Rubella

Rubella is a virus disease with specific small spotted rash called exanthem, generalized  lymphadenopathy, moderately frank fever and affect of fetus of women being pregnant. The disease is caused by the agent called togavirus and has a RNA genome. It is nonpersistent in external environment, dies rapidly when heated up to 56° C, when drying, under the action of ultraviolet rays, either, formalin and other abluents. The focus of infection is man diseased with rubella, especially being in subclinical form that passes without rash.

In interepidemic period selected cases are observed. The maximum number of cases are registered in April – June. The disease represents a particular risk for pregnant because of fetal infection. Rubella virus releases into external environment one week before the rash appears on skin and during the week when rash has appeared. Infection is transmitted via airborne.

Symptoms and course
Incubation period lasts 11-24 days. General condition suffers weakly that is why the first noticeable symptom is rash resembling with measly or scarlatina rash. Ill men suffer from little weakness, lack of energy, headache, pain in muscles and in joints. Temperature of the body often is subfebrile, although it in some cases  riches 38-39°C and keeps 1-3 days. When physical examination low-grade symptoms of catarrh, little redding of pharynx and conjunctivitis are observed.

From the very first days of disease appears generalized lymphadenopathy (in other words, the affection of lymphatic system). The most expressed are increasing and painfulness of back-necked and occipital lymph glands. Exanthem appears on 1-3 day from the beginning of disease, first on the neck and after several hours spreads on the whole body and it can be itching. Also there is some inspissation of rash of extensor surface of limbs, back and buns.

Elements of the rash represent little spots with diameter of 2-4 mm, usually they do not merge, are kept for 3-5 days and disappear without living pigmentation on skin. In 25-30% of cases rubella progresses without rash and is characterized by moderate fever and lymphadenopathy. The disease can course without symptoms, having the only manifestation of viremia and increasing of titre in blood of specific antibodies.

Complications
Arthritis, Acute Encephalitis.

Recognition
Clinical and laboratory data help to carry out the recognition of the disease. Nowadays virologic methods are not used widely. From serological tests are used the neutralization test and hemagglutination-inhibition test  injected together with paired sera taken 10-14 days apart.

Treatment
There is prescribed comfort care when uncomplicated rubella. When arthritis doctors usually prescribe 0.25g of  chingamin (chloroquine) 2-3 times per day during 5-7 days. Also are advised diphenylhydramine (0.05g two times a day), butadiene (0.15g 3-4 times a day), nosotropic treatment. When encephalitis, are advised corticosteroid remedies.
The general prognosis for rubella is favorable, excepting when encephalitis which has mortality of 50%.

Preventive Measures
Are very important for women in child-bearing age. Some specialists recommend to vaccinate girls of 13-25 years. People diseased with rubella should be isolated up to five days since appearing of rash.