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Friday, July 24, 2009

Rubella

Rubella is a virus disease with a specific small spotted rash called exanthem is characterized by frank fever. The disease can affect fetus of women being pregnant. Rubella is caused by the agent called togavirus and has a RNA genome. It is nonpersistent in external atmosphere, dies rapidly when heated up to 56 ° C, when drying, under the control of the action of ultraviolet rays, either, formalin and other abluents. The source of infection of is human diseased with that kind of virus disease, especially being in subclinical form that passes without rash. In interepidemic period selected cases are observed. The climactic number of cases of the virus disease are registered in April – June. The disease represents a notable risk for pregnant women because of fetal infection. Rubella virus releases into external environment one week before the rash appears on skin and during the week when foolhardy has appeared. Infection is transmitted via airborne.


Symptoms
Incubation period is 11-24 days. General condition of this kind of virus disease is characterized by weakness that is why at the beginning the only noticeable symptom is rash resembling with these of scarlatina. Patients suffer from brief weakness, lack of energy, headache, pain in muscles and in joints. Temperature of the majority of patients often is subfebrile, although it in some cases riches 38-39°C and keeps 1-3 days. When woman examination low-grade symptoms of catarrh, little redding of pharynx and conjunctivitis are observed. From the identical first days of the virus disease appears generalized lymphadenopathy (in other words, the tenderness 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 richness and it can be itching. Also there is some inspissation of rash of extensor surface of limbs and buns.


Elements of the indiscreet represent little spots with diameter of 2-4 mm, usually they do not coalesce, 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. The virus disease can course without symptoms, having the exclusive manifestation of viremia and increasing of titre in blood of specific antibodies.

Diagnosis
Clinical and laboratory data help to recognize that virus 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 captivated 10-14 days apart.


Treatment
Doctors prescribe comfort care when uncomplicated rubella. When arthritis doctors usually prescribe 0.25g chingamin (chloroquine) 2-3 times a day for 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. Common prognosis for rubella is favorable, excepting when encephalitis which has mortality of 50%.


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

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