Rubella
The rubella (or 3rd disease ) is an epidemic viral disease, of 15 days incubation close. It is a generally benign disease which touches primarily the children but who can cause serious congenital malformations when the women are infected at the beginning of their pregnancy.
History
It is at the time of a epidemic of congenital cataract that an Australian ophthalmologist, to sir Norman Gregg, highlighted the pathogenic capacity of the Virus with respect to the Fœtus.
Virus
It is a contagious infection, immunizing, due to a myxovirus: Rubivirus.
Epidemiology
Benign in the child, rubella can be serious at the pregnant woman because of the risk of malformations congenital S. But 80 to 95% of the women are immunized with a rate which increases with the systematic Vaccination S in childhood. The Contagion begins one week before the eruption and persists two weeks afterwards.
Thanks to the policy of vaccination, the disease becomes increasingly rare in the Western countries. It almost disappeared from the United States since 2002. 29.000 cases were declared in 2004 but the the World Health Organization table for an eradication in 2010.
Consequence of the infection on the fetus
The fetal risk is all the more great when the Infection occurs precociously in the Grossesse (30% in the first month, 7% with 3rd). One can see: Abortion, congenital malformations concerning the Eyes, the dental Heart, Internal ear, anomalies, psychomotor delay. The evolutionary chronic rubella congenital of new born can associate in a child Hypotrophique: hépatosplénomégalie (increase in the volume of the liver and spleen) with or without ictère, Adenopathy S, osseous lesions, myocardic and neurological attacks, Purpura thrombopenic and haemolytic Anemia.
Diagnosis
Clinical signs
After a Incubation from 2 to 3 weeks appears a moderate Fièvre with Céphalée S (headaches), Pharyngite, Adénopathies cervical S, Conjonctivite. The eruption appears in 48h: maculeux Exanthème not Prurigineux which begins with the face and extends to all the body in a few hours, initially Morbilliforme, then Scarlatiniforme. It prevails with the face, the lumbar areas and fessières and disappears into 3 to 4 days. But it is necessary to insist on the frequency of the attenuated or asymptomatic forms.
Complementary examinations
The Numération formulates blood (NFS) watch a Leucopénie (reduction of the white globules) and sometimes a Plasmocytose (5 to 10%) maximum to 4 day. The rise of the serum Antibody S or an high rate of IgM translates a current rubella.
Treatment
There is no curative treatment. It is necessary to vaccinate the séronégatives girls with the Puberté. For the symptomatic treatment, it is possible cause a drop in the fever by managing Paracétamol.
Prevention
The prevention passes by the Vaccination ( vaccine R.O.R. ).
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