Infectious diseases. Rubella (most important)

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Infectious diseases. Rubella (most important)

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41. Rubella

Rubella is a moderately contagious disease in childhood, characterized by mild general disorders, rashes, and swollen lymph nodes in the occipital, parotid, and posterior cervical regions.

Rubella transmitted by a pregnant woman can cause severe fetal malformations.

Etiology. Rubella is caused by a pleomorphic RNA virus. It belongs to the family Togaviridae of the genus Rubivirus. The presence of the rubella virus is manifested by the resistance of infected cells to the effects of the enterovirus. At the height of the disease, the virus is determined in the discharge from the nasopharynx, in the blood, feces and urine.

Epidemiology. Man is the only reservoir of infection. It spreads by airborne droplets or is transmitted transplacentally.

Clinical manifestations. Incubation period - 14-21 days; prodromal, characterized by minor catarrhal symptoms, usually shorter than measles, and often goes unnoticed. The most typical is an increase in the occipital, parotid and posterior cervical lymph nodes. Immediately before the skin rash, an enanthema may appear in the form of separate pink specks on the soft palate, some of which merge.

Lymph nodes increase at least 24 hours before skin rashes and remain in this state for 1 week or more.

The rash first appears on the face and soon spreads to the body.

The rashes are numerous and look like maculopapular formations, covering the body especially abundantly during the first 24 hours.

The mucous membranes of the pharynx and conjunctiva are somewhat inflamed.

The diagnosis of rubella is established on the basis of clinical and epidemiological data:

1) the clinical method includes the data of the anamnesis of the disease and an objective examination;

2) hematological data (leukopenia, lymphocytosis, plasma cells, normal ESR);

3) the virological method consists in isolating the virus from nasopharyngeal swabs, blood, urine, feces;

4) the serological method allows you to determine the state of immunity and identify its dynamics during the course of the disease.

Treatment. Rubella usually does not require hospitalization and prescription of drugs. Vitamin therapy, bed rest for 3-4 days are shown, in combination with ARVI - symptomatic agents, with streptococcal infection - antibacterial therapy, in the event of meningoencephalitis - urgent hospitalization and complex treatment, including anti-inflammatory, hormonal, detoxification, dehydration.

Rubella prevention is based on the complex use of:

1) measures in relation to sources of infection;

2) means of influencing the mechanisms of infection transmission;

3) means that affect the susceptibility of the population - active and passive immunization.

Author: Pavlova N.V.

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