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Rubella


An acute viral disease with a characteristic small spotted rash - exanthema, generalized lymphadenopathy, moderate fever and fetal damage in pregnant women. The causative agent belongs to togaviruses, contains RNA. In the external environment it is unstable, 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 with rubella, especially in a subclinical form without a rash.
The disease occurs in the form of epidemic outbreaks that recur after 712 years. In the inter-epidemic time, individual cases are observed. The maximum number of diseases is recorded in April. A particular danger is a disease for pregnant women due to intrauterine infection of the fetus. Rubella virus is released into the environment one week before the rash and within a week after the rash. Infection occurs by airborne droplets.
Symptoms and course:
The incubation period is 11-24 days. The general condition suffers little, so often the first symptom that attracts attention is exanthema, a rash that resembles either measles or scarlet fever. 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 shows mild symptoms of catarrh of the upper respiratory tract, slight redness of the pharynx, conjunctivitis. From the first days of the disease, generalized lymphadenopathy occurs (i.e., a general lesion of the lymphatic system). Especially pronounced increase and soreness of the posterior cervical and occipital l and mphatic nodes. Exanthema appears 1-3 days after the onset of the disease, first on the neck, spreads throughout the body in a few hours, it may be itchy. There is some thickening of the rash on the extensor surface of the limbs, back, buttocks. Elements of the rash are small spots with a diameter of 2-4 mm, usually they do not merge, last 3-5 days and disappear without leaving pigmentation. In 25-30% of cases, rubella occurs without a rash, characterized by a moderate increase in temperature and lymphadenopathy. The disease can be asymptomatic, manifesting itself only in viremia and an increase in the titer of specific antibodies in the blood.
Complications: arthritis, rubella encephalitis.
Recognition:
It is carried out according to a combination of clinical and laboratory data.
Virological methods are not yet widely used. From serological reactions, the neutralization reaction and rtga are used, which are placed with paired sera taken at intervals of 10-14 days.
Treatment:
With uncomplicated rubella, symptomatic therapy. With rubella arthritis, hingamine (delagil) is prescribed at 0.25 g 2-3 times a day for 5-7 days. Apply diphenhydramine (0.05 g 2 times a day), butadione (0.15 g 3-4 times a day), symptomatic agents. With encephalitis, corticosteroid preparations are indicated.
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 are isolated up to 5 days after the appearance of rashes.