Rubella in children and adults: symptoms, danger during pregnancy and vaccination - examination in Tashkent

How rubella occurs in a child

On average, 14–21 days pass from infection to the first signs. All this time, the child looks completely healthy, but already a few days before the rash becomes contagious - this is why the infection spreads so easily in children's groups. It is transmitted through airborne droplets, talking, coughing and sneezing.

• The initial period is short and weak: slight weakness, runny nose, slight redness of the throat, temperature usually does not exceed 38 degrees
• Lymph nodes enlarge, primarily the occipital and posterior cervical ones - they can often be felt behind the ears and on the back of the head even before the rash appears
• The rash is small, pale pink, flat or slightly raised, the elements do not merge with each other
• Appears immediately over almost the entire body - usually within a day: face, torso, extensor surfaces of the arms and legs, buttocks
• Lasts 2-3 days and disappears without a trace: without peeling and without pigmentation
• General health suffers little - many children continue to play and hardly get sick
• In adolescents and adults the course is more severe: higher temperature, more frequent joint pain, more weakness
• Contagiousness persists from approximately 7 days before the rash to 7 days after its appearance

How to distinguish rubella from measles and other rashes

A rash in a child is the most common cause of anxiety for parents and at the same time the most unreliable sign: even doctors make mistakes based on the appearance of the rash. You need to focus on the combination of the rash with other manifestations and the order in which they appear.

• Measles: several days of high fever, severe cough, runny nose and red, watery eyes BEFORE the rash; the rash is large, confluent, descends from top to bottom in three days, then leaves pigmentation and peeling
• Rubella: there is almost no initial period, the temperature is low, the rash is small, non-confluent, appears everywhere at once, disappears without a trace, occipital lymph nodes are characteristic
• Scarlet fever: bright pinpoint rash on a red background, thickens in folds, a pale triangle around the mouth, sore throat and crimson tongue, then large peeling on the palms
• Sudden exanthema: three days of high fever without other signs, then the temperature drops and a rash appears - against the background of already normal health
• Allergic rash: usually itchy, elements of different sizes, change during the day, no enlarged occipital lymph nodes
• Meningococcal infection: the rash does not turn pale when pressed with a glass, looks like hemorrhages and stars, the condition worsens quickly - this is an emergency situation

Main danger: rubella during pregnancy

The rubella virus penetrates the placenta and disrupts the formation of the child’s organs during the most vulnerable period. The resulting condition is called congenital rubella syndrome, and its risk directly depends on the stage of pregnancy at which the infection occurred.

• Infection in the first 8–10 weeks - the risk of damage to the fetus is highest, often affecting several organs at once
• At 11–16 weeks the risk is noticeably lower, but remains, most often in the form of hearing impairment
• After 20 weeks the risk of malformations is minimal
• Classic triad of the syndrome: congenital deafness, cataracts and other eye lesions, congenital heart disease
• Possible low birth weight, liver and spleen damage, low platelet count, developmental delay, brain damage
• A child with congenital rubella remains a source of the virus for many months after birth
• Infection in the early stages often leads to miscarriage and intrauterine fetal death.

How is the diagnosis confirmed?

1. Осмотр врача с оценкой характера сыпи, состояния горла, глаз и обязательным прощупыванием затылочных и заднешейных лимфоузлов.
2. Уточнение прививочного анамнеза и контактов за последние три недели — это часто важнее, чем сама картина сыпи.
3. Антитела IgM к вирусу краснухи — появляются при свежем заражении и подтверждают текущую инфекцию.
4. Антитела IgG — показывают наличие защиты: после перенесённой diseases или после прививки. Именно этот анализ сдают при планировании беременности.
5. Определение авидности IgG — помогает понять, была инфекция давно или недавно; это ключевой вопрос при обследовании беременной.
6. Общий анализ крови — обычно снижены лейкоциты, могут появляться плазматические клетки; вспомогательный, но полезный признак.
7. При выявлении инфекции у беременной — консультация акушера-гинеколога и инфекциониста для оценки срока, риска и дальнейшей тактики.

Treatment and care

There is no drug that would kill the rubella virus, and it is not needed: the body copes on its own. Treatment comes down to making the child comfortable and preventing infection of others - especially pregnant women.

• Home regime, quiet activities; strict bed rest is not required if the child feels well
• Drink plenty of small portions; food according to appetite, without coercion
• Antipyretic only when you feel unwell, and not for the sake of the number on the thermometer
• The rash is not smeared with anything: it does not itch, does not require treatment and goes away on its own
• Air ventilation and humidification; walks - after your health has returned to normal and the infectious period has ended
• Antibiotics are useless: they do not act on viruses and are prescribed only for a proven bacterial complication
• Isolation for approximately 7 days from the moment the rash appears, with complete exclusion of contact with pregnant women

Complications in children are rare, but they do exist. Inflammation of the joints is the most common - it is typical for teenage girls and adult women, and usually goes away in one to two weeks. Much less common are a decrease in the number of platelets with bleeding and brain damage that requires hospitalization. That is why the child continues to be monitored even after the rash disappears.

Vaccination and pregnancy planning

1. Вакцина против краснухи входит в состав комбинированной прививки вместе с корью и паротитом и защищает подавляющее большинство привитых после полного курса of двух доз.
2. Дети получают её по национальному календарю; если возраст прививки пропущен, вакцинацию проводят позже — наверстать её можно в любом возрасте.
3. Женщинам, планирующим беременность, стоит заранее сдать анализ на антитела IgG. Если защиты нет — сделать прививку.
4. После вакцинации беременность рекомендуют отложить примерно на месяц, а точный срок называет врач.
5. Во время беременности эта прививка не делается — она живая. Поэтому вопрос решается до зачатия.
6. Кормление грудью прививке не мешает, и молодой матери её можно сделать сразу после родов, если иммунитета не было.
7. Мужчинам и другим членам семьи вакцинация тоже нужна: привитое окружение — это защита беременной, которая не может привиться сама.