Rubella children born with the syndrome. congenital rubella

The content of the article

Rubella- an acute infectious disease caused by the rubella virus, transmitted by airborne droplets, characterized by moderate intoxication, minor catarrhal inflammation of the mucous membranes of the eyes and nose, exanthema, generalized lymphadenopathy, mainly of the occipital lymph nodes.

Historical rubella data

Rubella was not distinguished from measles and scarlet fever for a long time. In 1829 p. Wagner described it as a separate disease, but officially as a nosological form, it was isolated in 1881 in England. Rubella attracted close attention only in 1942, when N. Gregg described various anomalies of the fetus due to its intrauterine infection. The rubella virus was isolated simultaneously in 1961 p. P. Parkman et al. and T. Weller et al.

Etiology of rubella

. Rubella virus (Rubivirus) belongs to the genus Rubivirus, family Togaviridae. Its size is 60-70 nm, it contains RNA, neuraminidase, hemagglutination and complement-fixing antigens. One antigenic type of virus is known. Cultivated in primary human amnion cell culture, rabbit kidney cell culture. In the external environment, the pathogen is unstable, sensitive to sunlight, thermolabile, quickly dies when dried, under the influence of UV radiation and disinfectants. When frozen, it retains its viability for several years.

Rubella epidemiology

The only source of infection is a sick person, contagious at the end of the incubation period and within 2-5 days after the onset of the rash. For one patient with obvious signs of the disease, there are two patients with subclinical forms. The latter are the most dangerous in epidemiological terms. In children with congenital rubella, the virus persists for 12–28 months, making them a source of infection for older children and non-immune adults, including pregnant women.
The mechanism of transmission of infection is airborne, it is also possible transplacental. Susceptibility to rubella is high, children of preschool and school age are more likely to get sick. In closed groups, for example, in boarding schools, up to 100% of susceptible persons get sick, at home - 50-60% of susceptible family members. Children under the age of 6 months avoid this disease, since most of them have immunity inherited from their mother. The maximum incidence is noted mainly in the winter-spring period.
The transferred illness leaves strong immunity.

Rubella pathogenesis and pathomorphology

The virus enters the body through the mucous membrane of the upper respiratory tract, multiplies in the lymph nodes, and 6-8 days after infection enters the bloodstream. The virus infects the vascular endothelium, causing their increased permeability, edema and hemodynamic disturbances in the tissues. In the clinic, this is manifested by catarrhal syndrome, intoxication. In the vascular endothelium of the surface layers of the skin, the virus causes a focal inflammatory reaction, which predetermines the appearance of a rash. 2-3 days after that, virus-neutralizing antibodies appear in the blood, which leads to the release of the body from the pathogen and the formation of intense and long-lasting immunity.
The rubella virus has a tropism for embryonic tissue. Its teratogenic effect is manifested in the form of local suppression of the mitotic activity of cells, which leads to a slowdown in their separation and disruption of the normal development of the body as a result. In the early stages of pregnancy, the virus causes various malformations of the embryo, depending on which organ develops in a given period: 2-9 weeks of pregnancy - hearing organ defects, 3-11 weeks - the brain, 4-7 weeks - heart, 4-10th week - organs of vision, 10-12th - hard palate similar. Thus, the most dangerous for the development of the fetus is the rooting of the virus in its tissue in the first trimester of pregnancy. In this case, a chronic infection develops, when cells divide, their infected clones are created with a significant number of damaged chromosomes, which leads to rapid cell death. Damage to fetal tissues is aggravated by hypoxia due to damage to the vessels of the placenta and hemodynamic disorders in it.

Rubella Clinic

The incubation period lasts 14-2.1 days, more often - 16-18 days. Prodromal signs - lethargy, minor runny nose and cough - often go unnoticed.
The body temperature is subfebrile, rarely rises to 38 ° C. The general condition of the patient hardly changes.
On the first day of illness, a rash appears - a characteristic sign of rubella, and sometimes its first symptoms. It appears on the face j within a few hours spreads without any sequence to the whole body and limbs. Its characteristic predominant localization is on the extensor surfaces of the limbs, back, buttocks. A rash of dribnoplemis, 2-4 mm in diameter, less often - maculopapular (in adults), pale pink in color, round or oval in shape, with clear contours, a smooth surface, against an unchanged skin background. The rash with rubella is smaller than with measles, there is no tendency to merge elements. Disappears in 1-3 days, leaving no pigmentation or peeling.
The pathognomonic for rubella is an increase in all peripheral lymph nodes, especially the occipital, behind the ear and posterior cervical. Not a single disease is supported by such a significant increase, induration and often soreness of these groups of nodes. They increase no later than 24 hours before the rash on the skin. Swelling of the lymph nodes is the first longest symptom of rubella, as it persists for 2-3 weeks after the rash has disappeared, and sometimes longer. Any correspondence between the intensity of the rash and lymphadenitis is not observed. Lymphadenitis is a constant sign of rubella, but there may not be a rash.
At the height of the disease, signs of catarrh of the upper respiratory tract are possible in the form of a slight runny nose and conjunctivitis. Unlike measles, there is no photophobia, most rubella patients have enanthema - separate pink spots on the soft palate, some of them merge, move to the palatine arches and become dark red.
The course of rubella in children aged 2-14 years is the most typical and mild. Rubella in adults is also mostly typical, but it is more severe, with severe intoxication, fever. The rash is thicker, maculopapular, sometimes with a tendency to merge, especially on the back and buttocks. The duration of the rash period is 2-5 days. More pronounced lymphadenitis.
Atypical forms of rubella very varied. Sometimes it begins immediately with acne without any prodromal signs, variants of the course without an increase in body temperature or without a rash, and, finally, asymptomatic (inaparant) forms that are diagnosed only on the basis of laboratory data.
Changes in the blood with rubella are of diagnostic value. In the period of rashes, leukopenia, neutropenia, relative lymphocytosis, monocytosis (up to 20% and above) and the presence of plasma cells and Turk cells are observed, the total number of which can reach 10-25% and correlates with the degree of lymphadenopathy. The combination of such changes in the blood with lymphadenopathy is a diagnostic sign of rubella.
congenital rubella. In the case of a pregnant woman with rubella in a manifest or asymptomatic, subclinical (inparant) form, the risk of developing fetal anomalies is 100% if it is infected in the first weeks of pregnancy, 40% - in the 2nd month, 10% - in the 3rd month, 4 % - In II and III trimesters.
The teratogenic effect of the virus during the laying of organs leads to the development of various embryopathies. The syndrome of congenital rubella manifests itself in the form of a triad of predominant anomalies - cataracts, heart defects and deafness. This syndrome was described in 1941 by the Australian ophthalmologist N. Gregg. Later, microophthalmia, malocclusion, craniocerebral deformities (microcephaly, hydrocephalus), encephalopathy were attributed to these anomalies. In 40% of cases, fetal death and spontaneous abortion are observed.
If infection of pregnant women occurs after the completion of organogenesis, fetoiatia develops (anemia, thrombocytopenic purpura, hepatitis, damage to bones, lungs, etc.).
Separate developmental defects caused by the virus may appear in a later period. However, damage to some organs in the first days of life is not always possible to diagnose (deafness, retinopathy, glaucoma). Damage to the fetal brain leads to the development of chronic meningoencephalitis, but its clinical manifestations in a newborn are mild in the form of drowsiness, weakness, or, conversely, increased excitability, convulsions. In the future, the child manifests microcephaly.
Early neonatal signs of congenital rubella include profuse hemorrhagic rash on the background of thrombocytopenia, contained for 1-2 weeks, hemolytic anemia with reticulocytosis, hepatosplenomegaly, hepatitis with high hyperbilirubinemia, interstitial pneumonia. Most of these changes disappear within six months of a child's life. Children with congenital rubella have low body weight and short stature at birth, and they may lag behind in physical and mental development.
Complications are rare. Rubella is characterized by arthropathy, which is manifested by pain in the joints, and in some cases - swelling, redness of the skin in the joints, intra-articular effusion. Usually the small joints of the hands are affected, less often the knee and elbow joints. The course of arthropathy is benign, does not require additional medical treatment.
Encephalitis and meningoencephalitis are rare but very severe complications; lethality is 15-20%. Clinically, rubella encephalitis is characterized by an increase in body temperature on the 3rd-6th day of illness with headache, vomiting, pathological reflexes, various focal symptoms, impaired consciousness, and meningeal syndrome.
The prognosis is favorable. In congenital forms, it depends on the severity of the process. Mortality among children with rubella-associated thrombocytopenic purpura reaches 35% in the first 18 months of life. However, in most cases, death from congenital rubella occurs due to sepsis, pathology of the heart and brain.

rubella diagnosis

The main symptoms of the clinical diagnosis of rubella are pink, rounded (oval), with clear edges, a rash all over the body with predominant localization on the extensor surfaces, which appears on the first day of the disease against a normal background of the skin, polyadenitis with a predominant increase and often soreness of the occipital and posterior lymph nodes. Epidemiological data are of great importance.
Specific Diagnosis consists in the isolation of the pathogen from the blood, nasopharyngeal swabs, urine in the first 5-7 days of illness. Virological studies are complex, therefore, in practice, serological methods are more often used - ROG A, RSK, RN. The simplest and most convenient for practical use is RTGA. A 4-fold increase in antibody titre during the study of paired blood sera obtained from a patient with an interval of 10 days is considered a reliable confirmation of the diagnosis. The diagnosis of congenital rubella is confirmed by the detection of IgM antibodies in the blood.

Rubella differential diagnosis

Rubella should be differentiated primarily from measles, as well as from enterovirus exanthema, rash due to medication, infectious mononucleosis, infectious erythema, scarlet fever.
Measles differs from rubella in the presence of a clear catarrhal period, more pronounced fever, the presence of Belsky-Filatov-Koplik spots, the staging of the onset of a maculopapular rash with a tendency to merge and pigmentation after it fades. In the differential diagnosis of rubella with a rash due to drug intake, enteroviral exanthema is helped by studies of peripheral lymph nodes, an epidemiological history and information about the occurrence of a rash immediately after taking drugs. Infectious mononucleosis in the case of a course with acne is characterized by the presence of acute tonsillitis, hepatosplenomegaly, and characteristic changes in the blood along with polyadenopathy. Scarlet fever is distinguished from rubella by a punctate roseolous rash on a hyperemic background of the skin with a predominant localization on the flexion surfaces, the presence of significant fever, acute tonsillitis, symptoms of Filatov, Pastia, etc.

Rubella treatment

Patients with rubella are recommended bed rest during the rash. Medicines are not used in most cases. Only with a significant Intoxication and profuse rashes are prescribed mainly symptomatic drugs - ascorutin, analgesics, cardiac drugs according to indications.

Rubella prevention

Patients are isolated at home for 5 days from the moment of rash. Disinfection is not carried out. Quarantine is not established. Pregnant women who have not previously had rubella should be kept away from contact with patients for at least three weeks. The issue of mass vaccination against rubella in our country has not been finally resolved, although there is a domestic live vaccine.
For practice, it is important to resolve the issue of terminating a pregnancy with rubella in its first trimester. In case of contact of a pregnant woman with a patient, repeated serological studies are required at intervals of 10-20 days to identify an asymptomatic form of the disease. The use of immunoglobulin for the prevention of rubella in pregnant women is ineffective.

- a viral disease transmitted from an infected mother to a child in the prenatal period. Infection of a woman occurs during pregnancy or before it. The disease is manifested by multiple internal malformations and defects in the development of the fetus, mainly damage to the organs of vision and hearing, as well as the cardiovascular and nervous systems. In most cases, it manifests itself from the first days of life, but later detection of symptoms is also possible. It is diagnosed from the moment of birth by special laboratory tests and clinically (according to the above symptoms). There is no specific treatment, interferon and symptomatic therapy are used.

General information

congenital rubella- contagious disease. This means that the child who pediatrician made such a diagnosis, can transmit the virus to others. The disease got its name in 1740 from one of the common symptoms - thrombocytopenic purpura. F. Hoffman was the first doctor to describe the disease. However, more than two hundred years passed before congenital rubella began to cause serious concern, since it was in the second half of the twentieth century that the causative agent of the infection was identified. At the same time, a connection was found between a woman's illness during pregnancy and pathologies of the newborn.

Among other features, the high prevalence of infection in countries with a temperate climate and seasonality should be noted. The peak incidence occurs in spring and autumn. Major epidemics occur every 6-9 years, with a higher incidence among the unvaccinated population. For this reason pediatrics is the first and most important clinical discipline in the prevention of congenital rubella. It is in the first years of life that children receive the rubella vaccine, which makes it possible to avoid infection in adulthood, in particular, during pregnancy in women.

Statistics show that congenital rubella accounts for up to 10% of all congenital pathologies. When a woman and fetus are infected in the first weeks of pregnancy spontaneous abortion happens in 40% of cases. In 75% of cases, multiple organ lesions (two or more defects) are noted. Recent statistics indicate that the incidence is steadily increasing.

Causes of congenital rubella

The only cause of infection is the rubella virus, isolated by American scientists in 1961. It is an RNA virus and belongs to the Togavirus family. Infection occurs in the prenatal period, when the pathogen from an infected mother passes through the vessels of the placenta, entering the blood of the fetus. The risk of infection depends on when the expectant mother fell ill. If a woman suffers an infection in the first trimester of pregnancy, then in 60-90% of cases, the child will be diagnosed with congenital rubella. In the second trimester, the risk decreases to 10-20% of cases. Towards the end of pregnancy, the risk of infection of the fetus increases again due to the weakening of the placental barrier. Women who have not been vaccinated before are at greater risk.

Passing through the vessels of the placenta, the causative agent of congenital rubella enters the blood of the fetus, where it has a teratogenic effect. It acts directly on the genetic apparatus of the cell (chromosomes), slowing down the growth and development of organs, which is why multiple malformations are associated. Along the way, the virus destroys the small vessels of the placenta, which leads to a deterioration in placental blood flow. Lack of proper nutrition and chronic fetal hypoxia also contribute to slowing down the development of the child. In the lens of the eye and the cochlea of ​​the inner ear, the virus has a direct cytodestructive effect, that is, it destroys cells. The earlier the infection occurred, the more serious the symptoms of congenital rubella will be, since it is in the first weeks of pregnancy that the laying of the main systems occurs: first the organs of vision, then the organs of hearing, the cardiovascular and nervous systems, etc.

Symptoms of congenital rubella

Back in 1942, N. Gregg identified three main signs of congenital rubella: damage to the organs of vision (most often congenital cataract), deafness and heart defects. Symptoms are usually observed immediately after the birth of a child, less often congenital rubella manifests itself after a few years. It's about mental retardation. The severity of clinical manifestations depends on the gestational age at which the infection occurred. Therefore, in practice, the classical triad of N. Gregg's symptoms does not always take place, and if they are presented in the aggregate, then the violations may not be so gross.

Among congenital heart defects often there is damage to the aortic valve, aortic stenosis, atrial and interventricular septal defects. This causes severe circulatory failure, due to which all internal organs are underdeveloped to one degree or another. Nervous system damage can be microcephaly , hydrocephalus, there are cases of meningoencephalitis, paralysis and convulsions, impaired consciousness. Cataract , glaucoma, microphthalmia is most likely when infection occurs during the first weeks of pregnancy. Skeletal malformations, such as osteoporosis , hip dysplasia , syndactyly. Malformations of the genitourinary and digestive systems are less common.

The main symptoms of congenital rubella also include thrombocytopenic purpura, the cause of which is vascular disorders and changes in the blood of a sick child. Visually, purpura looks like a bright red rash all over the baby's body. The rash usually resolves without treatment within a couple of weeks after birth. A nonspecific symptom is prolonged neonatal jaundice associated with insufficient development of internal organs and the inability to utilize excess bilirubin in the blood, as is normal. Outwardly, the newborn usually looks slightly inhibited. This is primarily due to damage to the visual and auditory apparatus, but neurological disorders also play a role here.

The outcome of the disease directly depends on its severity. In severe cases, the life expectancy of sick children is several years. As a rule, malformations of the heart and blood vessels (stenosis of the aorta and pulmonary artery, open ductus arteriosus), microcephaly, hydrocephalus, meningoencephalitis, hepatitis, bone disease, severe thrombocytopenia, the addition of various infections due to low immunity, etc. Congenital rubella is considered completely cured when the virus is no longer detected in the blood. After the disease, a strong immunity is formed.

Diagnosis of congenital rubella

The first stage is early prenatal diagnosis, that is, the detection of a disease in a pregnant woman. This is done by an infectious disease specialist and an obstetrician-gynecologist who observes a woman during pregnancy. Once the diagnosis is confirmed, the likelihood of a child developing congenital rubella can be assessed. The expectant mother has the opportunity to make an informed decision about carrying a child or artificial termination of pregnancy for all medical indications. The risk of developing the disease in a child depends on the duration of pregnancy and reaches 60-90% in the first trimester.

After childbirth, congenital rubella is pre-diagnosed clinically, that is, according to the main symptoms. Doctors pay attention to the simultaneous damage to the organs of vision and hearing. First, during the physical examination neonatologist will find that the baby does not react to bright lights in the delivery room and does not turn his head towards the source of the sound. You can also immediately suspect heart defects. Sometimes neurological signs are externally noted: muscle tone disorders, microcephaly, hydrocephalus, symptoms of meningism, etc. A bright red rash is noticeable from the first days of life.

Congenital rubella is confirmed by laboratory tests. The diagnosis is considered reliable after the detection of specific IgM antibodies in body fluids: urine, blood, cerebrospinal fluid. Most often, urine and a smear from the nasopharynx are analyzed. ELISA diagnostics allows to detect antibodies. Laboratory tests help distinguish congenital rubella from many diseases with similar symptoms, such as cytomegalovirus infection , toxoplasmosis, Epstein-Barr virus and some others.

Rehabilitation measures are aimed at compensating or eliminating concomitant diseases of internal organs. Heart defects are most often operable and correctable. Hearing and visual impairments are eliminated as much as possible. Intrauterine brain damage is not treatable, the doctor can only correct intracranial pressure, convulsions, if any, but a complete cure is impossible. These measures can significantly improve the quality of life of a sick child. At the same time, social adaptation is also carried out, since the transferred congenital rubella makes the child disabled, and also affects his mental development.

Forecast and prevention of congenital rubella

The prognosis depends entirely on the severity of the disease, which is determined by the duration of infection of the fetus and the symptoms present. In severe cases, life expectancy is several years. If the organs of vision and hearing are little affected, in the future, congenital rubella will manifest itself only as a developmental delay and neurological disorders.

Prevention is closely related to the early diagnosis of rubella in a pregnant woman. In the first trimester, it is recommended to terminate the pregnancy due to the high risk of infection of the fetus and the most severe clinical manifestations in case of infection. Mortality among these children remains high. Another effective way to prevent congenital rubella is vaccination. In children, it is carried out in the first years of life. Rubella vaccination is mandatory in the National Immunization Schedule. For adults, especially women of reproductive age, booster immunization is recommended every 10 years.

Rubella in children is a viral disease with an acute course, typically with generalized exanthema. Congenital rubella syndrome - congenital malformations in a child caused by infection with the rubella virus in the first half of pregnancy.

For the first time, children's rubella was described in 1740 by the German therapist F. Hoffmann. In 1881, the disease was officially separated into a separate nosological form. In 1938, Japanese researchers proved the viral nature of the infection by infecting volunteers with nasopharyngeal discharge filtrate.

The causative agent of rubella was isolated in 1961 by several scientists almost simultaneously: P. D. Parkman, T. X. Weller and F. A. Neva. In 1941, the Austrian researcher N. Gregg described various anomalies of the fetus in connection with its intrauterine infection with the rubella virus during an illness of a pregnant mother.

  1. Etiological factor: rubella virus; the entrance gate of infection is the upper respiratory tract; penetrates into regional lymph nodes where replication takes place; causes viremia and can infect most cells and tissues (eg, lymphocytes, monocytes, conjunctiva, synovial membranes, cervix, placenta);
  2. Carrier and transmission routes: Humans are the only carriers; the infection is transmitted mainly by airborne droplets, also through direct contact with contaminated material (mainly secretions of the upper respiratory tract, also urine, blood, feces) and through the placenta (congenital infection);
  3. The incubation period and the period of contagiousness: the incubation period is 12-23 days (usually 16-18); high contagiousness with prolonged or frequent contact with the patient (also in asymptomatic cases) from 7 days before and up to 6 days after the onset of the rash.

Childhood rubella virus

Infection of the fetus occurs during the period of primary viremia in a pregnant woman - the risk is 85-100%, if the rash in a pregnant woman during the first 12 weeks of pregnancy, 54% - from 13 to 16 weeks, 25% from 17 to 22 weeks. The risk of fetal infection during reinfection exists but is very low.

Children with congenital rubella syndrome shed the virus in the urine and through the respiratory tract for a very long time, even > 12 months (50% up to 6 months, some up to 2 years).

Often the infection is asymptomatic or oligosymptomatic. In other cases, the symptoms of rubella appear gradually (not all of them should develop).

This text was stolen from the site
  1. Prodromal symptoms (lasting several days): feeling unwell, headache and muscle pain, pharyngitis, rhinitis, dry cough, conjunctivitis (without photophobia), low fever, loss of appetite;
  2. Soreness and enlargement of the lymph nodes (posterior cervical, occipital, behind the ear, cervical): appears 1 day before the onset of the rash and may be the only symptom of infection; may persist for several weeks;
  3. Period of rash: spotty or maculopapular, pink rash of variable nature; first on the face (usually first behind the ears) and torso, after 1-2 days on the limbs; on the face they resemble rashes with measles (elements merge), but also captures the skin between the folds of the cheeks (Filatov's triangle), on the body it is more similar to a scarlatinal rash. May be accompanied by itching. Passes in 2-3 days, does not leave pigmentation, slight peeling of the skin may appear;
  4. Others (less common): splenomegaly, pharyngitis, red spots on the soft palate, transient hepatitis.

congenital rubella in a child

Symptoms depend on the week of pregnancy in which the infection occurred:

1) infection in the first weeks; fetal death and miscarriage;
2) infection in the II or III trimester; numerous congenital malformations (the earlier the infection, the more significant the changes, up to and including the death of the fetus);
3) infection after 22 weeks. pregnancy is not dangerous for the fetus.

Diagnosis of rubella in children

Diagnosis of rubella based on the clinical picture very inaccurate, but in most cases no further testing is needed. The diagnosis of rubella in a person who has previously been vaccinated, even with 1 dose, is unlikely.

Ancillary studies are indicated in pregnant women and in cases of suspected congenital rubella.
1. Serological studies (ELISA, indirect immunofluorescence) - the main method for confirming acquired infection, has epidemiological significance:

1) specific antibodies against the rubella virus of the IgM class in the blood serum (false positive results occur) - appear on the 2nd day of the rash, persist for 1 month, reappear during reinfection;
2) >4-fold increase in the titer of specific IgG class antibodies in serum with an interval of 2-4 weeks; a stable concentration of IgG indicates a past infection and developed immunity.

2. Isolation of the virus (cultivation) or its RNA (RT-PCR) from the pharynx (smear) or nasopharynx (wash), urine, blood or cerebrospinal fluid - auxiliary in the diagnosis of congenital rubella.

differential diagnosis.
Other diseases with generalized rashes:

1) infections - measles, scarlet fever, infection with enteroviruses, adenoviruses, parvovirus B19, EBV (EBV), mycoplasma;
2) non-communicable diseases - drug rashes, allergic rashes.

Treatment is exclusively symptomatic:

1) arthritis; NSAIDs;
2) clinically significant thrombocytopenia; prednisone (1 mg/kg body weight), platelet mass may be administered;
3) encephalitis.

  • Arthritis: more often in young people and adults, mainly in girls and young women (frequency 1-25%); appear towards the end of the period of rashes up to several weeks after the rash, especially the small joints of the palms and wrists are affected, less often the knees and others; symptoms persist for 5-10 days (rarely several weeks); passes spontaneously, without consequences.
  • Thrombocytopenic hemorrhagic diathesis(frequency<1/3000): сохраняется в течение нескольких дней (редко до 6 мес.), спонтанно проходит.
  • Encephalitis(frequency 1/5000): appears within 7 days of rash onset, prognosis is good, usually clears up within a week, mortality is low.
  • Others (rare): myocarditis, optic neuritis, Guillain-Barré syndrome, bone marrow aplasia.

Acquired rubella

With acquired rubella - favorable, in the vast majority of cases, after infection, immunity develops for life. In congenital rubella - unfavorable (mortality> 15%, psychophysical retardation, problems and other long-term consequences).

Rubella prevention

  • Vaccination- the main method of prevention
  • Passive immunization(globulin) - controversial, only in exceptional situations.

Non specific methods

  1. Patient isolation(especially from contact with women of childbearing age) in the case of acquired rubella - up to 7 days after the onset of the rash; in the case of congenital rubella - up to 12 months. or a 2x negative nasopharyngeal and urine virus isolation at >3 months of age; Children hospitalized for congenital cataracts should be considered potentially contagious up to 3 years of age.
  2. Serological screening unvaccinated young women (in the absence of medical records of vaccination) - if specific IgG antibodies are not detected; emergency vaccination.

Video: Rubella disease in children

Rubella in an infant can be congenital or acquired. A baby can become infected from a sick person through direct contact. The virus is transmitted by airborne droplets, as well as contact-household. The rubella virus is found in the mucous membranes of the upper respiratory tract, as well as in the skin. Reproduction and accumulation of infection occurs in the lymph nodes, and also spreads through the bloodstream. But infants are the least likely to get rubella from another person. If a mother is breastfeeding her child, and at the same time she had this disease before pregnancy, the baby receives the necessary antibodies through milk. The most common cause of this disease in a newborn baby is intrauterine infection. If the mother was infected with this virus during pregnancy, then there is a high probability of rubella in the baby.

Symptoms

If the baby was born with the presence of this virus in the body, then the following symptoms will appear:

  • Deafness;
  • Sluggish state of the child;
  • White pupil or cloudy cornea;
  • developmental delay;
  • Light body weight;
  • Epilepsy attacks and increased nervous excitability;
  • The small size of the head, and as a result - the brain;
  • Rash on the skin.

If a newborn baby becomes infected with rubella after birth, the signs of the disease will be different. The most pronounced symptom of an infection in the body is a rash on the surface. Initially, spots appear on the face, but over time, the body becomes covered with a rash. The sizes of the spots do not exceed 5 mm and are round in shape, and also do not merge like measles rashes. The rash is not extensive, and there may be some redness in certain areas of the body and face. In addition to the red rash, the baby shows other signs:

  • Increase in body temperature up to 38 degrees. But usually the temperature fluctuates between 37.3-37.6 degrees throughout the entire period of the disease.
  • Up to the size of a pea, the lymph nodes are enlarged, which are well palpable. They continue to be in this state after recovery and the disappearance of the rash for some time.
  • The oral mucosa becomes inflamed, the tonsils become loose. Small pale pink spots form on the mucous membrane of the soft palate.
  • There is a runny nose and dry cough, but minor. Runny nose and cough may appear 1-2 days before the rash appears
  • The appearance of conjunctivitis and increased lacrimation. Conjunctivitis is mild, without the appearance of purulent discharge;
  • The baby feels unwell, eats and sleeps poorly.

Diagnosis of rubella in a newborn

Rubella can be diagnosed with the help of tests and examination of the baby. A blood test is taken from a baby with suspicion of congenital and acquired rubella. In the presence of the virus in the blood, there is a decrease in leukocytes and the appearance of plasma cells. In addition to tests, rubella can be determined by external signs and general symptoms. Therefore, the doctor can easily recognize the presence of infection in the baby's body and make a diagnosis.

Complications

Congenital rubella is dangerous for many severe consequences of the development of the child's body. Due to the virus, there is a violation in the development of many organs, including the central nervous and cardiovascular systems. Complications in infants who become infected with rubella after birth are very rare. As a complication, rubella encephalitis, an inflammation of the brain, can occur. The most rare occurrence is thrombocytopenic purpura. This is increased bleeding in the body due to a decrease in the number of platelets.

Treatment

What can you do

The first aid that a mother can provide if a newborn child is suspected of being infected with rubella is to call a doctor. But if the temperature rises above 38-38.5 degrees, it is necessary to give the baby an antipyretic. The main treatment is prescribed by the doctor after examination and obtaining the results of the tests. With a mild course of the disease, hospitalization of the infant is not required. For a newborn infected with a virus, a sufficient intake of fluid into the body is necessary, which must be provided by the mother. When breastfeeding, milk is a good substitute for water, so the mother can feed the baby more often than usual.

What does a doctor do

The main treatment for congenital rubella is currently not fully developed. Doctors prescribe therapy using drugs containing recombinant interferon. In addition, doctors with the help of various medications restore the functioning of the affected organs of the baby. For infants who were infected with rubella in utero, regular examinations by doctors of various specializations are necessary. For children who become infected with rubella after birth, complex treatment is prescribed to eliminate symptoms. Antihistamines, antipyretic drugs are prescribed. To reduce the lymph nodes, the infant must undergo a course of UHF therapy. If necessary, the doctor may prescribe the intake of vitamin complexes.

Prevention

To prevent congenital rubella in a baby, the expectant mother needs to be vaccinated before pregnancy. If vaccination has not been carried out, then she needs to be in crowded places as little as possible, wash her hands more often. A healthy newborn baby must be protected from infection in the same way. Since the rubella vaccine is given after 1 year, until this time it is necessary to monitor the environment of the baby. If someone in the family has contracted the virus, it is necessary to protect the baby from communicating with this person until he fully recovers. And household items through which a baby can become infected should preferably be treated with hydrogen peroxide.