Rubella is an acute viral infection, easily transmitted by airborne droplets from person to person, namely: sneezing, coughing, talking. But the infection requires a fairly long and close contact with the patient, for example, caring for a sick child, cohabiting in a room, etc. The incubation period lasts 15-21 days, and it is very difficult to establish the moment of infection, because the infection is hidden for the first time. The rubella virus is sensitive to the effects of temperature and chemicals.
Symptoms and course of the disease
In children, the disease begins acutely: a pale pink small-stubby rash appears on the skin that does not rise above the surface of the skin. The size of the spots does not exceed 3-5 mm. First the rash appears on the face, quickly spreads throughout the body, especially many elements on the back, buttocks, the inner surfaces of the hands and feet. At the same time on the palms of the rash is not manifested. Later, an increase in the posterior cervical and occipital lymph nodes, an insignificant increase in temperature, an inflammation of the upper respiratory tract and, as a complication, an inflammation of the joints may appear.
In adults, the disease is much more difficult. Before the appearance of stains, a person's body condition may worsen: general malaise, headache, chills with fever to 38 А C. , joint pain, runny nose, sore throat. In addition, there is an increase in lymph nodes, especially the posterior cervical and occipital lymph nodes. A third of the diseased adults are afflicted with brain damage and small joints of the hands. The patient with rubella becomes contagious to others already 7 days before the onset of a rash on the body and remains a source of infection even within 7-10 days after its appearance.
Peculiarities of rubella infection during pregnancy
During pregnancy, the virus primarily affects the tissues of the embryo, very easily penetrating the placenta. In the first trimester, this leads to chronic infection of the fetus, which disrupts its intrauterine development. Often the rubella virus provokes a miscarriage. The less the gestation period at which infection occurred, the more often and more severely the developmental anomalies in the fetus develop. For example, infection of a woman in the first 8-10 weeks of pregnancy, in 90% leads to the development of vices. Among them:
- heart disease;
- mental development disorder.
In addition to the development of vices in the fetus, there may be other types of complications of pregnancy: miscarriage, stillbirth.
We hasten to inform that the infection after the 20th week practically does not have any negative effect on the development of the baby.
If you have rubella, you do not need specific treatment. The patient is shown isolation and bed rest. In case of complications, prescribe analgesics, sulfonamide preparations. In some cases, the doctor prescribes antibiotics and gargling with antiseptic solutions.
Also introduce human gamma globulin, which facilitates the course of the disease. However, these measures are not taken in relation to pregnant women, since this does not prevent the fetus from being affected.
Indications for abortion
If infection does occur, the issue of interrupting or maintaining pregnancy is being considered. If this happened in the early stages, when the likelihood of complications in the child is maximal, a woman is recommended to interrupt pregnancy. At a later date, pregnancy is usually abandoned, but, in the presence of confirmed fetal lesions, an abortion procedure is also recommended. If the mother's infection occurred at the gestational age after 28 weeks, she is registered in a high-risk group under the constant supervision of doctors.
Keeping pregnant with a rubella virus
If for some reason a woman is not made an artificial abortion, she is considered to be at risk and is pregnant with due regard for her condition. In this case, the treatment of fetal hypoxia and placental insufficiency, preventive measures and restorative therapy. This helps to avoid the worst consequences and prevent a miscarriage. It is also taken into account that rubella during pregnancy does not only harm the fetus, but can also cause complications directly during labor. This can manifest itself in the violation of labor, infection of blood and bleeding.
In addition, a child with signs of congenital rubella can provide a risk of infection to others for several months after birth.
Symptoms of congenital rubella in a newborn
As we have already noted, the child born from an infected mother exhibits the following disorders: eye damage, heart defects, deafness, brain damage (encephalitis, meningitis), malformations of the skeleton, liver and spleen, urogenital organs. Some children without developmental defects are often born with a small body weight and small growth, and later lag behind in physical development.
What should a pregnant woman do if she finds herself in a rubella center?
If the pregnant woman did not suffer from rubella, did not vaccinate and did not determine immunity to the rubella virus, but found herself in contact with an infected person, she must immediately contact an infectious disease specialist. To answer the question about the presence or absence of immunity to rubella, modern methods of investigation - the detection of antibodies of IgM and IgG classes allow.
Immunity to rubella
A person has rubella only once in his life. In this case, the body forms a stable immunity. Therefore, for the ill women (and their unborn children), this infection is not a danger. True, you can not be completely sure that a woman has immunity to rubella, based on the fact, that once in her childhood she was sick with this illness. This is due to the fact that the symptoms could well have been mistaken for rubella. At the same time, a woman could have recovered from a latent form of rubella, without manifesting normal symptoms. To verify the presence (or absence) of antibodies to the virus, it is necessary to conduct a laboratory examination.
If a woman does not have immunity to rubella, she will be offered vaccination to avoid the risk of infection. At what it is necessary to do this, at least three months before the onset of pregnancy. If in the house there is a patient with rubella, then it is too late to do the inoculation. Contraindications for vaccination against rubella
This vaccination should never be done during pregnancy, because the virus, even if weakened, it damages the fetus.
In addition, rubella vaccination can not be done for people with immune system disorders (in particular, leukemia, lymphoma, malignant diseases, congenital immunodeficiencies).
Also, vaccination is contraindicated for those who take corticosteroid drugs, subject to chemotherapy and radiation.
If a woman previously had an allergic reaction to taking the antibiotic "neomycin", then the vaccination is also not carried out. Another contraindication is an increase in body temperature to 38 А C. C.