Update: November 2018
Rubella is an infectious disease caused by the same
a virus. The name itself comes from a picture of a red rash –
the main symptom of this disease. It used to be called German
short-term measles or three-day measles
Rubella is traditionally a childhood infection. But unvaccinated adults
can also be infected, with rubella
adults are much harder than children.
This infection is especially dangerous for pregnant women.
Intrauterine infection of the fetus occurs in 90% of cases.
There is no specific treatment for this disease. Protect from
infection can only vaccine.
How is rubella infected?
The disease spreads through airborne droplets. That is a virus
can get on the mucous membranes of the mouth and nose when inhaling small particles
saliva or mucus of a sick person.
Инкубационный период у краснухи – от 11 до 22
дней. That is, during this time the virus multiplies in
body, but so far does not manifest itself.
Particularly high probability of isolation of the virus from the patient:
- at the end of the incubation period, that is, when the rash is still
- during the rash and
- persists for 5-7 days after the disappearance of the rash.
Infection occurs only with sufficiently close contact,
rubella is less contagious than measles. Usually outbreaks of rubella occur.
in children’s groups. Adults are infected mainly from their
children. Most often among adults, young people under 30 fall ill.
After contact with mucous membranes, the infection is absorbed by
blood and lymphatic vessels.
Most often not vaccinated adults
The proportion of adults among all rubella cases is 22%.
Adults sometimes get this infection, despite the fact that
had it in childhood. But mostly sick unvaccinated. Periods
The rise in incidence occurs once every 3-5 years.
Since 2000, after the introduction of compulsory vaccinations, the incidence
began to decline markedly. Currently, the frequency of its detection
less than 1 case per 100 thousand population (for comparison, in 2006 this
the figure was over 500). However, in 2016 there was an outbreak
rubella in the Yaroslavl region (23 cases), with almost all
ill – these were unvaccinated adults aged 25-39
Symptoms of rubella
Rubella usually affects children under 6 and is not for them.
serious infection. Most children have its course
mild, with mild symptoms and moderate rash. Another thing –
rubella in adults, the symptoms are much worse. During
diseases distinguish the following periods:
Зуда при сыпи not, она может сливаться на сгибах рук и ног
Incubation. This is the time from virus hit to
manifestations of the disease. Duration usually 2-3 weeks. Symptoms
not, но выделение вируса в окружающую среду уже возможно.
Initial stage (prodromal period). This time of illness
before the rash appears.
- A few days before the rash increases lymphatic
knots. Usually it is zaushny, cervical, but may be axillary,
inguinal. They are felt under the skin in the form of painful mobility.
seals size 1-2 cm
- Sore throat, runny nose.
- Tearing, redness of the eyes.
- Muscle pain.
- There may be pain and even swelling of the joints.
- Weakness, lethargy, loss of appetite.
- Increased body temperature.
Rubella rash in adults
- Rubella rash in adults ярче и обильнее, чем у children. She is
It manifests itself as an oval-shaped spot from pale pink to
bright red color, not towering over the skin. Unlike
children, the rash appears almost at once all over the body and keeps
up to 5 days, accompanied by high temperature (up to 39 degrees).
The rash is brighter and more abundant on the extensor surfaces of the arms and legs,
here it can merge. Itching is usually not characteristic.
- Enlarged liver and spleen, which can manifest pulling
pains in hypochondria.
- Women may have polyarthritis – swelling and stiffness in
joints, lasting up to 2 weeks.
Period of permission. The rash passes without a trace, without peeling.
The temperature is dropping. Catarrhal phenomena in the nose and
throat But virus isolation can last up to 2 weeks.
Differences in the course of rubella in children and adults
|Severe muscle pain, fever, weakness,
sore throat, tearing
Pale pink, non-oily, appears first on the face and neck,
|Bright, abundant, can merge into a continuous redness,
appears immediately throughout the body, lasts up to 5 days, with a high
Prevailing light forms, often – erased, without rash
|Forms of moderate severity and severe occur 8 times more often than in
|Often, arthritis, meningoencephalitis, otitis media, bleeding|
The clinical picture of rubella is very typical and difficult to confuse.
with other infections. Previously, the diagnosis was made only on the basis of
But now, since this disease has become very common
rarely, and the task is to eliminate it completely, any case of it
must be confirmed.
The main methods of laboratory confirmation:
- virus detection by PCR in the mucous membrane scraping and
- detection of class M antibodies in paired sera by ELISA, or
the same increase in the titer of antibodies of class G in the second analysis.
When do rubella vaccination
Rubella in pregnant women
The infection is especially dangerous for women in the early stages.
of pregnancy. The virus easily penetrates the placenta. Intrauterine
infection occurs in 90% of cases, causing congenital syndrome
Infants infected in the womb may be born with congenital
deformities – cataracts, deafness, brain defects, defects
heart, enlarged liver and spleen.
If a pregnant woman has been in contact with a sick rubella, her
It must be remembered that the signs of rubella in adults, including
числе и у беременных, могут быть стертыми или отсутствовать
altogether. Pregnant women must take blood for antibodies Ig G and
Ig M immediately after receiving the contact information and through
10-14 days (paired sera method). Ig G is a consequence
rubella of unknown age or is it immune
after vaccination. Ig M is evidence of a “fresh” infection, with their
обнаружении в крови беременную предупреждают о возможном
infection and risk to the fetus.
Abortion is strongly recommended if
infection occurred in the early stages (4-6 weeks).
Специфического лечения краснухи ни у children, ни у взрослых не
held. The main task – isolation of the patient and removal
Rubella can be treated at home; only severe ones are hospitalized.
uniforms, patients from dormitories and barracks.
- The patient is isolated in a separate room for at least
of the week. Any contacts are undesirable, especially dangerous contacts
- You need plenty of drink – water, tea, juices, fruit drinks.
- Paracetamol is used to reduce the temperature.
- If itching bothers you can take antihistamines.
tavegil, suprastin, diazolin.
- Washing in the shower is not contraindicated, rubbing the skin with no washcloth
- An introduction may be given to pregnant women.
immunoglobulin, however, this does not prevent infection
The only method of prevention is live vaccination.
vaccine. Since 1997, rubella vaccination has been
обязательной для всех children. At first it was performed once, with
2002 – twice. The vaccine is administered at the age of one year and 6
years old. The effectiveness of double immunization 96% immunity
сохраняется до 20 years old.
At age 13, girls who have not been vaccinated before are vaccinated.
Обязательными являются также прививки для женщин 18-25 years old.
In addition, it is now recommended to vaccinate women of childbearing
age planning pregnancy, not previously vaccinated and not ill
rubella. After vaccination is not recommended to become pregnant for
of the month.
Rubella vaccination in adults is also given to employees.
medical institutions, recruits, employees of children
Do not refuse vaccinations. Remember: adults now
болеют краснухой чаще children только потому, что не получали прививку