Unvaccinated children 2-9 years old are most often affected. Rubella is especially dangerous in the first 3 months of pregnancy – in this case, severe congenital malformations of the child often develop, intrauterine death of the fetus is possible. In general, rubella is more severe in adults than in children.
The source of infection is a person with a clinically expressed or worn-out form of rubella. Routes of transmission – airborne (in conversation with the patient, kisses) and vertical (from mother to fetus). A contact route of infection is also possible – through children’s toys. The patient becomes contagious 1 week before the rash appears and continues to secrete the virus for 5-7 days after the rash appears. A child with congenital rubella excretes the pathogen for a longer time (up to 21-20 months).
The incubation period of the disease lasts from 11 to 24 days (usually 16-20).
Rubella virus enters the body through the mucous membranes of the respiratory tract and spreads blood throughout the body, causing an increase in lymph nodes, especially those located on the back of the head and back of the neck. Sometimes there is a slight runny nose and dry cough, a sore throat, and lacrimation. Rubella is most severe in adults: an increase in body temperature (up to 38-39 ° C), headache, muscle pain, and a decrease in appetite are characteristic.
On the first day of the disease, a characteristic rash on the skin occurs in 75-90% of patients, and rashes are more often observed in children. Elements of the rash are round or oval pink-red small spots. More often, the rash first appears on the face and neck, behind the ears and on the scalp, and then during the day it appears on the trunk and extremities. Especially typical is the location of the rash on the back, buttocks, outer surface of the arms and front surface of the legs. There is no rash on the soles and palms. Sometimes at the same time small single rashes appear on the mucous membrane of the mouth. The rash lasts two to three days.
In children, rubella is usually mild.
Complications are extremely rare and occur in children with immunodeficiency. These include: pneumonia, otitis media, arthritis, tonsillitis, thrombocytopenic purpura. Very rarely (mainly in adults), brain damage occurs – encephalitis and meningoencephalitis. Rubella in pregnant women does not pose a serious danger to the expectant mother, but significantly increases the risk of fetal malformations.
Diagnosis and treatment
The diagnosis of rubella is usually made if the child has had contact with a sick rubella, he is not vaccinated, a characteristic skin rash, swollen lymph nodes, and other symptoms are noted.
The diagnosis is confirmed by a blood test from a vein for antiviral antibodies, which is carried out on the 1-3rd day of the disease and after 7-10 days. Rubella is indicated by an increase of 4 times or more.
Treatment is usually carried out at home. During the rash, the child needs bed rest. Special treatment is not prescribed, sometimes symptomatic agents (medications that eliminate the symptoms of the disease) are used.
If complications occur, urgent hospitalization is required.
The prognosis of the disease in most cases is favorable. Re-infection with rubella is not possible.
To prevent the spread of infection, rubella patients are isolated for 5 days from the time the rash appears. No restrictive measures are envisaged in relation to the persons who interacted with them; no quarantine is imposed on groups of children’s institutions. It is important to prevent a sick child from contacting pregnant women.
Rubella vaccination is included in the vaccination schedule. In Russia, measles-rubella-mumps is the most commonly used vaccine. The vaccine is administered subcutaneously or intramuscularly at 12-15 months and again at 6 years. Specific immunity develops after 15-20 days in almost 100% vaccinated and persists for more than 20 years.