Symptoms of rubella in children, diagnosis andtreatment

Update: October 2018

Rubella is an acute viral infectious disease.
etiology, affecting, as a rule, children. They have it proceeds
easy enough, when infected with older age danger
is that if a pregnant woman falls ill, then
increases the risk of fetal malformation and the risk of spontaneous

Thanks to active rubella prevention and vaccination development
the incidence is decreasing every year. About 90% of Europe’s population
vaccinated against this infection. Children are more likely to get this infection because
that with age, susceptibility to it decreases. By the age of 20
20–25% of people remain susceptible.

Historical facts:

  • 1740 – F. Hoffman first described this infectious
  • 1881 – it is allocated in a specific nosological form.
  • 1938 – viral nature was proven in Japan
  • 1941 – N. Gregg – described the symptoms of congenital rubella in
  • 1961 г. – выделен возбудитель diseases.

An infected person becomes contagious (contagious) in 7
days before the appearance of lesions on the body and remains so for 2-3 weeks
after the first signs of rubella. More common disease
It is registered in cities with large crowding, as this
creates a greater chance for contact with a sick person.

How is the virus transmitted?

Возбудителем является  Rubella virus, он относится к
togavirus The source of infection is a sick person or
carrier of the virus. The transmission path is airborne and

Children are susceptible to this virus at any age, but the most
often infection occurs between the ages of 2 and 12, if the child
not vaccinated. Infection at an earlier age is also possible. If a
the mother of the child has had rubella and the child is on the chest
being fed, he receives from the mother some antibodies against this
virus, but in this way it is impossible to form a long and
strong immunity therefore vaccination is necessary in any

До 50% взрослых сохраняют восприимчивость to Rubella virus.
Of particular importance is for pregnant women, since
infection during this period, there is a risk of having a baby with
congenital rubella syndrome.

The degree of risk depends on which trimester a woman is in.
got infected. In the first trimester, the risk is about 90%, in the second
– 50%, in the third – 100%.

Infection with the virus occurs most often through airborne droplets.
– with the saliva of a patient when he coughs, sneezes, kisses.
The contagiousness of the virus is quite high, but not always infection
occurs after one contact with the patient, provided that
the contact was not very long or close. Other transmission path
– vertical (from mother to fetus through the placenta).

After entering the body through the mucous membrane of the respiratory tract,
the virus begins to multiply in the lymph nodes. Then the virus
enters the bloodstream, at this stage ends the incubation
a period and a few days later clinical manifestations occur.
The immune system begins to actively produce antibodies to
pathogenic virus when their concentration becomes sufficient
for the death of all pathogens, comes recovery.

During the breeding period in the lymph nodes, the virus can
detect on the mucous membranes of the respiratory tract, after release
in the blood of viruses – in the blood. In the period of clinical manifestations of the virus
found in the urine and feces of the patient. In the outcome of the disease in
the blood of the virus ceases to be detected, since most of it dies
thanks to the immune system.

With инфицировании беременной женщины на ранних сроках поражение
Vasculars of the placenta viruses can cause fetal death. In more
late in the years, the fetus is infected and that causes him chronic
форму diseases. Such children are born with a congenital form.
diseases and are a source of infection for other people
after birth for many months.

Immunity is produced resistant and long lasting. Rarely
There are cases of re-infection.


Consider first the clinical manifestations of acquired rubella.
у children. Symptoms появляются остро среди полного здоровья. Behind
a few days before the doctor when you examine the child may be alerted
an increase in certain groups of lymph nodes (parotid,
occipital or posterior cervical).

Swollen lymph nodes is one of the first
symptoms of the disease, appearing before the appearance of a rash on the body. It
the whole period of rash and a few days after
cleansing the skin from rash. Sometimes the lymph nodes are enlarged.
so that are determined without palpation.

Among the manifestations of the disease may be common symptoms –
increase in body temperature to 38 ⁰C, headache, and therefore
the child becomes moody, loss of appetite, tachycardia,
nausea, rarely vomiting. There may be signs of mild conjunctivitis.
(conjunctival hyperemia). Older children may complain
pain in joints and muscles. 

Rash на коже (экзантема) появляются сначала на лице, шее и
ear hook area, then quickly spreads down the body.
This process is fast, so sometimes it seems that the rash
appeared simultaneously on the whole body. Greatest concentration
elements observed on the back, buttocks and extensor
surfaces of limbs. The rash may be all over the body, but in other
localizations it is more scarce. The rash does not usually itch.

An enanthema may appear – a rash on the mucous membrane

Externally, the elements of the rash are small, bright pink, rounded or
oval shape. The size of the items can be from the pinhead
up to 4 mm. How does the rubella rash in children look like in the photo.

The period of rash lasts 3-4 days, on the second day you can
note the blanching of the elements of the rash, then it is without a trace

In rare cases, there may be complications such as
thrombocytopenic purpura, otitis media, arthritis, pneumonia, extremely rare
– encephalitis.

Congenital rubella syndrome

If in the prenatal period the fetus does not die from infection
virus, then most likely, it will be born with different
developmental disabilities. What kind of vices this will be depends on the time
when the mother of the child fell ill with this infectious disease or
has become a virus carrier.

Infection from 4th to 7th week of pregnancy will lead to
heart defects.

On the period of 7-12 weeks of pregnancy, infection will lead to
deafness and / or blindness of the child.

During the entire period of up to 12 weeks, nervous
system of the fetus, so when infected during this period will
disturbances in the development of the brain.

After birth, children with this syndrome often have
characteristic symptom complex:

  • Low birth weight
  • Cataract
  • Deafness
  • Congenital heart disease (s)

There may also be impaired coordination due to lack of
vestibular apparatus. Deafness может быть односторонней или
two-way. It in turn affects the development of speech, such
children find it harder and longer to talk.

Such children may have malformations of the skeletal system, such
as “cleft palate”, clubfoot, joint dysplasia, osteoporosis. With
side of the nervous system can be hydrocephalus, microcephaly,
mental retardation. At an older age they form
pathology of the endocrine glands, they often suffer from diabetes.

Children with this syndrome have a high mortality rate, about 20% of them
die in the first 3-4 years of life.

Diagnosis of the disease

Collecting complaints, history of the disease and examination of the child. Laboratory

  • Complete blood count: lymphocytosis, increased ESR, increase
    plasma cell numbers.
  • RTGA: serum is examined at the height of the disease and through
    10 days if the concentration of detectable antibodies to Rubella virus
    significantly increased, the diagnosis is confirmed.
  • ELISA: allows you to identify antibodies in the blood
    to Rubella virus. Class M immunoglobulins talk about the acute phase
    diseases and the presence of the patient rubella. Class G immunoglobulins
    can stay forever and talk about having
    formed immunity or the availability of vaccination from this
    diseases. Long-term detection of IgM in the blood indicates
    congenital infection.

Differential diagnostics

Many childhood infections occur with similar clinical findings.
manifestations. Therefore, the question arises how to identify rubella
among a variety of similar diseases.

  • Measles. When measles is much more common symptoms
    intoxication. For measles there are pathognomonic spots
    Filatov-Belsky on the oral mucosa. Rash
    on the skin appear simultaneously.
  • Scarlet fever. When scarlet fever rash smaller and is located
    mainly on the sides of the abdomen, chest and flexion
    surface of the limbs.
  • Infectious mononucleosis. With this disease, lymphatic
    the nodes increase very much, the liver also increases

Treatment of the disease

Treatment of rubella in children is usually symptomatic. With
fever given antipyretic, with severe rash or muscle
pains are prescribed antihistamines. In general, the flow
the disease is usually not severe, the acute period lasts 3-5 days.


The live attenuated vaccine has been used for over 40 years.
Immunity resulting from vaccination is identical.
immunity formed in a natural way.

In 1 year, children are vaccinated against rubella and a number of other
infections. Then, at 6 years old, revaccination is performed. With отсутствии
Contraindications vaccination do necessary! Despite
relatively favorable course of the disease may be
its complications. And for girls in the future is dangerous infection
rubella during pregnancy.

Vaccination – это забота о своем ребенке и его будущем.

Side effects are very rare, manifested in the form of
redness at the injection site, a slight rise in temperature or
small amount of skin rash. During the mass
immunization with the introduction of 250 million vaccines, complications revealed no
It was.

Frequently asked questions by parents

  • Can I bathe the baby? In the period of temperature rise bathe
    child can not. If there is no temperature, then bathing is possible.
  • Is it possible to walk? Since the child is the whole period of rash and
    some time after it remains infectious, you can not walk. Also
    during this period, the child can easily get respiratory
  • Do I need a vaccination or can I do without it? Vaccination
    mandatory in the absence of contraindications.

Автор: Ревус Олеся Григорьевна врач-невролог

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