The only protection against measles, rubella and mumps is vaccination! Measles, mumps, rubella - how is vaccination against these diseases tolerated?
Measles, rubella and mumps are infectious diseases that are traditionally considered to be childhood diseases. This definition is due to the fact that children of preschool and junior school age suffer from these infections much more often than adults.
You can only get measles, rubella and mumps once in your life. There is no cure for these infections, and after illness, immunity is developed for life. Sometimes these facts about childhood infections lead parents to think that vaccination against measles, rubella and mumps is a useless exercise: there is nothing wrong with getting one of these infections, so why give extra vaccinations? In fact, the infections themselves are not as scary as possible consequences and complications after them. Let's look at how measles, rubella and mumps occur, what complications are possible after them, and what are the rules for vaccination against these infections.
Measles
This is an infection that you can catch by airborne droplets. The radius of spread of the measles virus is quite large, so when one sick person appears in children's team Almost all children who come into contact with him get sick.
At first, measles manifests itself as an ordinary respiratory viral infection: the child’s temperature rises (up to 39 degrees), a cough appears, a runny nose, and the mucous membrane of the eyes may become inflamed. A couple of days after the onset of the disease, the child develops a rash. The characteristic rash of measles is white dots that first appear on the face and then spread throughout the body. Over the course of a week, the disease progresses: the temperature persists, the rash becomes larger and larger, and then it subsides, the temperature and rash recede, and the remaining spots from the rash disappear on their own in 3-4 days.
Children under one year of age practically do not get measles because they receive maternal antibodies to this infection. In most cases in childhood measles is easily tolerated, but can cause complications such as otitis (inflammation of the middle ear), pneumonia (pneumonia), encephalitis (inflammation of the brain). If an adult gets measles (and this is possible if he was not vaccinated and did not get sick in childhood), the disease will be severe, and the risks of complications increase significantly.
Rubella
This infection is also considered a “children’s” infection, and children can get rubella in a very mild form, and ultimately not even know accurate diagnosis because the symptoms light form the diseases do not differ from ordinary ARVI. Main symptoms – heat, headache, general malaise; in more severe cases, lymph nodes may become enlarged and a small rash may appear on the face and body (which can easily be mistaken for an allergy to medications).
In children, complications from rubella are extremely rare: encephalitis develops in approximately one case out of 1000. For adults, rubella is no longer so harmless. Adults suffer from the disease very hard and the risks of complications increase significantly. Rubella is especially dangerous for pregnant women: during pregnancy, this infection can cause severe pathologies in the fetus. It is in order to prevent such problems in the future that the rubella vaccine should be given in childhood.
Mumps or mumps
Mumps is also transmitted by airborne droplets, but its virus does not spread as easily or quickly as the measles virus, so it is more difficult to become infected with mumps. Main hallmark This disease is an inflammation of the salivary glands under the jaw and behind the ears. Because of this inflammation, the face seems to swell, hence the name “mumps,” and during the acute period it is painful for the sick person to chew and swallow. In addition to inflammation of the salivary glands, mumps is also characterized by known symptoms viral infection: high fever, malaise.
Possible complications after mumps: pancreatitis (inflammation of the pancreas), meningitis or meningoencephalitis (inflammation of the membranes or tissues of the brain). The most dangerous complications caused by mumps are in the reproductive system: in boys it is inflammation of the testicles (orchitis), and in girls it is damage to the ovaries (oophoritis). The severity of these complications varies, sometimes even leading to infertility. Vaccinations can help protect your child from these health risks.
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Vaccination against measles, rubella and mumps
Before getting vaccinated, read the article on how to prepare your child for vaccination - rules, tips and recommendations —
According to the vaccination calendar ( see the vaccination calendar for children under 1 year of age in Russia — ), the first vaccination against measles, rubella and mumps is carried out according to the following schedule:
- first vaccination – at 1 year
- revaccination – after 6 years.
If vaccinations were not done on time, then they are given after 13 years.
Typically, vaccination consists of two vaccines: double for measles and mumps and separate for rubella. In clinics, all vaccinations for children are free and they use already purchased vaccines: the first is Russian-made, the second is Indian.
If parents want to reduce the number of injections or trust imported vaccine manufacturers more, they can buy and supply an imported triple vaccine (MMP-II, Priorix). True, in the case of vaccination against measles, rubella and mumps, it turns out that domestic vaccines are better tolerated and less likely to cause allergies, because quail protein is used as one of the components, and chicken protein is used in foreign ones.
Vaccinations against measles, rubella and mumps can be given on the same day as any other vaccinations except BCG. In some cases, vaccination against these infections will have to be abandoned. Contraindications to vaccination against measles, rubella and mumps are:
- immunodeficiency states
- history of severe allergic reactions (especially to chicken protein)
It is worth temporarily postponing vaccination if the child has recently had a blood transfusion. Vaccination is postponed for 3 months.
After vaccination
The measles, rubella, and mumps vaccine usually does not cause a reaction in your child. Maximum – the injection site swells a little and turns red, maybe slight soreness in this place.
In cases where a reaction does appear, it may not appear immediately, but after 1-2 weeks. The child may develop a fever ( read the article: ) and suddenly signs of ARVI appear (runny nose, cough, swollen lymph nodes). Sometimes symptoms of an allergic reaction appear.
To prevent complications from vaccination, you can give your child an antiallergic drug in advance. Unpleasant sensations are relieved with painkillers, all other signs of complications are also removed symptomatically (antipyretic for fever, nasal drops for a runny nose).
In general, vaccinations against measles, rubella and mumps are considered the “easiest” for a child, while they protect him in the future from serious problems with health, therefore, refusing vaccination due to the belief that vaccinations are harmful is not reasonable. Timely vaccination against seemingly harmless childhood infections, carried out according to all the rules, will not cause any harm and will only help maintain health.
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The combined polyvalent vaccination against measles, mumps (mumps), rubella (MMR) is considered mandatory and is given free of charge in clinics. These diseases are very dangerous and can even be fatal. Vaccination does not cause complications, but only if a fresh, high-quality vaccine is used.
Why is MMR vaccination needed?
Vaccination is necessary because the diseases that vaccination protects against are very dangerous:
- Measles- a disease at the first stage of development similar to ARVI. High fever, runny nose, cough, and weakness appear. As the infection progresses, rashes, eye inflammation, and impaired consciousness occur. If the measles vaccine is not administered on time, this may cause fatal outcome.
- Mumps or mumps gives serious complications: damage to the parotid salivary glands, meningitis (inflammation of the membranes of the brain), hearing loss, lymphadenitis (inflammation of the tissues of the lymph nodes), pathology of the gonads.
- Rubella – dangerous disease, especially for pregnant women. If future mom infected, the fetus may experience various pathologies(malformations of the brain and heart, cataracts, deafness, anemia, bone damage, and so on).
Vaccine effectiveness
Sustained immunity after MMR vaccinations observed in 90% of people. Sometimes a person gets sick with rubella, measles or mumps after vaccination (4-5% of cases). Often, infection occurs in those who have not undergone revaccination (repeated administration of the drug).
Actions of the CCP enough for 10 years.
When is vaccination carried out?
There is a special vaccination calendar. The first PDA is done at 1 year, the second at 6 years. The next vaccination is carried out in teenage years(12-14 years), then at 22-29 years, then every 10 years. If vaccination was not performed at 12 months, the first one is carried out at 12-14 years. The drug is administered subcutaneously or intramuscularly. For children aged 1 year - in the thigh, for the rest - in the shoulder blade or shoulder.
Which vaccines against measles, rubella, mumps are better?
Several different vaccines are used against infections. Live preparations, combined divaccine (mumps-measles), trivaccines (MMR). Effective and high-quality one-component:
- Live measles vaccine produced in Russia. Contains quail egg whites.
- Imported vaccination Pavivak (Czech Republic) against mumps. Includes protein chicken eggs, therefore not suitable for all patients.
- Ervevax (England), Rudivax (France), Serum Institute vaccine (India)- rubella medications.
Multicomponent vaccination of measles, rubella, mumps:
- Medicine Priorix (Belgium). High efficiency, excellent cleaning, minimum side effects, a lot positive feedback.
- Mumps-measles vaccination (Russia). Reduced reactogenicity, side effects occur in only 8% of patients.
- Dutch vaccine MMP-II. Produces antibodies to infections for 11 years.
Preparing for vaccination
The patient is examined by a doctor (pediatrician or therapist). Before vaccination it is recommended:
- A couple of days before vaccination, take an antihistamine (anti-allergic) drug.
- Remove foods that cause allergic reactions from the menu (citrus fruits, chocolate, etc.).
- For diseases of the central nervous system contact a neurologist who will prescribe a course anticonvulsants.
- Take general blood and urine tests to avoid complications.
- Children who often suffer from ARVI are prescribed medications to generally strengthen the body and immunity.
Children's reaction to vaccination
After vaccination, a child may experience a reaction (after 5-14 days):
- Redness and thickening in the area where the vaccine was administered (goes away on its own within 2-4 days).
- Sore throat, swelling lymph nodes.
- Small rash all over the body or in certain areas.
- Temperature rises to 39-40 C.
Possible complications after vaccination
Complications rarely develop after administration of the measles, rubella, and mumps vaccine. If they occur, you should urgently call a doctor.
Severe reactions occur due to poor quality of the vaccine, the patient's ongoing illness, or improper vaccination.
Main complications after PDA:
- severe allergic reaction: Quincke's edema, anaphylactic shock;
- development of encephalitis - inflammation of the brain;
- toxic shock - when the vaccine is contaminated with staphylococcus;
- paralysis;
- confusion;
- thrombocytopenia - a decrease in the level of platelets in the blood;
- blindness, deafness.
Contraindications to vaccination
There are a number of factors under which you cannot get vaccinated against measles, mumps and rubella. Contraindications to immunization:
- severe reactions to previous vaccinations;
- acquired or hereditary immunodeficiency (HIV);
- allergy to constituent components vaccines;
- defects of the immune system at the cellular level.
Temporary contraindications to vaccination.
Measles
Measles is a highly contagious acute viral disease, transmitted by airborne droplets and manifested by an increase in body temperature, inflammation of the mucous membranes of the respiratory tract and conjunctiva, and a gradually appearing maculopapular rash.
ETIOLOGY
The causative agent of measles is an RNA virus from the paramyxovirus family. Measles virus - type species of the genus Morbillivirus(from lat. morbilli measles), contains a nucleocapsid and a lipoprotein shell. Antigenic structure stable. All known strains belong to the same serological variant. The measles virus is unstable in external environment, sensitive to insolation, high temperature and quickly destroyed by disinfectants and detergents. After long passages on tissue media, attenuated non-pathogenic strains with high antigenic activity are obtained from some strains, which are used to obtain a vaccine against measles.
EPIDEMIOLOGY
The source of infection is a sick person who is contagious from the last 1-2 days of the incubation period until the 4th day from the moment the rash appears. The route of transmission of infection is airborne droplets. The virus enters the environment with droplets of mucus when the patient coughs, sneezes, or talks; can spread with air currents over long distances, penetrate into adjacent rooms and adjacent floors. Due to the low resistance of the measles virus, transmission of infection through objects and third parties is impossible. Susceptibility to measles can be considered universal (more than 95%). The greatest contagiousness is noted in the catarrhal period of measles; from the 2-4th day from the appearance of the rash, the contagiousness decreases,
and from the 5th day of the rash the patient is considered non-infectious. After the introduction of vaccination, the incidence of measles decreased significantly. Nowadays, measles often occurs in older children and adults. Cases of the disease in newborns and children in the first 3 months of life are observed extremely rarely. Children in this group have passive immunity (ATs received from the mother if she had measles or was vaccinated), which completely disappears after the 9th month of life. The peak incidence of measles occurs in the spring and summer months. The frequency of epidemic morbidity is 4-7 years. Immunity after measles is lifelong. Recurrent diseases occur extremely rarely, mainly after mitigated measles or in weakened children who had measles in early childhood.
PATHOGENESIS
The entry point for infection is the mucous membranes of the upper respiratory tract. Primary fixation and reproduction of the virus occurs in the epithelium of the upper respiratory tract and regional lymph nodes, and then the pathogen enters the bloodstream (on the 3-5th day of the incubation period). The pathogen disseminates hematogenously throughout the body, fixing itself in the reticuloendothelial system. The period of viremia is short, the number of viruses in the blood is small, they can be neutralized by the introduction of Ig, which is the basis for passive prevention of measles in children who have been in contact with patients. Reproduction of the virus in infected cells of the reticuloendothelial system leads to their death and the development of a second wave of viremia with secondary infection conjunctiva, mucous membranes of the respiratory tract and oral cavity. Virus circulation in the bloodstream and developing defensive reactions cause damage to the walls of blood vessels, swelling of tissues and necrotic changes in them.
The dynamics of the production of specific antibodies corresponds to the primary immune response: IgM appears in the early stages, followed by IgG, the level of which reaches a maximum by the 15th day from the moment of rash. It is extremely rare that the measles virus can persist for a long time in the brain tissue, which leads to the development of subacute sclerosing panencephalitis.
CLINICAL PICTURE
The incubation period lasts 9-17 days. In children who received Ig for prophylactic purposes, it may be extended to 21 days. The clinical picture of measles is characterized by successively replacing each other periods: catarrhal, rash period and pigmentation period.
Catarrhal period
The catarrhal period lasts 3-6 days. The patient's body temperature rises, catarrhal symptoms appear and increase: conjunctivitis with severe photophobia, runny nose, cough; well-being is disturbed. After 2-3 days on the mucous membrane soft palate enanthema is detected. Soon, on the mucous membrane of the cheeks near the lower molars, less often on the gums, lips, and palate, characteristic Belsky-Filatov-Koplik spots appear (Fig. 22-1 on the inset) - grayish-white spots the size of a grain of sand, surrounded by a red corolla. By the end of the catarrhal period, body temperature decreases, but the manifestations of rhinitis and conjunctivitis intensify, and the cough becomes rough. The child's face has characteristic appearance: puffy, eyelids swollen, photophobia and lacrimation are characteristic.
Period of rash
The period of rash begins with a repeated rise in body temperature (up to 38-40? C) and worsening general condition sick. During the entire period of the rash, lethargy and drowsiness persist; There may be abdominal pain, diarrhea; Photophobia, runny nose, and cough increase sharply. Belsky-Filatov-Koplik spots usually disappear 12 hours after the appearance of skin rashes, leaving behind roughness on the oral mucosa. Measles is characterized by a maculopapular rash, which is located on an unchanged skin background; individual elements of the rash merge with each other, forming larger spots irregular shape; in severe cases, hemorrhages may also occur. A characteristic sign of measles is the staged nature of the rash. The rash first appears behind the ears and along the hairline, then spreads from top to bottom: on the first day it quickly covers the face and neck, on the 2nd day - the torso, on the 3rd-4th - the whole body, spreading to the proximal, and then distal parts of the arms and legs (Fig. 22-2 inset).
Elements of the rash begin to fade after 3 days. They become heterogeneous - bright maculopapular rashes predominate on the torso and limbs; on the face, the color of individual elements of the rash is less bright, brownish-cyanotic, then brown.
Pigmentation period
The period of pigmentation begins on the 3-4th day of the rash. Pigmentation appears in the same sequence as the rash. During this period, body temperature normalizes, catarrhal symptoms decrease and disappear, the rash acquires a brown tint and does not disappear when the skin is pressed and stretched. After 7-10 days, pityriasis-like peeling appears, the skin gradually clears.
CLASSIFICATION
When making a diagnosis, a classification based on the principles proposed by A.A. is used. Koltypin and M.G. Danilevich. The type, severity and characteristics of the course of measles are taken into account (Table 22-1).
Table 22-1.Classification of measles*
* According to Uchaikin V.F., 1998.
Typical form (predominant in modern conditions) is characterized by a cyclical course with changing clinical periods and pronounced classical symptoms. Atypical forms develop in 5-7% of cases, proceed more easily, sometimes with the absence of individual symptoms or periods of illness. Special place occupied by mitigated measles, which develops in the presence of antibodies to the measles virus (donor or maternal) in the blood. Sometimes this form occurs in children in the second half of life, but more often in persons who received Ig during the incubation period after contact with a measles patient, or if the disease was preceded by a plasma transfusion. For mitigated measles incubation period extends to 21 days, periods of illness are shortened, immunity is unstable. All symptoms (temperature reaction, catarrhal symptoms, intensity of rashes) are mild, but the rash remains staged and turns into pigmentation.
The severity of measles is determined depending on the severity of the fever, rash, and duration of the disease.
COMPLICATIONS OF MEASLES
Complications of measles are distinguished by etiology, timing of occurrence and localization (Table 22-2).
Distinguishing signs of complications from the usual but pronounced symptoms of measles in the catarrhal and rash periods is sometimes difficult. Especially it concerns early complications from the respiratory and digestive organs. During the period of pigmentation, complications include all arising pathological conditions, even mild and short-term ones. The development of secondary complications is indicated by the lack of normalization of body temperature after the 3-4th day from the moment of the rash or a new rise in temperature.
Table 22-2.Complications of measles*
According to Uchaikin V.F., 1998.
body temperature after its decrease, the appearance of symptoms of damage to the respiratory system, digestion, and nervous system. Regardless of the timing of development, complications of measles immediately include laryngitis, pneumonia, otitis media, and encephalitis.
DIAGNOSTICS
The diagnosis of measles is established based on a combination of epidemiological and clinical data:
Contact with a person with measles 9-17 days before the onset of catarrhal symptoms (with mitigated measles - 9-21 days);
The appearance of Belsky-Filatov-Koplik spots against the background of severe catarrhal phenomena and conjunctivitis;
A maculopapular rash that appears on the 3-4th day from the onset of the disease, accompanied by a second wave of fever and increased runny nose and cough;
The staged nature of the rash, pigmentation of the rash elements followed by pityriasis-like peeling.
DIFFERENTIAL DIAGNOSTICS
Diagnostic criteria vary during different periods of measles. In the catarrhal period, the only sign that allows one to reliably distinguish incipient measles from ARVI, primarily of adenoviral etiology, is the Belsky-Filatov-Koplik spot. During the period of rashes, it is necessary to carry out a differential diagnosis of measles with some infectious diseases accompanied by the appearance of a rash, as well as allergic exanthema (Table 22-3).
Table 22-3.Differential diagnostic signs of acute infectious diseases occurring with the appearance of a rash
Disease | Day of appearance rash | Type rash | Localization rash | Dynamics of rashes | Characteristic clinical syndromes |
Measles | 3-5th | Maculopapular | 1st day - face, 2nd - torso, 3rd - limbs | Stagedness, pigmentation, peeling | Fever, catarrhal symptoms, Belsky-FilatovKoplik spots |
Rubella | 1st-2nd | Small-spotted | Face, extensor surfaces of limbs, back | Disappears without pigmentation | Enlargement of the occipital, postauricular and posterior cervical lymph nodes |
Enteroviral exanthema | 1st-3rd | Spotted | Face, torso; at the height of the fever or when it decreases | Disappears within a day | Fever, headache, weakness, vomiting, hyperemia of the upper half of the body |
Allergic exanthema | 1st | Polymorphic, itching; urticarial | No specific location | Disappears without pigmentation | Connection with errors in diet, prescription of medications |
TREATMENT
Treatment is usually carried out at home. Patients with severe disease or complications, as well as for epidemiological and social indications, are hospitalized. Bed rest is prescribed until body temperature normalizes. Food should be mechanically and thermally gentle. Drinking plenty of fluids is recommended. To prevent bacterial complications, careful care of the mucous membranes and skin is necessary. Drug therapy uncomplicated measles, symptomatic: antipyretics (paracetamol), vitamins. At purulent conjunctivitis Prescribe instillation of a 20% solution of sulfacetamide into the eyes, and for severe rhinitis - vasoconstrictor drops into the nose. Frequent obsessive coughs are relieved by prescribing cough medicines, herbal decoctions, butamirate, etc. If complications develop, treatment is carried out in accordance with their etiology, location and severity.
PREVENTION
The most effective measure to reduce the incidence of measles is to vaccinate at least 95% of the population. In Russia, active immunization against measles is carried out with a live attenuated vaccine prepared from the vaccine strain L-16 (Leningrad 16). The vaccine is administered in a dose of 0.5 ml subcutaneously (under the shoulder blade or in the shoulder area) or intramuscularly. Vaccination is carried out for all healthy children at the age of 12 months and again at 6 years. On the 6-15th day after vaccination (as an option for normal infectious process) a short-term increase in body temperature, catarrhal phenomena, and sometimes the appearance of a measles-like rash are possible. Regardless of the severity of the reaction to the vaccine, the child is safe for others. Developed combination drugs, which also includes vaccines against rubella and mumps.
General anti-epidemic measures include: early detection and isolation of the source of infection, as well as in activities among contacted persons.
Activities in the outbreak: isolation of sick people from the onset of the disease until the 5th day of rash; with the development of pneumonia - until the 10th day of illness; ventilation of the room in which the patient was located, thorough wet cleaning; emergency vaccination or passive immunization of contact children (who have not had measles and have not been vaccinated); Isolation of children who have not had measles and who have not received vaccination from the 8th to the 17th day from the moment of contact, and those who received Ig - until the 21st day.
For emergency vaccination in children's institutions after the introduction of measles, live measles vaccine is used. It is introduced first
5 days after contact for children who have not had measles, have not been vaccinated and have no contraindications to vaccination. Passive immunization (intramuscular injection of Ig in a dose of 1.5-3 ml no later than the 5th day after contact) is carried out for children who have been in contact with a patient with measles, who have not been vaccinated and who have contraindications to vaccination. The final decision as to which of the contact children is subject to passive immunization is possible after a serological examination - passive immunization is advisable only if the results of RPGA (RTGA) are negative, i.e. in the absence of specific antibodies in the blood.
FORECAST
In modern conditions, the prognosis is favorable. The prognosis worsens with the development of currently rare severe complications(encephalitis, stenosing laryngitis, bacterial pneumonia etc.), especially in young children.
Rubella
Rubella is an acute viral disease that occurs in two forms, which have a significant difference in the mechanism of infection and clinical picture - acquired and congenital. Acquired rubella is characterized by airborne transmission of infection, moderate intoxication, small-spotted rash, and generalized lymphadenopathy. Congenital rubella is characterized by a transplacental route of transmission, a chronic course of the infectious process with the formation of various malformations in the fetus.
ETIOLOGY
The causative agent of rubella is an RNA virus from the genus Rubivirus families Togaviridae. The virus is tropic to epithelial, lymphoid, nervous and embryonic tissues, unstable in the external environment, and thermolabile. It exhibits a mild cytopathic effect and the ability to become chronically infected. Serologically of the same type, one serovar of the rubella virus is isolated
EPIDEMIOLOGY
The source of infection is a sick person or carrier. The patient is contagious during the last 2-3 days of the incubation period and during the first 7 days of the disease. Patients with congenital rubella pose an epidemic danger within a year after birth. The route of spread of acquired rubella is airborne,
congenital - transplacental. Less contagious than measles and chicken pox. Susceptibility to infection is high (80%).
Acquired rubella can be contracted at any age, with the exception of the first 6 months of life (due to the presence of natural passive immunity - AT, received from the mother). Children from 1 to 7 years old, organized in children's groups, are most often affected, since close and prolonged contact is necessary for infection. In families and hospitals, people who were in the same room or ward with the patient become ill with rubella. The rubella virus poses the greatest danger to pregnant women due to the possibility of its transplacental transmission to the fetus. The number of seronegative women of childbearing age currently amounts to 20% or more. In Russia, the incidence of rubella ranges from 200 to 800-1500 (during epidemic years) per 100,000 population. The incidence of rubella is far from being fully taken into account, which is due to the presence of asymptomatic and erased forms. The peak incidence occurs in the winter and spring months. The epidemic process of rubella is characterized by outbreaks and epidemics. The frequency of epidemic morbidity is 5-7 years. Following a rubella epidemic, 6-7 months later there is an increase in the incidence of congenital rubella. After an infection, lifelong immunity is developed.
PATHOGENESIS
The pathogenesis of acquired rubella has not been sufficiently studied due to the lack of an adequate model in laboratory animals. The virus enters the body through the upper Airways, is adsorbed on the epithelium of the mucous membranes of the oropharynx and enters the bloodstream. Viremia leads to the introduction of the virus into the lymph nodes, where it replicates, and causes skin rashes. With the appearance of the rash, viremia ends, which coincides with the appearance of antibodies to the virus in the blood. Specific AT IgM class appear in the blood in the first days of the disease, reaching a peak by the 10-15th day, then their level gradually decreases, and they are replaced by IgG class antibodies, which determine final immunity.
The pathogenesis of congenital rubella has been somewhat better studied. When a pregnant woman is infected, the virus penetrates the placenta and affects the capillary endothelium, causing fetal hypoxia. The virus spreads through the fetus's body through the blood. Intrauterine infection is most dangerous in the early stages of development. Formation of developmental anomalies various organs occurs as a result of the virus suppressing mitotic activity and slowing the growth of individual cell populations. The direct cytodestructive effect of the virus is also allowed, in particular in the lens of the eye and the cochlea of the inner ear. Critical
The periods of formation of defects during the intrauterine development of the fetus are considered to be: for the brain - 3-11 weeks, for the eyes and heart - 4-7 weeks, for the hearing organ - 7-12 weeks.
CLINICAL PICTURE
Acquired rubella
The incubation period lasts 14-24 days (18?3 days). IN last days During this period, the virus begins to be released from the nasopharynx. The prodromal period lasts 1-2 days and is characterized by a slight increase in body temperature and mild catarrhal symptoms. A small-spotted rash (Fig. 22-3 on the inset) on an unchanged skin background, not prone to merging, appears on the face within one day and quickly spreads to the torso and limbs. The rash is most pronounced on the face (cheeks), extensor surfaces of the limbs, back, and buttocks. 1-5 days before the rash, the occipital, posterior cervical, and parotid lymph nodes enlarge (up to 8-12 mm in diameter). In addition to rash and lymphadenopathy, there may be a short-term increase in body temperature up to 38? C, mild catarrhal symptoms, and enanthema. Elements of the rash disappear after 1-3 days without pigmentation or peeling. Then the size of the lymph nodes gradually decreases.
Classification.There is no generally accepted classification of acquired rubella. IN clinical practice When making a diagnosis, rubella is classified according to the principles adopted for the classification of other childhood infectious diseases. According to the type of clinical manifestations, rubella can be typical and atypical, according to the severity - mild, moderate severity and heavy. Its course can be smooth or complicated. The typical (manifest) form includes rubella with the presence of a rash, and the atypical form includes erased and asymptomatic forms. In erased forms, the disease manifests itself only as enlarged lymph nodes at normal body temperature or short-term low-grade fever. For asymptomatic forms clinical manifestations there are no diseases. In most cases, rubella is mild, rarely - in the form of moderate severity. Severe forms Rubella with complications or layers of secondary infections is observed extremely rarely - mainly in older children and adults.
Complications.With rubella, complications develop very rarely, usually in older children or adults. Typical complications of rubella are polyarthritis and encephalitis.
Polyarthritis usually develops a week after the appearance of the rash and disappears within 1-2 weeks. Manifested by pain
redness, sometimes swelling of the metacarpophalangeal and proximal interphalangeal joints of the fingers, less often of the knees and elbows.
Encephalitis, developing with a frequency of 1:5000, is the most serious complication of rubella. Almost all patients have impaired consciousness, sometimes generalized clonic-tonic convulsions and focal symptoms develop. Possible death.
Congenital rubella
In the case of a woman contracting rubella in the 1st-8th week of pregnancy, the embryo and fetus develop chronic course viral infection. This pathological process leads to severe lesions various organs, the formation of intrauterine developmental defects. There is a high probability of spontaneous abortion or the birth of a child with congenital rubella. After the first trimester of pregnancy, the rubella virus has a less harmful effect on the mature fetus. The classic manifestations of congenital rubella are cataracts, congenital heart disease and deafness. However, other developmental defects are also possible: microcephaly, hydrocephalus, retinopathy, glaucoma, skeletal defects, etc.
LABORATORY RESEARCH
IN general analysis blood reveals lymphopenia, lymphocytosis, plasma cells, normal value ESR. The virological method of isolating the virus is technically complex; it is used for scientific purposes. Serological studies use RTGA or RPGA in paired sera. An increase in the AT titer in the second sample compared to the first by 4 times or more confirms the diagnosis.
DIAGNOSTICS
The diagnosis of rubella is established based on a combination of clinical data taking into account the epidemiological history.
Acquired rubella.
The onset of the disease is the appearance of a rash.
The rash is small-spotted, spreads throughout the body throughout the day, and disappears without a trace.
Enlargement of the occipital, parotid and posterior cervical lymph nodes.
Mild symptoms of intoxication and moderate short-term catarrhal symptoms.
Contact with a person sick with rubella no earlier than 2 weeks before the onset of the disease.
Congenital rubella.
Rubella contracted by the mother in the first trimester of pregnancy.
The presence of congenital malformations, primarily cataracts, heart defects and deafness.
Clinical manifestations of IUI in a newborn.
Laboratory methods are rarely used: when retrospective confirmation of rubella is necessary, confirmation of congenital rubella syndrome or epidemiological studies.
DIFFERENTIAL DIAGNOSTICS
Differential diagnosis for rubella is carried out with measles, enteroviral exanthema, allergic rash, scarlet fever, pseudotuberculosis, infectious mononucleosis (Table 22-4).
Table 22-4.Differential diagnosis of rubella
Disease | General symptoms | Differences in rubella |
Scarlet fever | Finely spotted rash that appears within a few hours | The rash is located on an unchanged skin background and spreads to the extensor surfaces of the limbs and back. There is no sore throat, peeling of the skin of the fingers |
Infectious mononucleosis | Enlarged posterior cervical lymph nodes. Possible finely spotted rash | Lymph nodes are enlarged to a lesser extent. There is no prolonged fever, sore throat, enlarged liver and spleen, changes in peripheral blood typical of mononucleosis |
Pseudotuberculosis | Enlarged cervical lymph nodes. Maculopapular rash | There is no severe fever, abdominal pain, or tonsillitis. The rash appears at the beginning of the disease, and not on the 3rd-4th day; the localization of the rash characteristic of pseudotuberculosis (symptoms of “hood”, “gloves and socks”) is not observed. |
TREATMENT
Treatment is symptomatic. PREVENTION
Immunization with a live attenuated rubella vaccine is included in the compulsory vaccination schedule. Combination drugs have been developed that also include vaccines against measles and mumps. Vaccination against rubella is carried out at the age of 12 months, the vaccine is administered in a dose of 0.5 ml subcutaneously or intramuscularly. Second
Vaccination is carried out at the age of 7 or 13 years (for girls) to protect against rubella in children who have not been vaccinated or who have not developed immunity during the first vaccination. Sometimes, from the 5th to the 12th day after vaccination, enlargement of the occipital and cervical lymph nodes and a short-term rash may occur, which is regarded as a specific reaction to the introduction of a live attenuated virus.
Considering the ease of the course of rubella, the contagiousness of the patient already in the catarrhal period and the instability of the pathogen in the external environment, quarantine in children's groups in the case of rubella is not imposed. The following measures are carried out at the source of infection: the patient is isolated in separate room for 5 days from the moment the rash appears; children who have been in contact with the patient remain in the group, but are subject to daily examination for 21 days; in foci of rubella, pregnant women are isolated and observed for 21 days (serological tests are required in paired sera).
FORECAST
The prognosis for acquired rubella is favorable, but with the development of encephalitis, mortality can reach 20-40%. With congenital rubella, the prognosis is unfavorable, which is determined by a delay in physical development and the presence congenital anomalies. Immunity after rubella is usually persistent and lifelong.
Parotitis
Mumps is an acute infectious viral disease that occurs with damage to the glandular organs (usually the salivary glands, especially the parotid glands, less often the pancreas, genitals, mammary glands, etc.), as well as the nervous system (meningitis, meningoencephalitis). Based on the fact that clinical manifestations of mumps are not limited only to damage to the parotid salivary glands, it is more appropriate to call the disease a mumps infection.
ETIOLOGY
The causative agent is an RNA virus of the family Paramyxoviridae. The antigenic structure is stable; One serovar of mumps virus is known. The pathogen is stable in the external environment (at an air temperature of 18-20? C it persists for several days, and at low temperatures - up to several months), but is quickly inactivated when exposed to high temperatures and disinfectants.
EPIDEMIOLOGY
The source of infection is only a sick person (manifest, erased and asymptomatic form). The greatest epidemic danger is posed by patients with erased forms of the disease. The virus is released in the patient's saliva, starting from the last hours (possibly from the last 4-6 days) of the incubation period and during the first 9 days of illness. Maximum contagiousness is noted in the first 3-5 days; after the 9th day the patient is considered non-infectious. The route of transmission is airborne. The transmission factor is close contact. Contagiousness index - 70%. Susceptibility is about 85%. Children of preschool and primary school age are most often affected. With age, the number of cases of the disease decreases due to an increase in the layer of immune individuals. Cases of the disease among children of the first year of life are extremely rare due to the presence of specific antibodies received from the mother transplacentally and with milk. In persons over 40 years of age, mumps is rarely observed. Seasonality: the peak incidence occurs in the winter and spring months. The frequency of epidemic morbidity is 2-3 or 3-4 years.
The absence of catarrhal phenomena and reduced salivation make it impossible for the infection to spread to a distance of more than 2 m from the patient, so people from the immediate environment are mainly infected. This, as well as the presence of asymptomatic forms of the disease, also explains the relatively slow spread of infection during an epidemic outbreak (compared to influenza, measles and other droplet infections). It is possible to transmit the virus through toys and household items contaminated with saliva, but this route is not significant.
PATHOGENESIS
The mumps virus, entering the body through the mucous membrane of the nasal cavity, mouth, pharynx and conjunctiva, first circulates in the blood (primary viremia), then enters the glandular organs (salivary, gonads and pancreas), as well as the central nervous system, where multiplies and causes inflammatory reaction. The greatest reproduction of the virus occurs in the salivary glands. Primary viremia is supported by the repeated release of the pathogen from the affected organs (secondary viremia), so clinical manifestations of damage to a particular organ can appear both in the first days of the disease and at a later date. The persistence of the virus lasts 5-7 days, then IgM class antibodies appear in the blood. Final immunity with accumulation of IgG class antibodies is formed after several weeks.
CLINICAL PICTURE
The incubation period lasts 11-21 days (average 18), but can be shortened to 9 or extended to 26 days. The disease can manifest as isolated damage to individual organs or various combinations of characteristic syndromes (mumps, submaxillitis, serous meningitis or meningoencephalitis, orchitis, pancreatitis), occurring simultaneously or sequentially. Most often, mumps affects the salivary glands (mumps, submaxillitis, sublinguitis).
Mumps begins acutely with a rise in body temperature to 38-39? C, general malaise and pain in the parotid region, when opening the mouth and chewing, and sometimes tinnitus is noted. One of early signs mumps - pain behind the earlobe. Already on the first day before auricle and around the corner lower jaw you can palpate a swelling of doughy consistency, at first, as a rule, one-sided. On the mucous membrane of the cheek on the affected side, you can find an edematous and hyperemic outlet of the parotid salivary gland duct. With the sequential involvement of the second parotid, submandibular, sublingual glands and other organs, repeated rises in body temperature occur. During the height of the disease, the face of patients takes on a characteristic appearance, which is why the name “mumps” arose. Enlargement, swelling, tenderness of the parotid and/or submandibular glands (unilateral or bilateral) persists from 2 to 7 days, after which the pain subsides, the size of the enlarged gland begins to decrease and normalizes by the 8-10th day.
Submaxillitis develops in every fourth patient. In this case, the swelling with a doughy consistency is located in the submandibular region.
Sublinguitis, manifested by swelling under the tongue, develops extremely rarely.
Lesions of the pancreas (pancreatitis), gonads (orchitis, oophoritis), mammary gland (mastitis), as well as the central nervous system (serous meningitis, meningoencephalitis) are more often observed in combination with inflammation of the salivary glands (Table 22-5). Sometimes changes in the central nervous system or glandular organs come to the fore or occur in isolation.
CLASSIFICATION
The classification of mumps is presented in table. 22-6. There are typical and atypical forms mumps. Criteria for the severity of typical forms: severity and duration
Table 22-5.Clinical manifestations of damage to the glandular organs and central nervous system in mumps
Localization. Predominant clinical syndrome, frequency | Clinical manifestations |
Genital organs (testes, ovaries, mammary glands): orchitis (in adolescents and men); 10-34% | Increase in body temperature to 38-39? C 1-2 weeks after the onset of the disease, headache. Pain in the groin radiating to the testicle. Enlargement, hardening, soreness of the testicle, hyperemia of the scrotum. Reverse dynamics of symptoms after 5-7 days. Signs of testicular atrophy after 1-2 months |
Pancreas: pancreatitis; 3-72% (including asymptomatic forms) | Increased body temperature on the 5-9th day of illness. Pain in the abdomen of a “girdling” nature. Positive Mayo-Robson symptom, etc. Increased amylase levels in the blood and urine. Reverse dynamics of symptoms after 10-12 days |
CNS ( meninges, brain matter): serous meningitis (children from 3 to 9 years); 2-4% | Increased body temperature on the 7-10th day of illness. Headache, vomiting. Positive meningeal symptoms. High cytosis of lymphocytic nature in the cerebrospinal fluid. Reverse dynamics of symptoms after 3-5 days |
Table 22-6.Classification of mumps*
* According to Uchaikin V.F., 1998.
severity of fever and intoxication, the degree of damage to other glandular organs (orchitis, pancreatitis) and the nervous system (meningitis). Meningoencephalitis is an indicator of particular severity pathological process. The erased form differs slightly severe symptoms, slight swelling of the parotid gland, absence or minimal involvement of other glandular organs. Temperature
the patient's body is normal or subfebrile. Diagnosis of the subclinical form of the disease is based only on the results of serological studies.
DIAGNOSTICS AND DIFFERENTIAL DIAGNOSTICSDiagnosis of mumps in typical cases is not difficult. Difficulties arise in variants of the disease that occur in the form of submaxillitis or without damage to the salivary glands (isolated pancreatitis, serous meningitis, etc.). Epidemiological anamnesis provides some assistance in diagnosing these forms - cases of the disease in the family, children preschool institution, school. You can use serological diagnostic methods (RPGA, RTGA, ELISA), with the help of which the diagnosis can be confirmed retrospectively. Virological studies are labor-intensive, require specially equipped laboratory services, and therefore are not used in practical work.
Differential diagnosis of mumps is presented in table. 22-7.
TREATMENT
Treatment is usually carried out at home, patients are hospitalized for clinical (meningitis, meningoencephalitis, orchitis) and epidemiological indications. Specific therapy does not exist. Bed rest is prescribed until body temperature normalizes. A gentle diet (dairy-vegetable with a limitation of raw vegetables and fruits, fresh bread). Careful hygiene care behind the oral cavity. To the area of the affected glands - dry heat. If necessary, use symptomatic drugs (antipyretics for hyperthermia, etc.). For meningitis, dehydration and detoxification therapy, vitamins, nootropic drugs are prescribed, last years Interferon preparations have been successfully used. For orchitis, glucocorticoids, ribonuclease, and wearing a suspensor are indicated (at least 2-3 weeks). During treatment severe cases For pancreatitis, along with dietary measures, anti-enzyme drugs, such as aprotinin, are widely used.
Disease | General symptoms | Differences in mumps |
Purulent parotitis | It occurs suddenly and not against the background of a bacterial infection. There is no fluctuation in the center of the inflamed gland. Neutrophilic leukocytosis in peripheral blood and increased ESR are not typical |
|
Salivary stone disease | Enlargement and tenderness of the parotid gland | Increased body temperature, no indication of recurrent enlargement of the parotid gland in the past |
Cytomegalovirus infection | Enlargement of the parotid and submandibular glands | The enlargement of the glands is initially unilateral, and not symmetrical, as with generalized cytomegalovirus infection. Pneumonia, swollen lymph nodes, hepatosplenomegaly are not typical |
Sjögren's syndrome | Parotid gland enlargement | No “sicca syndrome”, no joint pain and other signs of rheumatic diseases, no changes in blood tests (except for leukopenia) |
Acute pancreatitis | Abdominal pain, increased amylase activity in the blood and urine | Typically, the picture of pancreatitis develops in the 2nd week of illness with subsiding symptoms of mumps (submaxillitis) |
Serous meningitis due to enterovirus infection | Meningeal syndrome, lymphocytic cytosis of cerebrospinal fluid | More often it occurs in the 2nd week of illness with subsiding symptoms of mumps (submaxillitis). There is no exanthema and the characteristic appearance of a patient with enterovirus infection |
in the form of a short-term increase in body temperature. Rarely, slight enlargement of the parotid gland occurs. It is extremely rare that complications may develop these days: excessive general reaction(high body temperature, intoxication, abdominal pain), meningeal syndrome, which requires hospitalization of the child and the issuance of an emergency notification to the Center for Sensitivity and Epidemiology. Final disinfection is not carried out at the source of the disease. It is enough to ventilate the room and carry out wet cleaning. Children under 10 years of age who have not had mumps are separated for 21 days from the moment of contact. When installed exact date contact children are not allowed into an organized group from the 11th to the 21st day.
FORECAST
The prognosis is generally favorable. Severe infection with systemic manifestations (meningitis, pancreatitis, orchitis) usually occurs in people over 15 years of age; in such cases, the disease does not always go away without a trace. For example, it is believed that 1/4 of all cases of male infertility are caused by mumps.
Vaccination measles rubella mumps - The trinity of well-known childhood infections - measles, rubella and mumps - are viral in nature and highly contagious. If an unvaccinated person comes down with one of these ailments, then with a probability of 95% he will get measles, 98% (almost 100%!!) rubella and 40% - mumps (colloquially called “mumps”). This infection can only be transmitted by humans and these diseases, accordingly, are also only “human”, so to speak.1. How is it transmitted?
2. Measles-rubella-mumps vaccination for adults
3. Vaccination of measles, mumps, and rubella for children
4. Where is the vaccine given?
5. Vaccination measles rubella mumps reaction
6. Complications
7. Contraindications
8. Types of vaccines
9. Vaccination measles rubella mumps Komarovsky vaccination. Video
How is it transmitted?
The pathogen reaches a person through airborne droplets or after communicating with a sick person. From the moment of infection until the onset of symptoms, an “incubation period” passes; this is usually 10-20 days, and all this time the person carries the virus within himself and, unwittingly, is a source of infection. In the chain, the incubation period is the disease-cure and the disappearance of symptoms after the onset last stage the sick person is contagious to others for about another week. The largest number of cases are children 5-7 years old.Measles-rubella-mumps vaccination for adults
A distinctive feature of this vaccine is its polyvalency, which makes it possible to give a child a drug with just one injection, on the basis of which protection will develop against three infections at once.After all, measles, rubella and mumps are by no means harmless diseases. And when a woman expecting a child becomes infected with rubella, there is an almost 100% guarantee that the baby will have health problems. If someone expecting a baby gets mumps, there is a 25% chance of a miscarriage.
It should be noted that rubella threatens women, while mumps threatens men.
Orchitis acquired during illness threatens the future man with the development of infertility in 20% of cases, which in general can be cured; orchitis can be temporary. But in the case of a boy aged 13-15 years old, childlessness threatens to be incurable, since your son became ill during his maturation and growth.
Measles, mumps, rubella vaccination for children
The injection is given to babies twice - at one year and at six years. This vaccination regimen is due to the incomplete formation of immunity in some children. Children will receive their next measles, rubella and mumps injection when they are 15 to 17 years old. For teenagers, vaccination is good because:- Firstly, protection against rubella is extended for girls, which is important because in the coming years they will become mothers.
- Secondly, immunity against measles is activated
- Thirdly, the protection of young people from mumps will also last and will not allow extremely negative consequences to develop in case of infection.
Vaccination schedule
Children tolerate the injection of the measles, rubella and mumps vaccine well. It gives minimal reaction and maximum possible protection. It is highly desirable to cover up to 80% of the population with vaccinations. Because if the coverage is less, the infection will develop due to the morbidity of adults and the elderly, here the complications will be complicated and aggravated by the age of the patients.By Russian calendar Vaccinations against measles, rubella and mumps are given at the following intervals:
- 1 year old
- 6 years
- 15-17 years old
- 22-29 years and further at intervals of 10 years.
Where is the vaccine given?
The vaccine is administered intramuscularly or under the skin. Children under three years old will receive an injection into the outer thigh, and for older children, the injection will be given into the shoulder. Preference is given to these parts, since nearby muscles, little subcutaneous fat and thin skin guarantee optimal quality of insertion and absorption.
The peculiarity of the response to the vaccine against measles, rubella and mumps in children is the appearance of a response after 5-15 days according to the delayed type of reactions. This happens due to the presence of weakened live viruses in the vaccine and the peak of their development occurs exactly 5-15 days after the injection.
Vaccination measles rubella mumps reaction
Local reactions are, in principle, standard for injections: redness and thickening at the puncture site occur on the first day and go away on their own within a few days.Special responses of the body in the form
- elevated temperature,
- enlarged parotid and cervical lymph nodes,
- subtle rash on the body,
- red throat,
- runny nose,
- mild cough.
Appears in 10-20% of vaccinated children. They are considered normal because their occurrence shows that the immune system is working. The post-vaccination state of health is not abnormal and will pass within a week. If any suspicious condition that requires additional attention appears after 5-15 days after the injection of the drug, then it is not related to vaccination, but reflects a new disease or its symptom.
Complications
Isolated complications are possible. They must be distinguished from severe reactions, which are expressed by extremely strong symptoms of side effects (rash, fever, cough). Such problems mean- Allergy and swelling at the puncture site,
- encephalitis,
- Serous meningitis,
- Pneumonia,
- decrease in the number of platelets in the blood,
- inflammation of the heart muscle
- syndrome toxic shock(due to contamination of the vaccine by microorganisms).
Contraindications
Contraindications to the measles, rubella and mumps vaccine can be divided into permanent and temporary.Temporary- expecting a child, various kinds exacerbations, obtaining blood products. At the end of all these processes, you can give an injection.
Permanent– reactions to Neomycin and Kanamycin; intolerance egg white; tumors of various nature; previous reactions to the drug.
Types of vaccines
We can highlight:- three-component (measles, rubella, mumps), d
- two-component (measles-rubella or measles-mumps) and
- monocomponent vaccine (against one infection).
Drugs domestic production based on quail egg. In our country they make a two-component drug - for rubella and mumps. In this regard, it is necessary to do two injections - involving several parts of the body, usually both arms. This is not always good.MMR-II
Compared to Russian ones, imported drugs have an advantage, if only because they are three-component and one administration is enough. By appearance rate adverse reactions foreign drugs are identical to domestic ones. The most common imported drugs are:
- "Priorix", Belgium,
- "Ervevax", Britain,
- MMR-II, American-Dutch vaccine.
To summarize, we can say that vaccination against measles, rubella, mumps for children, in our opinion, is one of the most important. The price for you to give up this drug is too high. Your daughter or son, in addition to the possible diseases already described above, may undermine their health and never have children, which will be a great tragedy
Please weigh the pros and cons. Assess your baby's health and think about the not-so-distant future, in which your fears may lead to dark times for your children. If you are one of the opponents of vaccination, protect them at least on the basis of gender (from rubella in girls and from mumps in boys) so that the joy of procreation does not pass them by in adulthood. The monovaccine will not harm their health.
Vaccination measles rubella mumps Komarovsky vaccination. Video
Endless childhood vaccinations are an opportunity to avoid many serious illnesses in a later period. When immunization is carried out against three dangerous infections at once, time can be saved and another emotional stress associated with this unpleasant procedure can be avoided.
The measles, rubella and mumps vaccine is a type of injection. It is easy to do, but how it is tolerated and how many side effects it has, few people think about until they encounter it in real life. What are the possible reactions to the measles, rubella, mumps vaccine and how can you prepare for the upcoming vaccination? Let's find out everything about her.
Why are measles, rubella and mumps dangerous?
You can become infected with the diseases for which this vaccine is intended even before birth. It happens that intrauterine infection occurs when the outcome is unpredictable for the mother and the unborn child. What other dangers can children expect when encountering these viruses, besides severe symptoms?
- If a pregnant woman becomes infected with measles or comes into contact with a sick person, this can result in the death of the fetus and numerous malformations of the child - myopia, heart defects, deafness and impaired physical development of the baby.
- characterized not only by inflammation of the parotid and salivary glands, it often leads to inflammation of the brain and testicles (orchitis), which sometimes causes infertility.
- Rare complications of mumps include pancreatitis, arthritis, and nephritis.
- reduces immunity, which can result in numerous and dangerous bacterial complications.
- Measles also causes illness internal organs: hepatitis, tracheobronchitis, panencephalitis (inflammatory process of all membranes of the brain).
The immunity that babies receive from their mother at birth is unstable and lasts only a few months. Therefore, every child needs vaccination against such infections to protect him at any age.
Vaccination schedule and location of vaccine administration
In most cases, vaccinations against measles, rubella, and mumps are combined against these three diseases, but there are also single vaccines. The measles, rubella, and mumps vaccination schedule is as follows.
There is no exact data on how long the vaccine protects a person against measles, mumps and rubella. It can last for 10–25 years, depending on the characteristics of the body and the susceptibility of the vaccine.
What to do if the vaccination schedule is violated or if the child did not receive immunoprophylaxis against these infections in a timely manner?
If a vaccination against measles, rubella and mumps virus is prescribed, where is it given?
The vaccination dose of the combined vaccine, which is 0.5 ml of the drug, is injected subcutaneously under the shoulder blade or into the outer surface of the right shoulder (the conventional border between the middle and lower third).
How do children tolerate the measles, rubella, and mumps vaccine?
Child's immunity different years life may react differently to the measles, rubella, and mumps vaccine. This is explained by the maturation of all body systems and the fact that in case of revaccination the drug is re-administered.
How is the measles, rubella, mumps vaccine tolerated at 1 year of age? Often children react to vaccination with a condition resembling a mild viral infection. This may appear:
TO local reactions include hyperemia (redness) and swelling of the tissue at the site where the vaccine was administered.
How is the measles, rubella, and mumps vaccine tolerated at 6 years of age? - the manifestations are still the same as at 1 year. In addition, sometimes allergic reactions occur in the form of a rash at the injection site or throughout the body. On top of that, bacterial complications occur in the form of bronchitis, sore throat, otitis, which is often the result of improper behavior before or after vaccination.
There are also specific symptoms for vaccination. They do not apply to all components of the polyvaccine, but to its specific components.
Reactions and complications to the measles vaccine component
Some conditions after vaccination should not be taken into account; many of them are quite natural reaction body for the introduction of protective antibodies. But forewarned means forearmed. It is much easier to cope with the consequences of vaccination when you have heard about them.
The measles, rubella, mumps vaccine has the greatest reactogenicity due to its measles component. It is important to remember that vaccines with a measles component are live. Is a child contagious after vaccination with measles, rubella, and mumps? There is no need to be afraid of it; it contains significantly weakened viruses that normally do not lead to the development of infection.
The body's reactions in children to the measles component of the vaccine are as follows:
As noted above, it is the measles component of this complex vaccine that most often leads to complications. Complications do occur, but nevertheless they do not happen very often and develop from 6 to 11 days. These include the following conditions:
Body reactions to a component of the mumps vaccine
- slight enlargement of the parotid salivary glands for one to three days;
- redness of the throat, rhinitis;
- short-term rise in temperature.
How long does the temperature last? - no more than two days.
Unlike complications of antibodies against measles, the consequences of the mumps component are less pronounced and rare.
Possible reactions to rubella protection
Prevention of rubella in multicomponent vaccine represented by living weakened virus cells. In children, reactions are rare and are not severe in nature.
- Enlarged lymph nodes after vaccination with measles, rubella, mumps and redness of the injection site.
- A slight increase in temperature for one, maximum two days.
- Very rarely, arthralgia or the appearance of pain in the joint area occurs with little stress and at rest.
If, after vaccination with measles, rubella, mumps, a rash appears in the form of small roseola (small reddish spots) or spots purple- this is a complication of the rubella component.
How to cope with the consequences of vaccination
Reactions in the form of redness and swelling are normal. This creates an inflammation with a large number of blood cells at the injection site, making the immune response faster and more effective. Even if the reaction lasts for two days, there is no need to panic. Conventional anti-inflammatory, antiallergic and antipyretic drugs will help cope with such symptoms.
If significant complications occur after vaccination with measles, rubella, mumps, you should consult a doctor as soon as possible. In some cases, more serious medicines, observation by health care workers or hospitalization.
Contraindications for vaccination: measles, rubella, mumps
Not everyone is eligible for the use of medications that protect against these infections. In all cases, contraindications can be divided into permanent and temporary.
Permanent contraindications to vaccination:
Temporary contraindications to vaccination:
- chemotherapy that suppresses the immune system;
- exacerbation of chronic diseases or ARVI;
- administration of immunoglobulin or blood components, then the vaccination is done no earlier than three months later.
How to behave before vaccination
How can I help my child tolerate vaccination more easily? It is easier to prepare for this unpleasant procedure than to deal with many complications later.
What not to do after vaccination
In order not to confuse vaccination complications with other similar conditions, you need to be on guard even after immunization.
It is important to stock up on the necessary medications in advance and discuss with your doctor the possible consequences of vaccination.
Types of vaccines used
There is no domestic three-component vaccine for measles, rubella and mumps. Now in clinics there is only a two-component version with protection against measles and mumps, which is a certain inconvenience, because you will have to do another additional injection against rubella. But in terms of portability they are not inferior to foreign ones.
Among the imported vaccines against measles, rubella, mumps, the following have been successfully used for many years:
- MMR against measles, mumps and rubella, which is produced by a joint American-Dutch company;
- Belgian Priorix;
- English "Ervevax".
Vaccinations made with imported vaccines are much more convenient. The protection of each against measles, rubella and mumps is not inferior Russian analogue. But unlike domestic vaccines, you will have to pay for imported ones yourself, and they cost a lot. Another disadvantage is the need to search for a foreign vaccine. You will have to take care of this in advance. You need to order it or look for it in others medical institutions, not forgetting about the conditions of transportation and storage of the drug.
Which vaccine to prefer is the choice of the people who will be vaccinated.
Do I need to get the measles, rubella, mumps vaccine? Without exaggeration, we can say that this is one of the most important vaccines against infections in our time. It is easier to deal with the side effects of the measles, infectious rubella and mumps vaccine than to correct the numerous complications of diseases caused by these viruses!
