Among acute infectious diseases, rubella in children has a special place, since the virus can cause irreparable harm to the immune system and internal organs of a developing organism. Required specific prevention, which consists of vaccination according to the schedule of the national vaccination calendar. This material provides basic information regarding rubella in children: symptoms and treatment, preventive measures and the main types of complications of the infection. General concepts of the incubation period and routes of infection in adults and children are also given.

Infection and rubella virus - how does infection occur?

The rubella virus is a highly resistant microorganism that has a double membrane and its own ribonucleic acid molecule. This allows long time survive in the external environment even under the most unfavorable conditions. When introduced into the mucous membrane of the upper respiratory tract The rubella virus integrates its RNA molecule, which is protected from the effects of lymphocytes and macrophages by the villous layer. Therefore, without prior vaccination, there are no specific means in the child’s body. immune defense from this type of infection.

A special feature of the Toga group of viruses is that outer surface their membranes produce hemagglutinin, a substance that promotes the rapid absorption of the viral molecule into human blood cells. As the concentration of viruses increases, the production of a substance such as neuraminidase gradually begins, which contributes to damage to nervous tissue.

Rubella infection is a highly contagious disease that is transmitted through airborne droplets. The degree of contact in the absence of specific immunity is more than 90%. The spread of rubella infection occurs mainly in confined spaces where large number people. These are kindergartens, schools, boarding schools. There are known cases of nosocomial infection in pediatric hospitals, where children are admitted with an erroneous primary diagnosis of lymphadenitis. The virus is released through coughing, sneezing, talking and simply breathing. If hit external environment the microorganism retains its aggressive properties for 5 - 8 hours, depending on dryness and air temperature. Instant deactivation occurs when quartzing or exposure to direct sunlight.

How does rubella manifest and look in children in the photo?

Not all parents know how rubella manifests itself and often confuse this disease with a typical cold or acute respiratory infection. But it is necessary to carefully diagnose each such case and take measures to prevent complications of infection, which can affect brain structures, nerve fibers, spinal cord and connective tissue. The walls of small blood vessels are especially often affected.

But it’s not enough to look at what rubella looks like in a photo; you also need to be able to differentiate these manifestations from other dermatological and systemic diseases, in which various types of rashes can also appear.

It is worth considering the following factors in assessing the condition of a sick baby:

• in the vast majority of cases, the infection develops only in persons who have not undergone specific vaccination;
• the risk of getting sick increases in autumn, winter and spring (there are practically no cases of rubella in summer);
• among contact persons cases of similar diseases have been identified;
• the average age of the most unstable individuals ranges between 1.5 and 4 years of life;
• there is a danger of the congenital presence of the virus, which can be activated under the influence of unfavorable external factors (teething, introduction of complementary foods and supplementary feeding, colds).

Difficulty differential diagnosis are that most often infection occurs from a patient at the stage of the incubation period. It can last up to 3 weeks. And at the same time, starting from the 2nd day, the patient actively releases the virus into the environment. The release of the virus by airborne droplets stops only a week after the appearance of a characteristic rash on the skin.

The first signs and symptoms of rubella in children (with photos)

The first signs of rubella in children may begin to appear only at the end of the incubation period. Although all this time the baby may complain of weakness and malaise, become capricious for no apparent reason, more sluggish, and drowsy.

At the time of infection, the virus enters the mucous membranes of the pharynx, larynx and tonsils. Ciliated epithelium The nasal passages are not susceptible to this type of microorganism, so breathing through the nose often saves you from this type of infection. Once introduced, the infectious agent enters the bloodstream through the capillary wall. Then disseminated reproduction and spread occurs throughout all organs and systems without exception. After some time, infection begins to manifest itself in the form of thickening, enlargement and soreness of the lymph nodes of the inguinal, axillary and submandibular group. Then these signs disappear, and the main localization of lymphadenopathy shifts to the region of the occipital lymph nodes. This is due to the fact that it is in this place lymphoid tissue has the least resistance to the introduction of the virus. Typical symptoms Rubella in children appears after the end of the incubation period. The so-called prodrome is distinguished, during which one feels weakness, pain in large muscles and headaches, sore throat, and slight nasal congestion. After 24 - 36 hours, sharp pain occurs in the occipital part of the neck. Upon palpation, small in size, immobile and dense are determined. lymph nodes. Their size can be up to 10 mm in diameter.

Further symptoms of rubella in children appear according to a certain algorithm:

• immediately after the protrusion of the occipital and cervical lymph nodes, the body temperature rises to 38 degrees Celsius;
• a dry paroxysmal cough occurs;
• the nasal passages are blocked due to massive swelling of the mucous membrane, but there is no mucus discharge;
• 2 days later on various parts small pinpoint rashes of a red, dried color appear on the body.

The typical initial location of the rash is the area around the ears, the anterior wall of the neck, cheeks and nasolabial triangle. Then, within 1 - 2 days, the rash quickly spreads along the upper shoulder girdle, going down to the back, stomach, groin area and then to the thighs. After 3 days, the rash begins to fade and disappears from almost the entire body. The most persistent lesions are the buttocks and inner thighs, and the extensor planes of the forearms. Rashes never appear on the palms of the hands or the skin of the soles of the feet. The period of rash lasts from 3 to 7 days. Then comes a period of convalescence, during which the baby’s condition quickly improves, appetite is restored and motor activity. Relieves cough, nasal congestion and sore throat. Lymph nodes may disappear completely only after 14 - 18 days from the moment the rash disappears. Don't be alarmed by this - this is a common occurrence with rubella infection.

Diagnosis of rubella

The primary diagnosis of rubella is based on medical history, epidemiological status in the locality, and the availability of information about outbreaks or episodic cases of infection in a particular preschool institution. IN kindergarten or a nursery, a quarantine regime is immediately established.

During examination, the doctor may see the presence of petechial rashes on the upper sky, in the larynx and pharynx. Enlarged occipital and cervical lymph nodes are palpable. During the period when there are no rashes, diagnosis can be carried out in the laboratory. To do this, blood is drawn from a vein. Based on the obtained biological material, a serological analysis is carried out, during which the titer of antibodies to the rubella virus is determined. The diagnosis can be established if the antibody titer exceeds the norm by 4 or more times. After the course of treatment it is necessary to repeat serological test blood.

Additionally, when diagnosing rubella, general analysis blood and urine, ECG to exclude possible complications. X-ray of the lungs is prescribed if pneumonia is suspected as a complication of this infection.

Why is rubella dangerous in children under one year of age?

IN pediatric practice Rubella up to one year of age is extremely rare and requires close attention, since it poses a serious danger to the health of a newborn baby. The fact is that during intrauterine development, the fetal body receives a portion of antibodies to various infections with which the mother’s body is “familiar”. This supply is usually sufficient until the baby develops its own immune system after birth.

But there are situations when a woman has not encountered the rubella virus in her life before pregnancy. In this case, the baby does not have any immunity against this type of infection. When infected, a rapid lightning-fast course with severe convulsive syndrome and intravascular disseminated blood coagulation can be observed. All sick children are subject to emergency hospitalization in an infectious diseases hospital. There is a high risk of developing meningitis and encephalitis, since the blood-brain barrier at this stage of life in a newborn is not able to repel attacks by pathogenic microflora.

Rubella in children under one year of age provides stable lifelong immunity, which allows you to refuse vaccination within the prescribed period.

Consequences and complications of rubella disease

Rubella disease in most cases is not a severe infection that leads to any catastrophic changes in the human body. In children, rubella can cause complications only if the immune system is severely weakened or secondary pathogenic microflora is added during the illness.

The most common consequences of rubella include the development of sore throats with the addition of staphylococcus or streptococcus, pneumonia, bronchitis, etc.

Less common are arthritis of rheumatoid etiology, myocarditis, pyelonephritis and inflammation of the middle ear. In adults this disease may lead to more serious consequences. Meningoencephalitis with pronounced meningeal symptoms often develops. Another common complication in adults is thrombocytopenic purpura.

Treatment of rubella disease in children

Treatment of rubella in most cases is carried out in outpatient setting. Mother or father is provided sick leave for a period of 21 days (until the moment when the baby stops releasing the virus into the environment and can visit the nursery preschool).

In order to begin treatment of rubella in children, it is necessary to prepare an isolated room that is well ventilated. Isolation from other children present in the family is carried out. Appointed bed rest for 5 - 7 days. At this time, it is important to organize proper nutrition and sufficient drinking regime. It is necessary to give at least 2 liters of fluid per day. Half of this amount should be in the form mineral water with released gases or Regidron solution. Multiple meals are prescribed in small portions. Dishes should contain a large amount of protein of plant and animal origin. It could be fermented milk products(cottage cheese, kefir, yogurt, fermented baked milk), pureed meat and fish puddings, chicken egg and much more.

Ascorutin is prescribed 500 mg 3 times a day for the prevention of disseminated intravascular coagulation syndrome. Antispasmodics and non-steroidal anti-inflammatory drugs can also be used to relieve headaches and muscle pain and normalize body temperature.

Currently, scientists do not know how to treat rubella in children using specific antiviral drugs. They simply don't exist. Antibiotics are not effective for this infection. They are prescribed only in case of complications, for lymphadenitis, sore throat and pneumonia. The drug “Wobenzym” has a certain effectiveness, which has an immunostimulating and anti-inflammatory effect on the child’s body. Prescribed 1 capsule 3 times a day for 12 - 15 days.

Gives a positive effect during the period of skin rashes antihistamines. This could be Suprastin, Tavegil, Pipolfen, Claritin or Diazolin. It should be given in a dosage that corresponds to the age and body weight of the baby.

Treatment of rubella disease in a hospital is required if the child develops convulsive syndrome and there are signs of infection spreading across the blood-brain barrier. In this case, rubella disease poses a threat to the health and life of the child.

Can rubella recur?

Rubella can develop again in people who have not been revaccinated in a timely manner. You should know that immunity after vaccination lasts for 20 years. Therefore, during the planning period of pregnancy, it is necessary to check your immune status and get a revaccination against this infection that is dangerous for the fetus.

In children, recurrent rubella is extremely rare. This can only be associated with total immunodeficiency, in which antibodies to this type of virus are completely absent. Revaccination is recommended to renew immune status. Most scientists agree that re-infection with this disease is in principle impossible.

Prevention of rubella in children

Prevention of rubella in children is divided into active and passive measures. Active prevention of rubella is timely vaccination, which is carried out in the first year of a baby’s life in strict accordance with the national preventive vaccination calendar. Primary vaccination is done between 1 year and one and a half years. Vaccinations against measles and mumps. Immunity appears 3 weeks after intramuscular injection of a weakened rubella virus culture. Revaccination is required to restore the immune status at the age of 6 - 7 years. Up to 28 years of age, this post-vaccination immunity remains in an adult. Then repeated revaccination is required. This is especially true for women planning a pregnancy over the age of 30.

Passive preventive measures include teaching the child the rules of personal hygiene. Also, if a case of infection is detected, quarantine measures must be introduced.

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There are two types of rubella:

• acquired - transmitted from a sick person to a healthy person, easily tolerated, complications rarely occur;
• congenital - transmitted from an infected mother to the fetus through the placenta, is difficult to tolerate, gives many complications, and miscarriage can often occur.

Previously, it was called rubella measles, because they could not distinguish the symptoms and were mistakenly diagnosed. Rubella occurs in children and adolescence, rarely in adults. A person who has had rubella as a child will never have rubella again, as a strong immune system develops. Rubella during pregnancy can lead to the death of the baby or congenital pathologies developments, among which congenital rubella syndrome is distinguished. According to statistics, every year 110 thousand children are born in the world with this syndrome.

The disease is predominantly acute. In children's and military boarding schools, outbreaks of rubella are observed, which can last for several months. In children who have had contact with a sick person, the virus is found in the mucous membrane of the upper respiratory tract 11-21 days from the date of contact with a sick person.

Congenital rubella occurs in a newborn if his mother had this disease during pregnancy. The fetus becomes infected through the placenta. Congenital rubella is characterized by diseases such as cataracts, hearing loss and heart disease. Children often experience underdevelopment of the brain, eyeball, corneal opacities, retinal pathology, cleft palate, hepatitis, pneumonia, dermatitis, myocarditis, organ damage genitourinary system, low birth weight.

Rubella, although rare, can cause complications in children with reduced immunity. These include diseases such as: pneumonia, otitis media, arthritis, tonsillitis, anthropocentric purpura. It is extremely rare for an adult to experience a complication heavy defeat brain: encephalitis and meningoencephalitis.

Rubella during pregnancy

Rubella during pregnancy is not as dangerous for the mother as for developing fetus, increasing the risk of defects. Most often suffers hearing aid And visual organs. Rubella affects the fetal bone and nervous system, brain and other internal organs. In some cases, intrauterine fetal death is possible.

Most often, a woman with rubella is advised to terminate her pregnancy. Especially if the mother’s disease began in the first trimester, when all the child’s organs are forming. The longer the pregnancy, the less likely infection of a child with a virus. At 1 month of pregnancy, the risk of damage is 60%, at the beginning of the third trimester it is 15%, and at 5 months it is only 7%.

Causes of rubella

The cause of rubella is a virus belonging to the Toga virus, which quickly spreads throughout the body. The source of infection is a person with rubella or a carrier of the virus. The virus can be easily transferred from room to room through the air and dies only at 55 degrees, so the disease is more common during cold periods, winter or spring.

The disease is transmitted by airborne droplets during communication or contact, as well as from a sick mother to the fetus. Rubella can be contracted through household items that contain virus molecules. The patient is contagious 1 week before the skin rash appears and sheds the virus for 5-7 days after the rash appears. A child with congenital rubella syndrome can be infectious to others for 2 years.

Rubella symptoms

The symptoms of rubella are pronounced and appear in short terms. The rubella virus enters the body through mucous membranes respiratory system and spreads throughout the body, causing enlargement of the lymph nodes, especially in the back of the head and on the back of the neck. The incubation period is 1-2 weeks, that is infected person dangerous to others during this period. The child may have a slight runny nose and dry cough, sore throat, watery eyes, and a slight rise in temperature.

What does rubella look like? On the first day of the disease, almost every patient experiences a skin rash; a more pronounced rash occurs in children. The rash appears as small spots, round or oval in shape, pinkish or red in color. The rash first appears on the face and neck, behind the ears and on the scalp; after a day it spreads throughout the body, arms and legs. The rashes are especially pronounced on the back, the outer surface of the arms, on the buttocks, and on the outer surface of the legs. No rashes appear on the palms and soles. IN in rare cases a small rash may appear in the oral mucosa. Rashes in a child go away after 2-3 days; in an adult they can last longer.

Some people confuse rubella with chickenpox. Chickenpox rashes are large and watery, causing severe itching. Rubella can be detected by pressing a finger on a spot of the rash: it disappears and then reappears. The rash does not bother a person and does not cause pain. Rubella is often mistaken for normal colds, but this is easy to check, since the rubella virus is not affected by antipyretic drugs and signs of the disease remain. At the first symptoms, you should consult a therapist.

The question of how one can distinguish a disease such as rubella from allergic reaction. First of all, a signal that a child or an adult has rubella is the gradual appearance of rashes on the skin and their rapid disappearance. In case of an allergic reaction, as a rule, the person is covered immediately and such skin damage takes a long time to resolve.

The second cycle of a disease such as rubella is also characterized by other symptoms. So, for example, to the number specific symptoms This disease includes a significant increase in lymph nodes in the back of the head, as well as submandibular and cervical lymph nodes. This and the presence of general infectious symptoms, in turn, are additional confirmation that rubella is developing in the patient’s body.

In adults with rubella there are more acute symptoms. The skin rash remains for five days. The spots on the skin do not appear separately, like in a child, but can merge into large spots. At the same time, body temperature rises greatly, sometimes reaching 40 degrees. Severe headaches and migraines, fatigue and weakness in joints and muscles occur, and appetite decreases. Due to severe lacrimation, an adult often experiences conjunctivitis, accompanied by photophobia and redness of the eyes. In addition to the main symptoms, a man experiences discomfort and pain in the testicular area.

Treatment of rubella

Treatment of rubella in patients with a mild course of the acquired disease is carried out at home. Special drugs there is no treatment, so the following rules must be observed:

• The patient needs strict bed rest, especially during the period of fever and for an adult, since his disease is more complicated.
• Ventilate the room twice a day so that the rubella virus evaporates.
• If you have a high temperature, take antipyretic drugs, paracetamol or ibuprofen. The child can be given medicinal decoctions from anti-inflammatory herbs.
• The patient needs peace and rest, the child needs to limit his time watching TV and staying at the computer.
• Be sure to quarantine for a week. Other children and adults who have not had rubella, especially pregnant women, should not be allowed to see the patient.
• Nutrition should be complete, but gentle, light, you should include more vegetables, fruits and vitamin complexes. Drink plenty of fluids in the form of hot tea, rosehip infusion and other herbal infusions.
• A sick person should have his own dishes, towel, and personal hygiene items, which must be treated with boiling water. After recovery, it is better not to use these items.
• Maintain personal hygiene: rinse oral cavity a weak solution of furatsilin, a decoction of chamomile, sage, take care of the skin.

Patients with congenital rubella syndrome are treated in a special hospital. Treatment is carried out depending on severe symptoms and complications.

Prevention of rubella

Measures to prevent rubella include vaccinating children against rubella (part of the mixed vaccine against measles, mumps and rubella) at the age of 12 months, and a second vaccination is given at 6 years. If a girl was not vaccinated at 12 months and 6 years old and has not had rubella, she needs to be vaccinated at 15 years old.

Vaccination against rubella based on a live strain has been used for more than 40 years. A single dose provides long-term immunity of up to 95%, similar to the immunity developed after past illness. There is usually no negative reaction to the vaccine; it can be mild. There is slight pain and redness at the injection site, the temperature rises slightly, muscle pain and small rashes on the skin.

To prevent congenital rubella, women are recommended to be vaccinated if they are planning a pregnancy, have not had this disease in childhood, and have not developed immunity to rubella. Vaccination should be carried out a year before the planned pregnancy to avoid complications.

To prevent the spread of the rubella virus, the patient should be isolated from family and society for 10 days from the onset of the disease. The room in which the patient is located should be ventilated twice a day and wet cleaned. Dishes and personal items, toys should be treated with boiling water, and then it is better not to use them. Quarantine in children's institutions or boarding schools can last up to 21 days from the moment the last sick child is isolated. All people who have had contact with someone who has rubella should be monitored, have their temperature taken every day, feel their lymph nodes, and examine their skin. Observation must be carried out for 23 days from the moment of contact with the patient.

Rubella – acute infectious disease with characteristic symptoms. Unvaccinated children most often get sick between the ages of 2 and 9 years due to weak immunity.

The virus is easily transmitted healthy people who refused vaccination. Rubella resembles scarlet fever, chickenpox and measles in many ways. Pediatrician consultation – prerequisite For successful treatment diseases.

Causes

The causative agent is the rubella virus. The infectious agent spreads easily in environment, multiplies quickly in the body. The source of infection is a sick person with pronounced or blurred signs.

A child whose body has been infected with the virus becomes infectious within 5–6 days after the rash appears. It is dangerous that a week before the appearance of small spots covering most of the body, the small patient is already infecting others without even knowing it.

Communication expectant mother with a sick baby can end disastrously for the developing fetus if the girl has not been immunized against rubella.

Provoking factors:

• weakened immune system;
• lack of vaccination in due time;
• congenital rubella. The pathogen is transmitted to the fetus from a sick mother.

Without vaccination, a person can become ill as an adult. In children, the symptoms are pronounced, but children/schoolchildren tolerate the disease well. The infectious disease in adults is severe and can lead to serious complications. The rubella virus is especially dangerous for pregnant women and the fetus. When the disease develops in the first trimester, deformities, developmental defects in the baby, and sometimes even fetal death are possible.

Routes of infection

The disease is highly contagious; even short-term contact with patients is enough to transmit the virus. Children who attend preschool, school, and unvaccinated family members get sick.

Transmission routes:

• contact. Through shared toys;
• vertical. From the mother, through the blood during pregnancy, the virus goes directly to the fetus;
• airborne. When communicating with a sick person, kissing.

Important! The rubella virus causes enormous harm to the fetus during pregnancy. The expectant mother should completely avoid contact with children diagnosed with rubella. It is important to remember that the virus is easily transmitted from a sick person to a healthy person.

Symptoms

What does rubella look like in children? The insidiousness of a viral disease is long-lasting incubation period with mild symptoms. The rash has not yet appeared on the body, but the sick child is already generously “sharing” the virus with others. Even adults can become infected if for some reason they were not vaccinated at 1 year of age, revaccinated at 6 years of age, and then in adolescence (for girls). Boys 15–17 years old are given revaccination against dangerous disease– mumps.

Clinical picture and signs of rubella in a child:

• After contact with a virus carrier, the infectious agent enters a healthy body, multiplies quickly, and gradually penetrates into the bloodstream. various organs and systems. The incubation period lasts 3 weeks;
• the first signs of the disease appear, which bear little resemblance to rubella: excessive irritability, whims without apparent reason, drowsiness, lethargy;
• after the virus spreads throughout the body, the lymph nodes in the groin, under the jaw, and in armpits. After two to three days, the signs move to the back of the head: the lymph nodes also enlarge in this area;
• the temperature rises, often up to 38 degrees, the child’s health worsens, and the child develops a cough. Children suffer from attacks several times a day;
• Nasal congestion, severe swelling of the mucous membranes is another symptom of rubella. It is characteristic that there is practically no discharge from the nasal passages;
• rashes appear all over the body after 2 days. Initially, flat spots up to 3 mm in size are localized in the area of ​​the nasolabial triangle, the front surface of the neck, near the ears;
• a day later - two round or oval spots of red color with a pinkish or orange tint appear on the shoulders, back, spread to the stomach, thighs, and cover the groin;
• the body becomes covered with spots for 3 to 7 days, then the rashes turn pale and gradually disappear without a trace;
• other signs disappear: the condition returns to normal, swelling of the mucous membrane subsides, there is no cough, the child is actively eating;
• The disease in children is mild. With bed rest and symptomatic treatment, complications are rare. If the child is very weak, the therapy is carried out incorrectly, the virus affects parts of the brain, throat and nasopharynx. Possible consequences of an untreated infection are meningitis, otitis, encephalitis. Sometimes arthritis and sore throat develop.

Diagnostics

Many parents mistake rubella for an acute respiratory infection and begin therapy on their own initiative, but often choose the wrong medications. Symptoms blur, self-medication sometimes provokes complications, especially in children.

To make an accurate diagnosis, a blood test from a vein is required. The goal is to identify antiviral antibodies. It is important to conduct a study on days 1–3 of the disease, then after 7–10 days. After penetration, active action rubella virus, the amount of antibodies increases more than 4 times.

If they do not consult a doctor in a timely manner, parents do not suspect that they are dealing with a dangerous viral disease. The child attends kindergarten, school, plays with peers in the yard, and infects unvaccinated children. The fashion for refusing vaccinations provokes the emergence of new cases of the disease.

Methods and rules of treatment

Special drugs to combat viral infection does not exist. The only method to prevent infection is vaccination in a timely manner.

The goal of therapeutic measures is to improve the condition of a small patient and reduce discomfort from unpleasant symptoms. When the first signs appear (lethargy, loss of appetite, plus enlarged lymph nodes), contact your pediatrician to find out the cause. feeling unwell young patient.

When treating rubella in children, follow these recommendations:

• prepare a separate room for the baby, exclude access for pregnant women to the patient;
• limiting contact is required for five days after the appearance of a small-spotted rash;
• ventilate the room well, carry out wet cleaning in the morning and evening;
• Bed rest is required for 4–6 days. When the condition improves, quiet games are allowed, but you cannot go outside and have contact with children and adults;
• change the diet: give the children small portions, but every 3 hours. Give up large pieces, rough food. Choose dishes that your little patient likes;
• exclude sweets, fatty, spicy foods, give up buns. Give us boiled/fresh vegetables, fermented milk products, buckwheat porridge, steamed beef/chicken cutlets, light vegetable soups. When creating a menu, be sure to look for dishes rich in protein and vitamins;
• keep drinking regime. Proper drinking regimen will help avoid dehydration due to high temperature. The optimal volume of liquid per day is from 1.5 to 2 liters. Recommended electrolytes are Regidron, Biogaia, low-mineralized water without gas. Additionally, give unsweetened fruit drinks, compotes, and green tea.

• It is mandatory to take multivitamins to strengthen the immune system. Great option– vitamins Vita-Bears, Centrum for children, Multitabs complex taking into account age, Vita Kids;
• do not rush to immediately lower the temperature below 38 degrees. Increased performance– a sign of an active fight against the virus. Does the thermometer stay at 38 degrees or higher for a long time? Give the little patient an antipyretic - children's Paracetamol, Efferalgan, Nurofen, Ibuprofen (remember age, dosage, frequency of administration);
• Ascorutin will prevent vascular damage and reduce excessive blood clotting. The vascular wall will become stronger, swelling of the mucous membrane will decrease;
• for severe headaches, use antispasmodics, non-steroidal drugs with an active anti-inflammatory effect - Nimesulide, Paracetamol. Do not give aspirin to children under 12 years of age: serious complications are possible;
• antihistamines reduce swelling of the mucous membranes. Choose compositions last generations, do not cause drowsiness, with minimal effects on the liver and kidneys. Effective drugs: Zyrtec, Erius, Cetrin;
• in case of secondary infection, bacterial complications (pneumonia, tonsillitis), antibiotics are required. The doctor will take a throat swab for bacterial culture. After clarifying which drug is most active against the identified infectious agent, the doctor will prescribe the appropriate antibacterial agent. While taking antibiotics, give your child drugs to protect the intestinal microflora (probiotics).

Severe forms of rubella in children are treated in a hospital, in the infectious diseases department.

Prevention

The rubella vaccine is a reliable way to prevent infection. Refusal to vaccinate is a risk for the baby.

Features of vaccination:

• Trivaccine is more often used against the following diseases: measles, mumps and rubella;
• The baby is vaccinated for the first time between 12 and 15 months;
• revaccination is carried out at the age of 6 years;
• When a teenager reaches 15–17 years of age, immunization against the rubella virus is mandatory (for girls). The mumps (mumps) vaccine is recommended for guys;
• introduction of a weakened virus culture in adolescence will provide stable immunity for 25 years. This point is important for warning dangerous infection in pregnant women, severe complications reproductive system in young men;
• If for various reasons you refused to vaccinate your baby at the age of 1, you can correct the situation until the age of 18. Contact your doctor to schedule your vaccinations.

Be sure to strengthen your children's immunity. Healthy body tolerates any infection more easily.

Prevents rubella in children simple measure– vaccination according to the vaccination schedule. Contact your pediatrician promptly and do not refuse vaccination. The disease in adults is severe, and complications often occur. Remember: The rubella virus is dangerous for the reproductive system in men and the health of the baby in the womb.

Video about the symptoms and treatment of rubella at home:

Rubella is an infectious disease that occurs with skin rashes, enlarged lymph nodes (posterior cervical, occipital) and minor signs of intoxication. Also known according to ICD 10 as German measles.

There are such forms of the disease:

Congenital - transmitted through the placenta, severe fetal malformations develop;
- acquired - airborne transmission, the outcome is favorable.

The disease is caused by a virus containing RNA. The source is exclusively a patient with any form of rubella and a virus carrier. Contagiousness is observed 2-3 days before the onset of the first symptoms of the disease and in its first 7 days. Congenital form - patients are dangerous for a year from the moment of birth.

It affects people of all ages, but most often affects children between 2 and 10 years of age. Rubella is extremely rare in newborns, since their blood contains antibodies from the mother. The disease is characterized by high susceptibility. It is almost impossible to get rubella again, but cases are rare. reinfection are still recorded.

Rubella symptoms

Manifestations of rubella depend on its form.

Acquired rubella is manifested by the following symptoms:

• Rash that occurs against an unchanged background skin in the form of roseola or small spots, it does not itch. Localization of rashes is the face and limbs (extensor surfaces). On the first day of the disease, they appear almost immediately in all areas, disappear without any traces after 2-3 days.
• Intoxication is moderate (body temperature rises slightly, muscle aches occur, general weakness).
• The lymph nodes are enlarged - posterior cervical, occipital, and less often - parotid. They may hurt a little when palpated.
• Catarrh of the mucous membranes of the nasopharynx (rhinitis with mucous discharge or nasal congestion) and conjunctiva are slightly expressed.
• Enanthema (spotty redness) may appear on the hard and soft palates.

Congenital rubella manifests itself depending on the stage of pregnancy when the infection occurred:

• If infected in the first 16 weeks of pregnancy, intrauterine death of the fetus is possible as a result of defects incompatible with life or the formation of serious developmental anomalies. The most typical is the so-called Greg's triad, which is manifested by eye damage, defects cardiovascular system and deafness. Developmental abnormalities of the skeletal and nervous systems may also occur.
• Rubella in expectant mothers later(16 weeks and later) - the risk of congenital deformities is lower, most often these are minor developmental defects and inflammation. The most dangerous is meningoencephalitis.

In adults, the manifestations of rubella are the same, only they are more pronounced. Synovitis is possible - small joints of the hand are most often affected, sometimes the wrist and ankle. This can happen from 2 to 7 days of illness. The course of synovitis is short-term and benign.

There is a type of disease - rubella measles. In this case, patients experience typical signs rubella, but the rash is very similar to measles. It starts from the face, then quickly goes down to the neck, upper limbs and torso. Elements of the rash are smaller than with measles and disappear quickly.

Course of rubella

During the course of the disease, the following periods are distinguished:

• Incubation - average duration 18-23 days.
• Prodromal - from several hours to 1-2 days. There is not always.
• The period of rashes is constantly present. Its duration is 3-4 days.
• The period of convalescence for this disease, as a rule, proceeds smoothly. Complications such as damage to the nervous system are rarely possible ( serous meningitis, encephalitis).

Variants of the course of rubella

The course of rubella is typical (its characteristics are described above). Many parents know what rubella looks like. But you need to take into account the presence of atypical forms, which come in two varieties:

• Erased - in this case clinical manifestations lungs, mildly expressed in the form of a reaction of the lymph nodes, a slight, not profuse rash, low-grade fever.
• Asymptomatic - in this case there are no clinical or hematological abnormalities. This variant can mainly be detected in rubella foci using a serological diagnostic method.

Features of the course of the disease in children of the first year of life

In children of the first year of life, rubella infection occurs extremely rarely. During intrauterine development, the fetus receives antibodies to various infectious diseases that the mother had. They last for some time after birth.

But sometimes it happens that a woman did not have rubella before pregnancy. Therefore, her child in this case has no immunity against this virus. If infected at this age, the disease is characterized by a lightning-fast course, and the baby’s condition is serious. Since the blood-brain barrier is not mature until 1 year of age, there is a high risk of encephalitis and meningitis. When infected with rubella, all children of this age are hospitalized as an emergency.

Difference between rubella rash and other diseases

1. With allergies, the rash is heterogeneous and is often accompanied by itching. The nature of the rashes with rubella is different, and they do not itch. Enlarged lymph nodes, intoxication, and catarrhal symptoms are inherent in rubella and do not occur in allergic dermatitis.
2. Rubella and chickenpox differ in the nature of the rashes - with chickenpox they are vesicular, and with rubella they are roseola or macular. During chickenpox, the rash can be found on the scalp, but with rubella this is not the case. The rash with rubella does not itch; with chicken pox, severe itching occurs. With chickenpox, the lymph nodes do not enlarge, which is typical for rubella. Sometimes many parents wonder whether a child who has rubella can become infected with chickenpox. The fact is that both diseases are caused by a virus, but they are completely different - the causative agent of chickenpox is a DNA-containing virus, and rubella is caused by a virus that contains RNA. Therefore, if you had rubella, you can also get chickenpox after that. There is an opinion that rubella and chickenpox are the same thing, but they are two completely different pathologies.
3. Common symptoms of rubella are rash and intoxication. The nature of the rash is different in these diseases: the rash with scarlet fever is pinpointed and appears on a red background of the skin; with rubella, the background of the skin does not change and the rash is roseola or spotted. But with rubella, the lymph nodes become enlarged, which is not the case with scarlet fever. Symptoms such as white dermographism, tonsillitis, crimson tongue are characteristic of scarlet fever, but do not occur with rubella.
4. Measles and rubella are common rashes. With rubella, the rash is the first symptom, and measles begins with pronounced catarrhal symptoms, and the rash appears after that. The nature of the rash in these infections is different: with measles it is maculopapular, and with rubella it is small-spotted, roseolous or roseolo-papular. Rashes with rubella appear on days 1-3 of illness, immediately spreading throughout the body, with measles - on 3-4 days, on the first day it covers only the face and neck, and spreads to other parts of the body in stages. The fact that the patient has measles is indicated by a pronounced intoxication syndrome (increase in temperature to 38.5-39 degrees, muscle pain, general weakness); with rubella, intoxication is moderate. With rubella, the lymph nodes become enlarged, but with measles this does not happen. Photophobia is inherent in measles and does not occur with rubella.
5. False rubella or pink roseola. Many parents believe that this is the same as rubella. The rashes associated with these diseases are similar, but the causative agent of pseudorubella is the herpes virus. In this case, the intoxication syndrome is maximally expressed, which is not the case with rubella. There is no enlargement of lymph nodes with false rubella.

Diagnostics

To confirm the diagnosis of rubella, use additional methods research:

• General clinical blood tests (leukopenia, lymphocytosis, normal ESR) and urine.
• Isolation of the virus from biological materials (nasopharyngeal swabs, blood, feces, urine).
• Special serological tests - the state of the immune system and its changes throughout the disease are determined. Antibodies to rubella virus are most often determined using RTGA. The examination for this purpose is taken from the patient’s vein twice - at the beginning of the disease on days 1-3 and again after 7-9 days. Rubella is indicated by an increase in antibody titer by more than 4 times in the second analysis compared to the first. Infection is indicated by the presence in the ELISA IgM antibodies. If immunoglobulin G is present, this indicates a previous illness.

What is the danger of rubella

The rubella virus is most dangerous for girls. The fact is that if they did not have rubella in childhood, there is a possibility of becoming infected during pregnancy, and this is a threat to the congenital form, which is manifested by miscarriage or fetal malformations.

For boys, the disease is less dangerous. But still, it is extremely rare for them to experience this dangerous complication, like rubella panencephalitis. Cases of testicular damage have been described.

The disease is more severe in adolescents and adults.

Treatment of typical rubella is primarily outpatient. Shown symptomatic treatment(antihistamines, vitamins, antipyretics, etc.). If meningoencephalitis occurs, the patient needs urgent hospitalization and more comprehensive treatment in a hospital, which includes hormonal, anti-inflammatory, antibacterial, and detoxification agents.

You can wash with rubella, but only if it is mild. If you decide to buy a sick child, it is better to limit yourself to a shower. It is not advisable to take a bath during this period. Swimming in reservoirs is prohibited until complete recovery.

It is not advisable to walk from the moment the rash appears, as there is a possibility of infecting others. Therefore, during this period it is worthwhile to ventilate the patient’s home well.

Prevention of rubella

Important preventive measures for rubella are identifying sick people and isolating them, and recording contacts. A patient with rubella is isolated until the rash disappears, that is, until the 4th day of the disease, in the case of a congenital form of the disease - up to 1 year.

Persons who have been in contact with the sick person are not separated, but quarantine is set for 21 days.

It is important to determine specific antibodies if a pregnant woman has been in contact with rubella. If antibodies are detected in them, this indicates that this disease was in the past, so contact is completely safe for the unborn baby. The examination of the expectant mother is carried out 2 times, the interval between examinations is 7-10 days, because antibodies detected once may be a consequence atypical shape rubella. If there is no dynamics during the repeated study, then this indicates the absence of the rubella pathogen and no further measures are taken.

You can influence your susceptibility to rubella using immunoprophylaxis. Vaccination against this infection is carried out with a live vaccine at 1 year of age, as well as subsequent revaccination at 6 years of age and for girls at 15 years of age. Vaccination is carried out with a complex vaccine against rubella, mumps and measles (MMR) or a single vaccine. Of course, it is better to be vaccinated with a complex vaccine, since compared to a single-component vaccine it practically does not cause any reactions.

It is advisable for women who have not had rubella to be vaccinated against rubella after childbirth. Expectant mothers are not vaccinated due to the risk to the fetus. If immunization has been carried out, conception should be avoided for three months.

Acquired rubella, as a rule, has a mild course and is not difficult to cope with. The congenital form of the disease is dangerous, but with timely immunization the risk of infection during pregnancy can be reduced to a minimum.

A viral infectious disease is characterized by the appearance of a finely spotted ruby-colored rash on the body. Young parents have no idea what rubella looks like in a child. Thanks to mass vaccination in Russia and developed countries In the West, the disease is almost defeated. Outbreaks of infection are a thing of the past, but vaccinations have not been canceled. This is the best way to prevent infection, which is especially dangerous for unborn children in the womb.

Some infectious diseases primarily affect children and fall into the category of so-called childhood infections. Rubella belongs to this group, chicken pox, mumps, whooping cough, scarlet fever, measles, diphtheria. The cause of the first disease on this list is the rubella virus, transmitted from patients to healthy children. After a child has been ill or received the appropriate vaccine, antibodies appear in his body. They make the body immune to reinfection.

The rubella virus enters the body and multiplies in the cells of the lymph nodes. The response to the activity of the pathogen is the appearance of signs of rubella. There may be an increase in temperature, enlarged and painful groups of lymph nodes, and an itchy bright red rash.

Comparison of signs of rubella in a child and measles:

• The similarity of infections is in how the pathogen is transmitted - with droplets of saliva and particles of epithelium from the walls of the nasal cavity of the oropharynx (airborne).
• Measles is severe, severely depletes the child’s body, and makes him more susceptible to bacterial infections.
• Reproduction of the measles pathogen in most cases occurs within 9 days, the incubation period of rubella is several days shorter.
• Measles is characterized by redness of the eyes, watery eyes and photophobia.
• Rubella is milder, with fewer complications.
• Runny nose and cough with rubella are mild.
• Measles and rubella cause a blotchy rash.

Sometimes uninformed parents express the opinion that chickenpox and rubella are the same thing. In fact the differences between the two viral diseases significant. The causative agent of chickenpox is the herpesvirus Varicella zoster. The development of the elements of the rash and the consequences of infection for the body differ. A child who has had chickenpox may be reinfected throughout his life. In such cases, adults develop herpes zoster or herpes zoster with high temperature and a rash under the armpits and on the skin of the chest.

Rubella is transmitted through the placenta from an infected pregnant woman to the fetus, which causes serious disorders in the body of the unborn child. The infection especially affects the first months of pregnancy. Symptoms of congenital rubella in children are more severe, there is a risk fatal outcome, or the baby develops deafness or mental retardation.

How do symptoms appear?

There is an incubation period during which the virus multiplies. Typically the first stage lasts two to three weeks. The prodromal phase occurs predominantly in adults and is often absent in children. The duration of this “pre-disease” period is 24–48 hours. Manifested by general malaise, fever, loss of appetite.

How rubella manifests itself in children - a triad of first signs:

1. Enlarged lymph nodes behind the ears, on the neck.
2. Fever -37.5–38.1° C (rare).
3. Rubella rash is red.

Only in rare cases do signs of serious damage appear; usually a small patient does not show any special complaints.

What rubella looks like in children during the rash phase:

• The spots usually first affect the skin behind the ears.
• Elements of the rash quickly spread throughout the body.
• Reddish spots predominate, oval in shape, with well-defined edges.
• Minor damage may appear on the hard and soft palate (also red).

If you are infected with rubella, you may develop atypical symptoms characteristic of other infectious diseases. However, the temperature often remains normal. Five days after the start light form sick child may be allowed to visit childcare facility. This issue is decided by the local pediatrician.

Features of the course of the disease

With the acute onset of rubella, the child complains of a headache and begins to cough due to inflammation and irritation of the mucous membrane of the upper respiratory tract. The patient should be left in bed as long as the temperature is elevated. Young children feel discomfort, but cannot describe their sensations in words. Infants begin to behave restlessly, cry, and eat poorly. In the first months of life, children rarely get rubella; they have congenital immunity.

Newborns receive antibodies from the body of the ill mother during fetal development and through breast milk.

Swollen lymph nodes in a sick child can be felt behind the ears and on the neck like pearl beads. After about a day, a typical rash appears, which at first looks like small single spots ruby color. The rash continues to spread, appearing both on the face and on the torso and limbs. The child feels slight itching or does not feel discomfort.

Approximately 3-4 days after the illness begins, the rash fades away. The saliva of infected children remains a source of virus for others for another week. The pathogen is then suppressed by the immune system and remains latent in the body. Antibodies remain in lymph tissue for the rest of life.

If the rubella virus re-enters, then human body“weapons” already exist to combat this type of infection.

Congenital rubella syndrome in a child is characterized by serious lesions and malformations of many organs. Children and adults in complicated cases may develop encephalitis or hepatitis. In the female body, after suffering an infectious disease, arthritis often develops, affecting the fingers, wrists and knees. Strength decreases vascular walls, which leads to bleeding.

Laboratory diagnostics

The first manifestations of rubella in children may be missed or mistaken for another disease, so laboratory tests are necessary. To establish correct diagnosis It is not enough to conduct an examination and do a general blood test. A blood test will not show significant changes, the only important factor considered to be a decrease in the number of platelets and white blood cells. The virus is very difficult to isolate from oropharyngeal cells, urine samples and other biomaterials.

Laboratory determination of antibodies against specific viral particles will help clarify the diagnosis.

Special significance correct diagnosis acquires rubella for pregnant women. If ultrasound determines a malformation in the fetus, a biopsy of the placental tissue may be prescribed. This type of diagnosis is used only after 11 weeks of pregnancy to avoid complications.

Treatment and prognosis of rubella

There is no specific therapy; usually the child is given medications to reduce fever and reduce pain. Children's syrups and suppositories with paracetamol and ibuprofen are suitable. Symptoms in adults are more intense. Treatment depends on the severity of the disease and the consequences for the body. Be sure to frequently ventilate the room where the patient is located, give herbal tea, complete dietary nutrition.

For a child who has had rubella, the prognosis is favorable. The rash heals without complications, but complications occasionally occur - encephalitis and arthritis.

The severity of the consequences of rubella for a pregnant woman and child depends on the period when the infection occurred. In the first trimester, the virus provokes the development of severe fetal malformations in almost 100% of cases. In the second trimester, the impact of infection decreases to 35%, in the last three months birth defects not usually associated with rubella. Children who were born with congenital rubella syndrome are treated for liver damage, diabetes mellitus, and complications of cardiovascular and respiratory activity.

Prevention of rubella

A specific vaccine has been available since the late 1960s. Immunization involves the introduction of a weakened pathogen. The body produces specific antibodies to it. Thus, the immune system acquires its own weapon to counteract the virus that has entered from the outside and immediately transfers it to an inactive state.

Symptoms of rubella during reinfection are practically not observed. Specific antibodies remain in the lymphatic tissue, which provides lifelong immunity.

Immunization is carried out everywhere, the rubella vaccine is administered twice. The epidemic danger has decreased significantly; the disease mainly affects only children who have not been vaccinated. Side effects vaccine administration - joint pain, fever. Developed and used in many countries combination vaccine from three viruses - rubella, measles and mumps. The first dose is administered before the age of 15 months, the second dose up to 3 years.