Rubella symptoms and treatment, rubella vaccine
Rubella is an infectious viral infection that is contagious. This disease is well treated. On the other hand, it can be very dangerous during a pregnancy for the fetus. The vaccine is the best way to protect against this infection. We focus on rubella, the signs suggestive of the disease and its treatment.
Rubella, what is it?
Rubella is a contagious viral infection most commonly occurring in children between 5 and 9 years of age. It confers a good immunity and does not relapse.
Contamination during pregnancy is serious because of a high risk of fetal malformations. The risk of transmission of infection to the fetus is variable according to gestational age: very common (90%) before the 9th week of pregnancy, it then decreases (25%) around the 23rd week. The risk of congenital anomalies is very high before the 9th week of pregnancy and very low after the 16th week.
Transmission of the infection is via the respiratory route (acquired rubella) or transplacental route (congenital rubella).
Causes and risk factors of rubella
The rubella virus is a virus belonging to the family Togaviridae. Prior to widespread vaccination, rubella was epidemic in the spring. The reservoir (possible source of infection) of virus is represented:
By subjects with acquired rubella. The virus is present in the pharynx of these subjects 7 to 10 days before the eruption until 15 days later. It is spread by nasal droplets expelled by infected people when they sneeze or cough;
By newborns with congenital rubella. They excrete the virus for several months after birth and are thus very contagious for the environment.
Rubella: the signs of the disease
Incubation (period between infection and first symptoms) lasts an average of 2 weeks after virus penetration by the respiratory route.
The disease is most often inapparent. In other cases, it is characterized by moderate fever, muscle and joint pain and cervical lymphadenopathy (palpable lymph nodes in the neck area).
The rash, when present, begins in the face and spreads rapidly to the trunk and upper limbs in the form of red spots (macules). It disappears on the third day.
The fever is most often moderate (less than 38 ° 5). We find palpation of the ganglia in the neck and behind the ears. These are small painless ganglia that can persist for several weeks. The doctor sometimes finds the characteristics of the rash previously described.
Rubella: additional examinations and analyzes
The blood count shows a decrease in the total number of white blood cells in the blood and an increase in the number of plasma cells in the blood, the blood cells responsible for the production of antibodies. The detection of specific antibodies in the blood confirms the diagnosis.
Evolution of rubella
Some complications can be observed:
Polyarthritis (inflammatory involvement of several joints): disappear without sequelae in less than a month;
Meningoencephalitis (inflammatory involvement of meninges and encephalon).
If rubella occurs during pregnancy, the risks are many:
Abortion and prematurity;
Fetal malformations (cataract, auditory and cardiac malformation, mental retardation);
Congenital congenital rubella: it corresponds to the persistence of the virus and makes the newborn very contagious. It is associated with multiple malformations.
Treatment of rubella
The treatment of rubella acquired is purely symptomatic: antipyretic treatment to fight fever, vitamin C …
Prevention of rubella in pregnant women
The prevention of congenital rubella is essential: the rubella serology was checked as part of the prenuptial examination, which is no longer compulsory since 2008 but whose examinations are now recommended for women who wish to have children. If the pregnant woman is HIV-negative, surveillance is essential. If there is a suspected rash or contact with a rubella subject, she should have a serological examination to rule out an infection.
The search for an infection in the fetus can be done by looking for antibodies in the umbilical cord blood from the 22nd week of pregnancy under radiological control. The definite demonstration of infection during the first 3 months of pregnancy is an indication for termination of pregnancy.
The rubella vaccine
The prevention of rubella is based on vaccination. It avoids the risk of fetal harm in pregnant women and must be practiced in all children. It is a vaccine injected intramuscularly or subcutaneously, which can be combined with vaccination against measles or mumps. It is practiced systematically between 12 and 24 months and may be offered later if it has not already been done (children between 2 and 10 years, pre-pubescent girls, young woman of childbearing age). It should be noted that in young women, vaccination must be carried out under effective contraception, started one month before and continued two months after vaccination. His tolerance is good and his efficiency excellent.
Do not confuse rubella with …
In front of a rash, other diagnoses can be discussed:
Scarlet fever (a bacterial infection that combines angina and rash in a young person);
The exanthem undergoes, eruptive fever of viral origin;
Other viral infections (Echovirus and Coxsackie virus)