Rash virus, the virus exists in saliva and blood of sick children 5 ~ 7 days before rash, but rash 2.
Tianhou is hard to find. Rubella virus has weak viability in vitro, but it is as infectious as measles.
Strong. It is usually spread by coughing, talking or sneezing. This disease is more common in 1 ~ 5 years old children, 6
Babies who gain resistance from their mothers within a few months rarely get sick. Get it at once
Disease, lifelong immunity, rarely reoccurring.
It takes 14 ~ 2 1 day for rubella to develop symptoms from contact infection. Symptoms at the beginning of 1 ~ 2 days
Very mild, low or moderate fever, slight cough, fatigue, loss of appetite, sore throat and eye pain.
Redness and other mild upper respiratory symptoms. The patient's oral mucosa is smooth, without congestion and mucosal spots, while the ear
Posterior and occipital lymph nodes are swollen with mild tenderness. Rash usually appears after 1 ~ 2 days of fever.
The rash starts on the face and neck and spreads to the whole body within 24 hours. The rash started with sparse erythema.
The papules and rashes on the face and limbs can be fused, similar to measles. The day after the volcano erupted,
Rashes on the face and limbs can turn into needle-like red spots, such as scarlet fever rash. Rash usually occurs at the age of 3.
It quickly subsided within a day, leaving a shallow pigmentation. During the eruption period, the body temperature no longer rises, which is common in sick children.
Do not feel sick, eat and play as usual. Rubella is different from measles. Rubella has mild systemic symptoms and no symptoms.
Measles mucosal plaque with swollen lymph nodes behind the ear and neck.
Rubella has a good course of disease, a good prognosis and few complications, but pregnant women (early pregnancy within 4 months)
After being infected with rubella virus, the virus can be transmitted to the fetus through the placenta to cause congenital rubella.
Congenital malformations, such as blindness, congenital heart disease, deafness and microcephaly, occur. Therefore,
Pregnant women should avoid contact with rubella patients as much as possible in the early pregnancy, and should be vaccinated with live attenuated rubella vaccine.
Miao. If rubella occurs, consider terminating the pregnancy.
Patients should be isolated in time until 1 week after eruption. The patient should stay in bed.
Give vitamins and nutritious and digestible foods, such as minced vegetables, minced meat and rice porridge. Pay attention to the skin
Clean and hygienic, secondary bacterial infection. Rubella has few complications. Once bronchitis and lung disease occur,
Complications such as inflammation, otitis media or meningoencephalitis should be treated in time.
Strengthen the medical observation of close contacts, pay attention to rash and fever, so as to facilitate the early detection of diseases.
People. During the incubation period, the contact classes in kindergartens should be isolated from other classes and not accept new students.
Health, prevent transmission.
Rubella is a viral infectious disease, and its clinical characteristics are: mild systemic symptoms, red maculopapules on the skin, swollen lymph nodes behind the pillow, behind the ear and behind the neck with tenderness, and rare complications. After pregnant women are infected with rubella in the first trimester, the virus can spread to the fetus through the placenta and cause various congenital defects, which is called congenital rubella syndrome.
The cause of disease
Rubella virus belongs to Lepidoptera virus family, with only one serotype. The virus is spherical, with a diameter of 50~70nm, and has hemagglutinin (h a) on its envelope, which can agglutinate pigeon, goose, chicken red blood cells and human O-type red blood cells. Rubella virus is not heat-resistant, and it is quickly inactivated at room temperature of 37℃. -20℃ can be stored for a short time, and -60℃ can be relatively stable for several months. Viruses can be found in nasopharyngeal secretions 7 days before eruption and 7~8 days after eruption.
epidemiology
Human is the only natural host of rubella virus, which spreads through droplets and is most contagious in the days before, during and after the eruption. In addition to nasopharyngeal secretions, viruses also exist in blood, feces and urine, and subclinical patients are also contagious. Most cases occur in winter and spring, especially in children aged 1 ~ 5, and the incidence rate of male and female is equal. The mother's antibody can protect the baby from getting sick for 6 months. After the vaccine was widely used, the incidence rate decreased and the age of onset increased. Mother's first infection during pregnancy can cause fetal intrauterine sensation, and its incidence and teratogenic rate are closely related to the gestational age at the time of infection, especially in the first trimester. Children with congenital rubella still have virus excretion within a few months after birth, which is contagious.
clinical picture
(1) Acquired rubella
1, and the incubation period is generally 14~2 1 day.
2. the precursor period is short, mostly only l~3 days. There are low fever and catarrh symptoms, most of which are mild, and they are often ignored because of their mild symptoms or short time.
3. The typical clinical manifestations of eruption stage are swelling of lymph nodes behind ears, occipital region and neck with tenderness, which lasts about 1 week; 24 hours after lymph node enlargement, a rash appears, which is polymorphic, mostly scattered in maculopapular rash, or a large skin redness or needle-like scarlet fever rash, starting from the face, spreading all over the neck, trunk, arms and finally to the feet within 24 hours; Often the facial rash subsides, and there is a rash on the lower limbs, which generally lasts for 3 days and rarely peels off after seeing a doctor. At the end of prodromal stage and the beginning of eruption, red punctate mucosal rash can be seen in soft palate, which is similar to that caused by other virus infections and has no specificity. Rash may be accompanied by low fever, lasting 1~3 days, and mild splenomegaly is common. Young women have polyarthritis when they have a rash or within a few days after it, which is often symmetrical. The proximal phalangeal joint is most commonly involved, and the order is metacarpophalangeal joint, wrist, knee, ankle, foot, shoulder and spinal joint. It is characterized by local redness, pain, tenderness and exudation, lasting for several days to two weeks, with few sequelae. In addition, there are reports of paresthesia and testicular pain.
4. Complications Rubella rarely has complications, and its clinical manifestations are mainly respiratory infection; Pneumonia, post-infection encephalitis and thrombocytopenic purpura occasionally occurred in the eruption period, and the prognosis was good.
(2) Congenital rubella syndrome Rubella virus can cause fetal damage by inhibiting cell mitosis, cytolysis and placental villitis, which can produce: ① transient neonatal manifestations; ② Permanent organ deformity and tissue injury; ③ Late-onset diseases caused by chronic or autoimmune diseases. These delayed symptoms can appear within 2 months to 20 years after birth.
treat cordially
There is no specific medicine, mainly symptomatic and supportive treatment. Children with congenital rubella are infected with the virus for a long time, which affects their growth and development. Vision and hearing impairment should be found early and special education and treatment should be given to improve their quality of life.
prevent
Isolation period: 5 days after the visit.
(a) passive immune susceptible intramuscular injection of immune serum globulin to passively protect or alleviate symptoms, but its effect is not exact, and this method is usually not used for prevention. However, if susceptible pregnant women are unwilling or unable to have therapeutic abortion after exposure to rubella, they should immediately inject 20~30ml of immune serum globulin into muscle.
(two) active immunization has been used in foreign countries, and the effect is positive. After vaccination, 98% of the susceptible population can get lifelong immunity. It is generally used for women from 15 months to adolescence, and can also be used for women who are not pregnant and cannot get pregnant within 3 months after vaccination. Even if pregnant women accidentally use it. Congenital rubella syndrome rarely occurs.