Rubber is an acute infectious disease that does not lose its relevance in many countries of the world.
In the case of infection of a pregnant woman, the virus can cause congenital malformations of development in the fetus, known as the syndrome of congenital rubella (hereinafter - SVK).
The highest indicators of the SVK are recorded in the African region and the Southeast Asian region (about 110 thousand children are born annually!), The lowest level of vaccination coverage is noted.
Reference. In 2010, 53 countries of the European region of the World Health Organization (hereinafter - WHO) expressed their commitment to the target of the interruption of the endemic (local) transmission of measles and rubella. In April 2012, the WHO initiative to combat measles-currently known as an initiative to combat measles and rubella-announced a global strategic plan for the fight against measles and rubella, covering the period of 2012-2020. The plan includes a global goal: by the end of 2020, to complete the elimination of measles and rubella, at least in 5 regions of WHO.
In the Republic of Belarus, the greatest incidence of rubella was recorded in 1999 - 441.6 cases per 100 thousand people, when more than 44 thousand people fell ill. In the past five years, despite the fact that the rubble of the rubella virus in the country has been recorded almost annually, a successful epidemiological situation has been preserved - from the lack of cases to single ones, cases of SVK have not been recorded.
Based on the results of the conclusion of the European Regional Commission of WHO since 2012, the Republic of Belarus is assigned to the group of countries where these infections are eliminated (there is no local transfer of viruses).
According to WHO:
in 9 out of 10 women infected with the rubella virus at an early stage of pregnancy (during the first three months of pregnancy), miscarriages, stillbirths, premature births or the birth of a child with congenital malformations (SVK) are possible;
The last outbreak of rubella in the United States, registered in the 60s. Twentieth century, led to a disease of 12.5 million people, more
2 thousand cases of encephalitis, more than 11 thousand abortions, more than 20 thousand cases of SVK with hearing loss (11 thousand cases), loss of vision (3.5 thousand cases), mental retardation (almost 2 thousand cases);
before the vaccine against rubella was introduced (the 70s of the XX century), 1 thousand live-born children had up to 4 cases of SVK;
In 2013, 49 children with SVK were born in the countries of the European region;
In the countries of the European region, the maximum number of cases was registered in 2012 and 2013: 29 601 (flash in Romania) and 39,562 (outbreak in Poland) cases, respectively;
In 2018, in the countries of the European region, 850 cases of rubella were registered, with the largest number of registered cases in Poland (450) and Ukraine (235).
The causative agent of the infection
The causative agent of the infection is the rubella virus.
The virus is transmitted from a sick person to a healthy airborne droplets when sneezing, coughing. It is characterized by a long period of infectivity, refers to "diseases of close contact", i.e. It easily spreads into rooms where people are closely and re -contacting among themselves (family, kindergarten, school, hospital).
At the same time, when infected during pregnancy, the pathogen can be transmitted “vertically” (through the placenta), which result in intrauterine infection of the fetus.
Source of infection
The source of infection is a sick person in a clinically expressed or asymptomatic flowing form 7-10 days before the rash and within 5-7 days after the appearance of the rash.
How does the rubella manifest?
Rubbound, as a rule, proceeds in a mild form. The incubation period is an average of 14-21 days.
The disease begins with a slight increase in body temperature within 1-5 days, malaise, conjunctivitis, inflammatory phenomena in the upper respiratory tract, headaches, joint pain, which is characteristic of adults. An increase in the occipital, parotid, posterior lymph nodes occurs 1-7 days before the appearance of the rash and is one of the most characteristic clinical signs of infection. The rubella is characterized by a small, spotted rash that is not inclined to merger, which first appears on the face and neck, and then spreads throughout the body and disappears 2-3 days after the appearance, leaving no traces.
Along with clinically pronounced forms of infection, with rubella can also occur asymptomatic forms (about 20-50% of cases of infection).
As a result of the infection, complications are possible in the form of damage to the small joints of the hands (polyarthritis) in adults, in severe cases - damage to the brain (encephalitis), its frequency is 1 per 5 thousand cases of infection.
Rubella and pregnancy
Infection of a woman’s rubella virus at an early stage of pregnancy, especially in the first trimester of pregnancy, in 90% of cases can lead to miscarriage, stillbirth, premature birth or the birth of a child with congenital malformations known as SVK.
The CBC clinic is due to the degree of damage to various organs and systems: the cardiovascular system, organs of vision, hearing, the central nervous system, the endocrine system, the musculoskeletal system, etc.
In children born with the SVK, the release of the rubella virus is possible throughout the year.
Vaccination is the best protection!
There are no specific treatment methods for rubella, but the disease can be prevented by vaccination as a safe and effective method of protection.
For more than 40 years, vaccination has been used to combat rubella. Vaccination of a live red -wing vaccine began in the countries of the European region since 1970. In 1971, a combined (trivalent) vaccine against measles, epidemic mumps and rubella was created, which has begun to use in our country since 1996.
Rubbing vaccines are highly effective. After the introduction of one dose of the vaccine containing a rednuting component, more than 95% of the vaccinated is a long -term immune defense of the body, after the introduction of the second dose, the effectiveness reaches almost 100%.
When planning a pregnancy, a woman should clarify her vaccination status (information about the prophylactic vaccinations) in the healthcare organization at the service place and, on the recommendation of a doctor, if necessary to make a preventive vaccination, after which pregnancy should be avoided within 4 weeks.
Preventive vaccinations in the Republic of Belarus
In the Republic of Belarus, immunization against measles, epidemic mumps and rubella is carried out in accordance with the national calendar of preventive vaccinations of the Republic of Belarus, approved by the Decree of the Ministry of Health of the Republic of Belarus dated 17.05.2018 No. 42 “On preventive vaccinations”, and consists of two preventive vaccinations at the age of 12 months and 6 years.
Currently, the immunization against measles, epidemic mumps and rubella in the Republic of Belarus is carried out using the combined prioriks vaccine, the production of Glaxosmithline Biologicals S.A., Belgium.
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