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Rubella


Acute viral disease with a characteristic small-blooded rash - exanthema, generalized lymphadenopathy, moderately severe fever and fetal impairment in pregnant women. The pathogen belongs to the Togavirus, contains RNA. It is unstable in the external environment, quickly dies when heated to 56 ± C, when dried, under the influence of ultraviolet rays, ether, formalin and other disinfectants. The source of infection is a person suffering from rubella, especially in the subclinical form, which occurs without a rash.
The disease occurs in the form of outbreaks that recur after 712 years. In interepidemic time there are isolated cases. The maximum number of diseases is recorded in April. Of particular danger is the disease for pregnant women due to fetal intrauterine infection. The rubella virus is released into the external environment a week before the rash appears and within a week after the rash. Infection occurs through airborne droplets.
Symptoms and course:
The incubation period is 11-24 days. The general condition suffers a little, therefore often the first symptom that attracts attention is a rash, a rash resembling either measles or scarlatina. Patients have a slight weakness, malaise, headache, and sometimes pain in muscles and joints. Body temperature often remains subfebrile, although sometimes it reaches 38-39 ± C and lasts 1-3 days. An objective examination noted mild symptoms of catarrh of the upper respiratory tract, slight redness of the throat, conjunctivitis. From the first days of the disease, generalized lymphadenopathy (i.e., a common lesion of the lymphatic system) occurs. Especially pronounced increase and soreness of the posterior and occipital lymph nodes and mfaticheskikh nodes. The exanthema appears on day 1-3 from the onset of the disease, first on the neck, after a few hours it spreads all over the body, it can be itchy. There is some thickening of the rash on the extensor surface of the limbs, back, buttocks. Elements of the rash are small specks with a diameter of 2-4 mm, they usually do not merge, hold 3-5 days and disappear, leaving no pigmentation. In 25-30% of cases, rubella occurs without a rash, characterized by moderate fever and lymphadenopathy. The disease can be asymptomatic, manifesting only in viremia and an increase in the titer of specific antibodies in the blood.
Complications: arthritis, rubella encephalitis.
Recognition:
Based on a combination of clinical and laboratory data.
Virological methods are not widely used yet. From serological reactions, the neutralization reaction and rtha are used, which are set with paired sera taken at intervals of 10-14 days.
Treatment:
With uncomplicated rubella, symptomatic therapy. For rubella arthritis, hingamin (delagil) is prescribed 0.25 g 2-3 times a day for 5-7 days. Dimedrol is used (0.05 g 2 times a day), butadiene (0.15 g 3-4 times a day), symptomatic agents. When encephalitis shows corticosteroid drugs.
The prognosis for rubella is favorable, with the exception of rubella encephalitis, in which mortality reaches 50%.
Prevention:
Most important in women of childbearing age. Some recommend starting vaccinations for girls aged 13-15. Rubella patients undergo isolation up to 5 days from the onset of rash.