What should you pay attention to when rubella occurs in hot weather?

Rubella, also known as "Wind Sha", is a common respiratory infectious disease in children. Rubella is caused by rubella virus. The virus is present in the saliva and blood of sick children 5 to 7 days before the rash appears, but it is not easy to find 2

days after the rash appears. The rubella virus has little viability outside the body, but is as contagious as measles

. It is usually spread through coughing, talking or sneezing. This disease is more common in children aged 1 to 5 years old. Infants under 6 months old have acquired resistance due to antibodies from their mothers and rarely develop the disease. Once you get sick once, you will be immune for life and rarely get sick again.

It takes 14 to 21 days from contact with infection to the onset of symptoms. Symptoms in the first 1 to 2 days of illness are very mild, including low or moderate fever, slight cough, fatigue, loss of appetite, sore throat, and red eyes

Upper respiratory symptoms. The patient's oral mucosa was smooth, without congestion or mucosal plaques, and the posterior ear and occipital lymph nodes were swollen with mild tenderness. The rash usually appears 1 to 2 days after fever.

The rash first starts on the face and neck and spreads to the whole body within 24 hours. The rash initially appears as sparse red spots

Papules. Later, the rash on the face and limbs may merge, similar to measles. Starting from the second day after the rash occurs,

the rash on the face and limbs can turn into pinpoint red spots, such as a scarlet fever-like rash. The rash usually subsides quickly within 3 days, leaving behind lighter pigmentation. During the rash period, the body temperature no longer rises, and the sick child often has no feeling of illness and can eat and play as usual. Rubella is different from measles. The systemic symptoms of rubella are mild, without the mucosal spots of measles, and accompanied by swollen lymph nodes behind the ears and neck.

The course of rubella is good, the prognosis is good, and there are few complications. However, after pregnant women (early pregnancy within 4 months

) are infected with the rubella virus, the virus can be transmitted to the fetus through the placenta. Congenital rubella,

Congenital malformations occur, such as blindness, congenital heart disease, deafness and microcephaly. Therefore,

pregnant women should avoid contact with rubella patients as much as possible in the early stages of pregnancy and be vaccinated with live attenuated rubella vaccine

at the same time. In the event of rubella, termination of pregnancy should be considered.

Patients should be isolated and treated promptly until 1 week after the onset of rash. The patient should rest in bed and be given vitamins and nutritious and easily digestible food, such as minced vegetables, minced meat, rice porridge, etc. Pay attention to skin hygiene

Keep your skin clean and hygienic to avoid bacterial secondary infection. Rubella has few complications. Once complications such as bronchitis, pneumonia, otitis media or meningoencephalitis occur, they should be treated in time.

Strengthen medical observation of close contacts and pay attention to rashes and fever to facilitate early detection of patients

Contact classes in childcare institutions should be isolated from other classes during the incubation period and should not admit new students to prevent transmission.

Rubella is a viral infectious disease. Its clinical characteristics are: mild systemic symptoms, red maculopapular rash on the skin, and swollen and tender lymph nodes behind the occipital, behind the ears, and behind the neck. Complications are rare. After pregnant women are infected with rubella in early pregnancy, the virus can be passed to the fetus through the placenta, causing various congenital defects, which is called congenital rubella syndrome.

Cause

Rubella virus belongs to the Togaviridae family and has only one serotype. The virus is spherical, with a diameter of 50~70nm, and has hemagglutinin (HA) on the envelope, which can agglutinate pigeon, goose, chicken red blood cells and human O-type red blood cells. Rubella virus is not heat-resistant and is quickly inactivated at 37°C and room temperature; it can be stored for a short period of time at -20°C and is relatively stable for several months at -60°C. The virus can be found in nasopharyngeal secretions 7 days before the rash appears and 7 to 8 days after the rash subsides.

Epidemiology

Humans are the only natural host of rubella virus. It is transmitted through droplets and is most contagious in the days before, during and after the rash occurs; except for nasopharyngeal secretions Viruses are also present in substances, blood, feces, and urine, and subclinical patients are also contagious. It usually occurs in winter and spring, and is more common in children aged 1 to 5 years old. The incidence rate is equal in men and women. The mother's antibodies can protect the baby from developing the disease within 6 months. Widespread use of vaccines has reduced the incidence and increased the age of onset. Primary infection of the mother during pregnancy can lead to fetal intrauterine infection. Its incidence and teratogenicity rate are closely related to the gestational age at the time of infection, with the highest rates in the first trimester. Children with congenital rubella still shed the virus within a few months after birth. Contagious.

Clinical manifestations

(1) Acquired rubella

1. The incubation period is generally 14 to 21 days.

2. The prodromal period is short, mostly only 1 to 3 days. There are low-grade fever and catarrhal symptoms, most of which are mild and often ignored because the symptoms are mild or short-lived.

3. The typical clinical manifestations of the rash stage are swollen lymph nodes behind the ears, occiput and back of the neck accompanied by tenderness, which lasts for about 1 week; the rash appears 24 hours after the swollen lymph nodes and is polymorphic. Most of them are scattered maculopapular rashes, which can also appear as large areas of skin redness or pinpoint scarlet fever-like rashes. It starts on the face and spreads throughout the neck, trunk, arms, and finally the feet within 24 hours; the rash on the lower limbs often appears after the facial rash subsides. , usually lasts for 3 days, and there is very little peeling after the visit. At the end of the prodromal stage and the early stage of rash, red punctate mucosal rashes can be seen on the soft palate, which are similar to mucosal rashes caused by other viral infections and are non-specific.

The rash may be accompanied by low-grade fever, which lasts for 1 to 3 days. Mild splenomegaly is common. Young women have multiple arthritis when the rash occurs or within a few days after the rash. It is often symmetrical and most commonly affects the proximal finger (toe) joints, followed in order by the metacarpophalangeal joints, wrists, knees, ankles, feet, and Shoulder and spinal joints; characterized by local redness, swelling, pain, tenderness and oozing, lasting from several days to 2 weeks, with few sequelae. In addition, there have been reports of paresthesia and testicular pain.

4. Complications Rubella rarely has complications, and respiratory infections are the main clinical manifestations. Occasionally, pneumonia, post-infectious encephalitis, and thrombocytopenic purpura may occur during the rash period. The prognosis is good. .

(2) Congenital Rubella Syndrome Rubella virus causes fetal damage by inhibiting cell mitosis, cell lysis, placental villitis, etc., which can produce: ① Transient neonatal period manifestations; ② Permanent organ malformations and Tissue damage; ③ Late-onset diseases caused by chronic or autoimmune conditions. These late-onset symptoms can occur from 2 months to 20 years after birth.

Treatment

There is no specific medicine, mainly symptomatic and supportive treatment. Pediatric patients with congenital rubella carry the virus for a long time, which affects their growth and development. Visual and hearing impairment should be detected early and special education and treatment should be given to improve their quality of life.

Prevention

Isolation period: to 5 days after the visit.

(1) Passive immunity: Intramuscular injection of immune serum globulin in susceptible persons can passively protect or reduce symptoms. However, the effect is not exact, so this method of prevention is usually not used. However, if susceptible pregnant women are unwilling or unable to undergo therapeutic abortion after being exposed to rubella, 20~30ml of immune serum globulin should be injected intramuscularly immediately.

(2) Active immunization Vaccine prevention has been used in foreign countries, and the effect is certain. After vaccination, 98% of susceptible people can obtain lifelong immunity. It is generally used for women between 15 months and puberty. It can also be used by non-pregnant women who are confirmed to be antibody negative and can not become pregnant within 3 months after vaccination. Even if used accidentally by pregnant women. Congenital rubella syndrome also rarely occurs.