A central place among the tasks assigned to public health takes the fight against viral diseases. Achieving these goals is impossible without the development and use of modern methods of laboratory diagnostics as well as the accumulation of fundamental knowledge about the nature and characteristics of the spread of diseases. Rubella infection as a problem of Clinical Virology remains relevant in the health care system in the US and abroad. It is due to its ubiquity and ability to cause the disease in unborn child. Therefore, the current paper will discuss and explore the characteristics of rubella and its impact on the health of the person.
Rubella was firstly mentioned in the literature in the 16th century by J. de Bayou. In 1829, Wagner pointed that the disease is different from scarlet fever and measles. In 1881, it was officially identified as a separate nosological form. In 1938, Japanese researchers proved the viral nature of the infection (Kaslow, Stanbery, & Le Duc, 2014, p. 147). In the late 1960s, in the United States, the researchers received the first rubella vaccine after the outbreak of the disease (Kaslow et al., 2014, p. 147). According to the US statistics, the complications of the central nervous system after rubella are in 1 case per 6,000 patients.
Rubella is an acute infectious disease caused by the rubella virus. It is transmitted by the airborne droplets and is characterized by the moderate intoxication, minor catarrh mucous membranes of the eyes and nose, finely speckled rash, and generalized lymphadenopathy of the cervical lymph nodes. In the environment, the rubella virus dies when heated to 56°C. It is also vulnerable to drying, a change in pH (below 6.8 or above 8.0), under the influence of ultraviolet rays, ether, formaldehyde, chloroform, and other disinfectants (Kaslow et al., 2014, p. 155). However, the virus remains infective for several years at low temperature (from -70°C to -20°C). The pathogen of rubella belongs to the family called Togaviridae. A type of virus is named Rubivirus, which has the protein-fat shell that contains a gene having one RNA molecule. Virion diameter of the virus is 60-70 nm (Kaslow et al., 2014, p. 160). Rubella virus has the spherical form. It has a central nucleoid placed in the shell.
Rubella infection could be found almost in every country in the world. The source of infection is always a human. Patients could have a symptomatic form of rubella or a typical measles without a rash as well as children with congenital rubella in the body where the virus may persist for many months up to 1.5 years or more (Schlossberg, 2015, p. 89). Before the implementation of the active immunization, rubella was occurring in the form of epidemic outbreaks with the intervals of 6-9 years. The introduction of vaccination resulted in a sharp decrease of the disease accidents. For example, in 1964, more than 1.8 million patients in the US were sick with rubella. However, in 1984, after the implementation of the vaccine, only 745 people were sick with presented infections (Schlossberg, 2015, p. 97). During the outbreak, not only children but also adults, especially in organized groups (military servants and others) were sick. Rubella presents a special danger to pregnant women due to intrauterine infection. Rubella virus is released into the environment for a week before the rash appears and for a week after the rash.
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The virus enters the body through the mucosa of the upper respiratory tract and multiplies in the lymph nodes. The infection enters the bloodstream after 6-8 days (Schlossberg, 2015, p. 115). The virus affects the vascular endothelium, causing their increased permeability edema and geodynamic violations in the tissues. In the vascular endothelium of the surface layers of the skin, the virus causes the focal inflammatory reaction that in turn leads to the appearance of the rash. On the first day of the disease, 75-90% of the patients have the specific skin rash (Schlossberg, 2015, p. 109). It is more frequently observed in children. It could be characterized as round or oval pink or red shallow spots. Often, the rash appears on the face and neck, behind the ears and on the scalp, and then during the day it appears on the trunk and extremities. Rash is absent on the soles and palms. Sometimes, small rashes appear on the oral mucosa. It lasts two to three days. The blood virus neutralizing antibodies appear after 2-3 days, leading to the release of the body from the pathogen and the formation of intense as well as prolonged immunity. The presence of rubella in pregnant women increases the risk of the congenital rubella syndrome (CFS) (Sweet & Gibbs, 2012, p. 189). Such a condition develops when the mother passes rubella to the child while he/she is still in her womb. It could lead to the birth of a child with one or more birth defects, including heart problems, vision problems, mental retardation, problems with bones, growth as well as damage to the liver and spleen.
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The diagnosis of rubella is usually put if the child has had contact with the sick individual and was not vaccinated. In addition, there are a characteristic skin rash, swollen lymph nodes, and other symptoms (Sweet & Gibbs, 2012, p. 196). The diagnosis is confirmed by a blood test from a vein on the antiviral antibodies. It takes place on the 1-3rd day of illness and after 7-10 days (Sweet & Gibbs, 2012, p. 206). If rubella antibodies is increased by four times or more, it indicates the infection. The treatment is usually performed at home. During the eruptions, the child needs bed rest. Special treatment is not administered; however, sometimes the symptomatic agents (medications that remove symptoms of the disease) could be used. In most cases, the prognosis of the treatment is favorable. Re-infection with rubella is impossible.
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