 degrees. To drink food, you can cook a warm compote or fruit drink.
- Mandatory inclusion of protein products. For the immune system to work perfectly, a child needs to eat high-quality protein. Try to include foods containing different amino acids in every meal. Veal, low-fat bird or fresh fish are perfect for this. You can complement the dish with a side dish of well-cooked cereals. For kids of the first year of life, mashed vegetable purees are perfect.
- The inclusion in the diet of foods rich in vitamins and minerals. To strengthen immunity, be sure to add fruits and berries to the child’s diet. In the acute period, it is better to give preference to fruit puree or smoothie. They are easily absorbed and charge the body with all the necessary trace elements and vitamins.
Rubella is relatively mild, without causing dangerous adverse effects in most children. Even in boys, the risk of developing serious post-infectious complications is significantly lower (compared with mumps).
Rubella causes the most adverse complications in pregnant women. If the expectant mother did not vaccinate on time, then her baby may still have developmental abnormalities. In the early stages of pregnancy, there is even a risk of miscarriage or death of the fetus.
Rubella virus has a particularly toxic effect on babies on the nervous system and brain. The child may experience anencephaly, hydrocephalus, visual disturbances in the laying of organs. In some cases, there is an underdevelopment of the hearing organs.
Congenital heart defects and impaired functioning of the heart valves can be quite common consequences. In infants, defects in the heart valves, dislocation of large blood vessels develop in utero.
Rubella virus is very dangerous for the unborn baby. It literally slows down the development of vital organs and systems in the fetus. In many cases, pregnant women can not even report; miscarriages occur. The virus also has a toxic effect on the formation of the immune system in the fetus. Underdevelopment of cells of future immune defense leads to the birth of children with congenital immunodeficiencies.
From the very first days of life, such children are very susceptible to any (even the most harmless) infections and require compulsory medical supervision.
The most relatively safe period of pregnancy is the third trimester.. If a pregnant woman becomes infected with the rubella virus at this time, then you should not wait for such pronounced negative consequences as in the first six months of pregnancy. The laying of vital organs in the fetus by this time, as a rule, is already completed. With infection at this time, the future baby may experience congenital immunodeficiency or chronic diseases of the nervous system. In rare cases, hearing impairment occurs.
Rubella incubation period
Rubella virus spreads through the air, where it gets when a sick person coughs or sneezes. Microorganisms are excreted in a small amount, but they are quite resistant to environmental influences and disinfectants, therefore they maintain their vital activity for a long time.
The main danger of the disease is a sufficiently long incubation period, which is 10-24 days. During this time, the child has no signs of the disease, while he is the spread of the infection and is able to infect a large number of people.
Rubella Symptoms in Children
The development of rubella begins with a general deterioration in well-being. The child is tormented by headaches, muscle weakness, chills and a slight increase in temperature. There is an increase in lymph nodes, in particular, in the neck and on the back of the head. Palpation can cause pain or discomfort.
In addition, symptoms of acute respiratory illness can be observed: runny nose, cough and hoarseness. Moreover, these signs are not very pronounced.
A few days later, the main symptom of the disease appears - a rash on the skin. First of all, the rash covers the face and the area behind the ears, gradually spreading to the back, buttocks and legs. Rashes have a red tint and resemble small spots up to 5 mm in diameter. In some cases, they merge into a single conglomerate, covering the entire area of the skin in a certain area. An ignorant person who has not previously encountered an ailment may confuse its manifestations with measles or scarlet fever.
Rashes go away after a few days. At the same time, there is no peeling, pigmentation or other marks on the body.
In most cases, the disease in children proceeds quite safely. Complications are extremely rare, usually with the addition of a secondary infection or in the presence of serious chronic diseases. As a rule, meningitis, encephalitis, bronchitis or pneumonia are observed.
Diagnosis of the disease
For an accurate diagnosis, a pediatrician consultation is required. Diagnosis includes the delivery of a general blood test and serological testing for the detection of antibodies to rubella.
It is important to differentiate rubella from other viral infections:
- Unlike measles, the disease does not cause a strong increase in temperature and the appearance of pronounced signs of intoxication. A mild cough and inflammation of the conjunctiva may be observed. Rashes appear almost simultaneously, and not in stages, as with measles.
- With rubella, the lymph nodes increase slightly, while with mononucleosis there is a significant increase in size. At the same time, there are no signs of purulent tonsillitis, and the liver and spleen maintain their normal physiological dimensions.
- Unlike scarlet fever, with rubella, the rashes are quite large and are localized throughout the body.
What is rubella?
The virus is a highly resistant microorganism. It is equipped with a double membrane and its own RNA molecule. This helps his cells survive even in adverse environmental conditions. Because of this, children need to be vaccinated on time, since the immune system itself is not able to cope with the virus. Rubella usually affects children between 1.5 and 4 years old. The peak incidence occurs in the autumn-spring period. The risk group includes children attending kindergarten and school, as well as children from boarding schools.
Also at risk are children:
- who haven’t been vaccinated,
- in whose families rubella cases have been identified.
Also, doctors note the facts of the inborn presence of virus cells in the baby.
Adults who don’t know what the disease looks like can type in the search line a query with the words: “rubella photo”. So they can visually imagine what they are faced with.
How does the virus penetrate?
Once in the body, it penetrates the lymph nodes and begins to actively multiply there. From there, virus cells with blood flow spread throughout the body. As the concentration of viral cells increases, the disease begins to produce neuraminidase, which can damage the nerve tissue of the human body.
Doctors say that there are several ways to transmit the virus:
- Airborne. Virus cells spread during coughing and sneezing, talking, and even with the breathing of a sick person.
- Through nasopharyngeal discharge of a sick person.
- Through direct contact with a sick person.
Characterization of the pathogen and methods of its transmission
Rubella is a highly contagious infectious disease; the susceptibility to this infection in people without specific immunity is 90%.
The causative agent is the RNA virus Rubella virus - the only representative of the genus Rubivirus of the family Togaviridae. In the external environment, it is unstable, remains viable only for 5–8 hours. It quickly dies under the influence of UV rays (quartzization), changes in pH, sunlight, high temperatures, various disinfectants (formalin, chlorine compounds), organic solvents, detergents . However, it survives at low temperatures and even in a frozen state is able to remain active for several years.
The incidence of rubella is most often recorded during periods of changing seasons: in spring, winter and autumn. Virus transmission is from an infected person:
- airborne droplets (when sneezing, coughing, talking, kissing),
- by contact (through toys, dishes, a towel and other household items),
- transplacental from a pregnant woman to a fetus.
In the first two cases, rubella is acquired. The entrance gates of the infection are the mucous membranes of the respiratory tract and the oral cavity, then the virus penetrates the bloodstream through the walls of the capillaries and spreads through the blood stream to all organs and tissues of the body. The incubation period is 2-3 weeks. With intrauterine infection through the placenta, rubella is congenital.
Carrier Rubella virus poses a danger to others from the second half of the incubation period: a week before the rash and a week after. It will spread most easily and quickly in confined spaces, in crowded places (kindergartens and schools, hospital wards).
After the acquired form of rubella, the child develops a stable immunity, so re-infection is extremely rare. It is fundamentally possible in case of malfunctions of the immune system and in severe immunodeficiency.
It is believed that after 20 years or more after the illness, the immunity formed to it can weaken, therefore, re-infection is not excluded during this period. With secondary infection, the infection usually proceeds without symptoms or with an implicit clinical picture (cough, runny nose), without a rash on the body.
In the congenital form of the disease, immunity against rubella virus is less resistant, as it is formed under conditions of the immature fetal immune system. Such babies within 2 years from the moment of birth are carriers of infection and secrete the virus into the environment.
In the disease, the prodromal period is isolated. It does not happen at all and can last from several hours or up to a couple of days and be accompanied by the following symptoms:
- muscle and joint pain
- loss of appetite,
- sore throat,
- nasal congestion.
The main symptoms of the disease
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:
- paroxysmal dry cough,
- nasal congestion caused by swelling of the mucosa,
- body temperature rises to 38 ° C and lasts 2 days.
After 2 days, a small red rash appears on the face, neck and scalp. It represents round or oval pink-red spots with a diameter of 2 - 5 mm, not merging with each other. The appearance of rashes is due to the toxic effect of the virus on capillaries located under the skin.
Within a few hours, the rash spreads throughout the body (on the shoulders, arms, back, stomach, inguinal zone and legs), except for the palms and feet. After 3 days, it turns into nodules, begins to fade and disappear, leaving no scars or age spots on the skin. Lastly, the rash passes on the buttocks, inner thigh and arms, where the highest density of its elements is noted.
The rash period lasts an average of 3 to 7 days. Then the condition of the child improves markedly, the appetite returns, the cough and sore throat goes away, nasal breathing is facilitated. The size and density of the lymph nodes returns to normal 14-18 days after the disappearance of the rash.
Forms of the disease
Rubella in a child can occur in two main forms:
- typical (light, medium, heavy),
In a typical form, the clinical picture described above is observed. Atypical form is not accompanied by a rash, can occur without symptoms.Children with atypical rubella pose a great danger in terms of uncontrolled virus isolation and the spread of infection.
How to distinguish from other diseases
Diagnosis can be difficult with an atypical form or when rubella in children occurs with mild symptoms.
If rubella is suspected, it is important to differentiate it with other infectious diseases, accompanied by similar symptoms, or allergic skin reactions. Often, by external signs, it can be confused with measles, scarlet fever, adenovirus or enterovirus infection, infectious erythema, mononucleosis.
Unlike measles, rubella is not accompanied by severe intoxication and fever, the elements of the rash do not interconnect, appear almost simultaneously, and there are no pathological changes in the oral mucosa.
Rubella is distinguished from scarlet fever by the absence of blanching of the nasolabial triangle, by larger elements of the rash, localized mainly on the back and extensor surface of the extremities, and not on the abdomen, chest, and bends of the arms and legs.
Unlike mononucleosis, with rubella, peripheral lymph nodes are slightly enlarged, purulent tonsillitis is absent, and there is no enlargement of the liver and spleen.
Why is rubella in a young child dangerous?
Doctors note that rubella in infants is extremely rare and its appearance requires careful attention of the doctor. She is very dangerous for a newborn baby. This is due to the fact that during pregnancy a woman gives her baby a certain set of antibodies to those diseases that her body has previously encountered. But it is not uncommon that the mother's body has not previously been encountered with rubella. Because of this, a newborn who has rubella can suffer greatly from it: the disease will quickly turn into a serious form, he will have cramps and disseminated blood coagulation. A sick child should be immediately sent to an infectious diseases hospital.
How to cure rubella at home?
A mild form of rubella is treated at home. For this, doctors recommend parents to follow the following simple recommendations:
- Isolate the baby for 3 weeks.
- Observe bed rest for 1 week.
- Give the child food fractionally. In the diet of the baby should be: dairy products, meat and finely ground fish, eggs.
- Give the baby more fluid. The volume of fluid per day should be at least 2 liters. Also, water can be replaced with mineral water without gas or Regidron.
In order to relieve unpleasant symptoms and reduce the risk of dangerous effects, doctors prescribe the following medications:
- Ascorutin. Dosage 500mg, 3 times a day. It helps relieve DIC.
- No-Shpu, children's Nurofen and Paracetamol. They help get rid of headaches, body aches and lower body temperature.
It is important to remember that you do not need to lubricate the skin rash.
- Diazolin, Claritin, Fenistil, Tavegil and Suprastin are prescribed to reduce the intensity of rashes and relieve skin itching.
In the event that during the rubella the child has tonsillitis, pneumonia or lymphadenitis, then antibiotics may be prescribed.
It is important to remember that the appearance of seizures in a child, an increase in body temperature to critical levels and the appearance of signs of damage to the nervous system are indicators for emergency hospitalization of the patient.
Of the drugs for the treatment of rubella in children, symptomatic agents can be prescribed:
- vitamins (group B, ascorbic acid, ascorutin),
- antihistamines with a large number of rashes (suprastin, erius, fenistil, zirtek, zodak and others),
- antipyretic based on ibuprofen or paracetamol at a temperature of more than 38 ° C,
- resorption tablets or sprays for severe sore throat (septefril, lysobact),
- vasoconstrictor drops from severe nasal congestion.
Antibacterial drugs are used to treat secondary bacterial infection, if any.
Features of rubella in children up to a year
In children up to a year, rubella is extremely rare. This is due to the fact that at the time of conception, most women had either had rubella in childhood or had been vaccinated with it. In this case, during fetal development and subsequent breastfeeding, the baby receives antibodies from the mother’s body to various infections, including rubella, and for about a year his body is protected by the mother’s immunity.
If a woman before conception did not suffer from rubella and did not receive vaccination in childhood, then the chances of her unborn child to get rubella in utero or before the age of one year (before the planned vaccination) are high.
Rubella in infants is hazardous to health. It may be accompanied by convulsive syndrome, DIC, (disseminated intravascular coagulation), the development of meningitis and encephalitis. A feature of the course of the disease at this age is rapid development. Characteristic rashes can be present on the skin for no more than 2 hours, and then immediately disappear without leaving a trace. In children under one year of age who have had rubella, a stable immunity to this disease is formed, which allows them to no longer receive routine vaccination.
Consequences in pregnant women
The most severe and dangerous is intrauterine infection with rubella. And the sooner it happened, the less favorable the forecast. When a pregnant woman is infected before the age of 12 weeks, the probability of fetal death and miscarriage or the occurrence of gross deviations in its development is high. These include damage to the central nervous system (microcephaly, hydrocephalus, chronic meningoencephalitis), defects in the formation of bone tissue and a triad of defects:
- eye damage (cataract, retinopathy, glaucoma, chorioretinitis, microphthalmos) up to complete blindness,
- damage to the auditory analyzer up to complete hearing loss,
- development of combined abnormalities in the cardiovascular system (open ductus arteriosus, defects of the septum of the heart, pulmonary artery stenosis, improper localization of large vessels).
The teratogenic effect of Rubella virus is manifested in the fact that it inhibits cell division and thereby stops the development of certain organs and systems. Rubella causes fetal ischemia due to damage to the vessels of the placenta, suppresses the immune system and has a cytopathic effect on the fetal cells.
If the fetus becomes infected after 14 weeks of pregnancy, then the risk of developing defects is significantly reduced, single defects, meningoencephalitis, mental retardation, and mental disorders are possible. Symptoms of congenital rubella in children can be low birth weight and inhibited reaction to age-related external stimuli.
The causative agent of the disease and transmission
The causative agent of rubella is extremely contagious. This is a microscopic organism belonging to the Togavirus family, from the genus Rubiviruses. If a person who does not have immunity to this pathogen comes into contact with an infected patient, the probability of illness is more than 90%. That is why early vaccination and revaccination of children is considered the only way to prevent the epidemic of the disease.
How long does the incubation period last? The time for the rubella virus to mature is approximately 15 to 25 days. During this time, the virus undergoes active reproduction, settles in the tissues of the body. The duration of this period depends on the child’s immune system and some other individual characteristics.
That is, rubella can be infected by coming into contact with an infected person. Among children, infection occurs through toys, dishes, and other household items.
Even a completely healthy-looking child can be a carrier of infection if the virus in his body is in the incubation stage.
How does rubella manifest in childhood
Once in the body, the causative agent of the disease quickly spreads blood to all internal organs and systems. In this case, children experience symptoms such as an increase in the size of the lymph nodes in the neck, jaw, armpits, and groin. Usually this symptom is short-term in nature, lasts several days, after which the main manifestations of rubella develop.
It is very difficult for parents to distinguish the initial stage of the disease in children from the common cold. The onset of the disease is characterized in a small patient by such signs:
- a breakdown
- loss of appetite
These manifestations are more common during the incubation period. With the further development of rubella, the clinical picture deteriorates sharply. The following symptoms are characteristic of this stage:
- runny nose
- sore throat,
- muscle weakness
- joint aches,
- soreness in the neck, which is associated with an increase in the size of the lymph nodes.
The above symptoms are characteristic of a typical course of the disease.
Immediately after this, the child has a high fever. It can reach 38 - 40 degrees, last from 3 to 5 days. The cough is usually dry, barking. The mucous membrane of the nose swells, but discharge, as a rule, does not occur.
The nature of the rash with the disease
Until the first rashes appear on the body in children, characteristic spots can be found on the mucous membrane of the mouth. These are small acne that gradually merges into areas with a dark red tint.
The process of the formation of a rash on the body begins with a lesion in the area of the cervical folds, nasolabial triangle, ears, cheeks. Later, redness spreads throughout the body, spots begin to itch. Most clearly you can see the rash on the knees, elbows, buttocks. The shape of the spots is usually round or oval, the rashes merge with each other.
You can recognize the disease in children by such a characteristic feature as the absence of a rash on the palms, feet, and groin. This is what makes it possible to distinguish rubella from chickenpox, measles, mumps and other pathologies.
Can rubella be distinguished from other more dangerous diseases?
It is very difficult to independently determine the rubella in children at home, because its symptoms may differ from the typical course. The disease can begin not with signs of a cold, but may be accompanied by such uncharacteristic symptoms as vomiting, diarrhea, and nausea. That is why it is not recommended to make a diagnosis on your own. If there is a suspicion of a baby's disease, you should show the pediatrician.
At the doctor’s appointment, the mother must answer the specialist the following questions:
- whether there was a rubella vaccine given to the child, and also what was the reaction,
- whether a small patient came into contact with an infected person,
- attends kindergarten, school,
- whether the mother had rubella recently or during pregnancy.
This information will help your doctor make a diagnosis.
Most at risk of the disease are children who attend kindergarten and school, but have not received the vaccine. Children under one year old get sick less often, as they are less in crowded places and do not attend children's institutions. In adults, rubella can be more severe, often causing complications. That is why it is so important to vaccinate the baby in the period indicated by the vaccination calendar.
There are several stages of rubella. These include the incubation period, during which clinical signs are absent or least expressed, the prodromal period, characterized by symptoms resembling a cold - fever, dry cough, general worsening of the condition, the appearance of rashes. The last stage is recovery. There is a decrease in all manifestations, an improvement in appetite, normalization of body temperature and other vital indicators in children.
Since rubella in boys and girls often has a very similar course with other diseases, differential diagnosis is carried out. Here the difference is sought with such diseases:
- measles, which occurs in children with more vivid signs, can manifest itself in the form of high fever, the gradual development of a rash, severe catarrhal manifestations,
- scarlet fever, characterized by smaller spots, the absence of rashes in the region of the nasolabial triangle,
- infectious mononucleosis, which can begin with a sharp increase in lymph nodes, fever, tonsillitis,
- baby roseola - accompanied by a body temperature of up to 40 degrees for three days, after which it normalizes and a rash appears on the body.
Differential diagnosis is necessary for making a diagnosis and choosing the right treatment tactics.
In the atypical course of rubella in children, the rash may appear as a slight reddening of the dermis. Often, mothers confuse her with diathesis, prickly heat, or an allergy in the baby.
Rubella is divided into acquired and congenital species, depending on the route of infection. In the first case, we are talking about infection from a virus carrier. Any person can become ill - an infant, children of preschool and school age, and even adult men and women. In the second option, the disease is transmitted to children through the placenta of the mother. At the same time, its course is very dangerous, often causing severe consequences, damage to hearing, vision, heart and other internal organs. If this condition is not treated, the prognosis for the newborn is extremely unfavorable.
Rubella rash localization
Rubella is accompanied by a rash in children throughout the body. In the photo you can see how the nature of the rashes differs in this and other diseases.
The picture will help to form an idea of the nature of the rashes in the baby with the disease.
Features of the course of the disease in infants
Newborn babies can also get rubella if contact has been made with an infectious person. At risk are babies who regularly communicate with older brothers, sisters and parents who in childhood did not receive vaccination, but they never had the chance to get this insidious disease.
In infancy, the disease is easily tolerated, especially among children who are breastfeeding. Despite this, the first thing parents should remember - to treat a disease in a small patient should only be under the supervision of a doctor.
In infancy, rubella can be expressed in the form of the same symptoms as in older children. Its features include:
- loss of appetite
- violation of the stool, vomiting,
- temperature rise,
- the appearance of a rash.
Treatment in babies is carried out by alleviating the clinical signs of the disease with the help of medications, dieting and drinking, treatment of sipy with special means, which we will talk about later.
In children up to a year, the most atypical form of rubella is most common, in which the symptoms are weak or some of them are absent.
Methods of treatment in children
What should parents do to alleviate the condition of their child? A necessary condition for the treatment of rubella is the timely diagnosis of the disease and the appointment of competent drug therapy. To do this, you need to visit the hospital, pass the necessary tests.
In addition to taking medications, the baby needs proper care from the mother, since this pathology with an uncomplicated course is usually treated at home. Hospitalization and nursing care may be necessary for various complications requiring the supervision of doctors.
The use of medicines
There is no specific treatment for children with rubella drugs. The effect of drugs is primarily aimed at eliminating the symptoms. Medications are selected depending on the clinical picture in a small patient. In this case, the following drugs are used:
- antipyretic drugs - Paracetamol, Nurofen, Ibuprofen. For children in the first months of life, it is better to use drugs in the form of rectal suppositories. This form is more convenient at this age, less likely to cause side effects,
- antiallergic drugs - help eliminate muscle and joint pain, severe itching. Suprastin, Diazolin, Zirtek are prescribed here. With them, the baby will be much easier to bear the disease,
- with conjunctivitis, Albucid will be effective,
- ordinary baby creams and oils will help reduce dryness and inflammation of the skin, with which you need to smear the affected skin several times a day. Usually, rashes do not require separate treatment, do not leave scars and age spots on the body.
Use any drugs against the manifestations of the disease should be in strict accordance with the instructions for use and only as directed by the doctor.
How to bathe the baby
Many parents, faced with rubella in their child, are concerned about the question of what to do to relieve itching and is it possible for the baby to wash? At the initial stage of the disease, it is better to exclude water procedures, doctors recommend waiting for the temperature to drop, after which you can prepare a bath for a little patient with a decoction of herbs (chamomile, string, St. John's wort). Bathing will help to quickly cope with rashes, prevent the attachment of a bacterial infection, and alleviate the symptoms of the disease during treatment. In this case, wash areas affected by a rash should be very careful, without using a washcloth.
Features of the daily regimen and nutrition
Compliance with the daily routine and a healthy diet is a necessary condition for recovery, because during this period the child's body needs special care and light nutrition. The following recommendations will help defeat rubella and prevent the development of complications:
- food should not contain large amounts of carbohydrates and animal fats. Preference should be given to cereals, vegetable soups, dairy products, baked vegetables, fruits,
- during treatment, the child should drink enough water. This will help prevent dehydration, remove harmful decay products from the body,
- medications should be used in strict accordance with the recommendations of the doctor,
- it is necessary to regularly change bedding and ventilate the room in which it is located,
- children can take walks after lowering the temperature, while avoiding contact with other people.
Adhering to these recommendations, parents will help the child to transfer the disease faster and easier.
The menu for a child with rubella should be based on the age of the small patient and his taste preferences. In the table you can see the useful and harmful products for children with the disease:
|Recommended Meals||Prohibited Products|
|Porridge - buckwheat, oat, rice, wheat||Fast food|
|Sour-milk products - kefir, yogurt, fermented baked milk, yogurt||Butter baking, cakes, pastries, candies|
|Low-fat fish and meat||Chips, Chocolate Bars, Nuts|
|Vegetables - carrots, beets, potatoes, cucumbers, tomatoes, cauliflower, broccoli||Smoked meats, marinades, hot spices, seasonings|
|Dairy products - sour cream, butter, low fat cottage cheese||Fatty varieties of fish, meat|
|Soft-boiled eggs, not more than one per day||Fried eggs, pasta|
|Fruits - apples, bananas, apricots, peaches, citrus fruits in limited quantities||Margarine Dishes|
|Green tea, rosehip broth, compotes, natural juices||Coffee, strong tea, carbonated drinks, juices with preservatives|
If the baby is breastfed, the problem disappears. Breast milk contains all the necessary components that will help the body cope with rubella faster.
Vaccination of children
Recently, many mothers refuse vaccinations, believing that vaccination can lead to serious consequences. On the forums, you can really find negative feedback from parents about some types of vaccinations. This position is fundamentally wrong, because refusing the vaccine, they expose the baby to a much greater risk. Only timely vaccination is able to form an artificial immunity in the baby to this disease, to prevent an epidemic.
The main condition for setting a vaccine is that it should be given to a healthy child. For this baby, it is necessary to prepare, cure chronic diseases, drink it with an antiallergic drug.
The first time a rubella vaccine is given at the age of one. At six years, revaccination is carried out. In both cases, the vaccine includes a triple component against measles, rubella and mumps.
After the procedure, the child may experience a temporary reaction in the form of an increase in lymph nodes, tearfulness, fever. These are normal manifestations that do not require treatment.
Epidemiology of the disease
Rubella virus has a low level of resistance to environmental factors. He dies within thirty seconds when exposed to ultraviolet radiation and within two minutes when boiled.
At low temperatures, the virus can remain viable and active for a long time. This is due to the fact that rubella outbreaks are recorded mainly in the cold season (winter-spring).
The source of rubella viruses are rubella patients (including patients with asymptomatic and erased forms of the disease) or healthy carriers of the virus.
In babies diagnosed with congenital rubella, viruses can be excreted in urine, feces, and sputum particles up to two years after birth.
The transmission of the virus is carried out by airborne droplets and transplacental (during pregnancy).
The natural susceptibility of people to rubella viruses is extremely high. Infection occurs even with short contact with the patient.
Children under six months of age who are born to vaccinated or previously rubella-infected mothers are immune to the disease.
After the infection, the patient develops a stable and lifelong immunity. Repeated cases of rubella are recorded in isolated cases.
Expectant mothers need to be tested for rubella antibodies. In the absence of immunity to this disease, women are recommended a rubella vaccine (at least three months before the planned conception).
Rubella vaccine can be administered as a single vaccine or as part of PDA vaccinations (measles-rubella-mumps).
Rubella in children - prevention
Planned prophylaxis of rubella and other controlled infectious pathologies (infectious diseases against which vaccinations exist) plays an important role in preventing the occurrence of outbreaks of the disease.
Scheduled rubella vaccine is administered as part of the CPC to children at twelve months of age and again at six years of age. If the patient does not have routine vaccination, rubella vaccination is recommended for all girls over thirteen who have not previously had rubella.
Vaccination for this disease is not carried out:
- patients with a high level of anti-rubella virus antibodies,
- pregnant women
- patients with individual intolerance to the components of the vaccine,
- persons with acute pathologies of somatic or infectious genesis.
For patients with immunodeficiency conditions, the vaccine can be administered only after a comprehensive examination and consultation with an immunologist.
After the introduction of the vaccine, the development of specific immunity occurs within fifteen days from the vaccine.
Generally, vaccination against rubella is well tolerated. Undesirable effects are extremely rare.
Side effects from the introduction of a monovaccine can be manifested by febrile symptoms, exanthema, lymphadenopathy.
How does rubella develop?
The introduction of rubella viruses is carried out in the mucous membranes lining the respiratory tract. Massive entry of viruses into the bloodstream (viremia) is already observed during the incubation period.
Further reproduction of viral particles occurs in the tissues of the lymph nodes (at this stage of the disease, the development of polyadenopathy occurs), as well as in the skin (the result is the development of a rash).
In the later stages, the fetus's sensitivity to rubella virus is lower than in the early stages of pregnancy.
Rubella - symptoms in children and adults
Classical rubella in children and adults occurs with the development of specific syndromes:
Rubella intoxication syndrome in adults and children is manifested by the appearance of malaise, weakness, lethargy, headaches, arthralgia and myalgia, nausea and decreased appetite.
Feverish symptoms are characterized by fever, the appearance of chills.
Damage to the respiratory tract is manifested by catarrhal symptoms. Patients are concerned about a mild runny nose, a rare cough. Mild hyperemia of the posterior pharyngeal wall is also often noted.
Cough with rubella in children is dry, unproductive. With the development of rhinitis, sneezing, nasal congestion and passage of liquid, transparent contents from the nasal passages are noted.
In isolated cases, with rubella in children, there are single hemorrhagic elements on the mucous membrane of the oropharynx and pale pinkish spots on the mucous membranes of the soft palate (Forchheimer spots).
The defeat of the lymph nodes with rubella in children and adults is an obligatory symptom of the disease. Lymphadenopathy often appears not only before a rubella rash occurs, but also before catarrhal symptoms appear.
Normalization of the size of the lymph nodes begins a few days after the disappearance of the rash.
Lymph nodes with rubella in children are not soldered, moderately painful or painless on palpation, dense, mobile. Fluctuation syndrome (a sign of suppuration) is absent.
The skin over the inflamed lymph nodes is not changed. Edema of the surrounding soft tissue is not observed. The size of the lymph nodes can vary from one to two centimeters in diameter (a more pronounced increase in lymph nodes is extremely rare).
Rubella lymphadenopathy in children and adults is benign. Suppuration is not characteristic and can be noted in isolated cases, with the attachment of a secondary bacterial infection in patients with immunodeficiency states.
In this case, the affected lymph node becomes sharply painful, softening appears in the center and fluctuation syndrome during palpation. The skin above the lymph node is hyperemic and tense.
The rubella rash is small-spotted (less often large-spotted or spotty-papular) in nature. The diameter of small-spotted rashes is five to seven millimeters.