About MMR and MMR vaccination symptoms - Side Effects of MMR vaccine

About MMR and MMR vaccination symptoms - Side Effects of MMR vaccine

The MMR vaccine protects your child against measles three potentially serious diseases, mumps and rubella, also known as rubella. MMR vaccine is usually given in two doses. The first dose is mandatory given when the child is 12-15 months old.

And the second when the first school going, that is 4 to 6 years of age. MMR may be substituted by MMRV which is the same as MMR, but give protection against varicella virus as well. Varicella virus is what leads to the fowl pox disease.

The first M MMR, which is the Measles is a highly contagious, especially in children and can lead to pneumonia, convulsions, brain injury, encephalitis, ear infection and diarrhea. The usual symptoms of measles include fever, cough, runny nose, itching and irritation.

OM second MMR means mumps which is a viral infection. Mumps can affect the operation of the child's reproductive organs. Its symptoms include inflammation of the cheeks and along the jaw line, fever and headache. And finally, the R rubella MMR means which is also known as German measles.

 Rubella has the following symptoms red rash on the face, low-grade fever and swollen lymph nodes. Pregnant women should avoid getting rubella, it can lead to miscarriage or infant birth defects.

Each vaccine may have some small or, in rare cases, important side effects. Possible side effects of MMR vaccine include swelling or pain at the site where the picture is taken, slight fever, body pain, swelling and rashes. Serious side effects include allergic reactions and long-term seizures.

In case your child has mild fever, then it is better to postpone the vaccination. In case your child has had some side effects of the first dose, let the doctor know about it before the second dose. Discuss with your doctor if your child has any allergies to egg, it is allergic to gelatin (the one used in Jell-O) is on steroids, have any disease that is related to the immune system or have a blood disorder.

Lately, it has been reported that some children vaccinated with MMR showed symptoms of autism later. These reports have not been proven by the scientific community though. However, it should be remembered that the benefits derived from the MMR vaccine far outweighs any side effects.

Rubella vaccination campaign

Rubella vaccination campaign

A disease that can cause vision problems requires attention

Rubella is an acute and highly contagious disease caused by Togaviridae, a virus Rubivirus genre. Its main symptom is a rash, small red lesions, similar to those of measles, which usually begins on the face and then spreads throughout the body. The vaccine against rubella, which is part of the Brazilian Vaccination Official Calendar, provides effective protection against the disease and the first dose should be given to children in the first year of life and adults, especially women, who have not contacted with the virus.

Until September 12, the Ministry of Health promotes greater vaccination campaign against the disease ever undertaken in the world in order to immunize adults. Men are the main focus of the campaign this year, as in previous years, the audience were children and women. To get an idea of 8,684 rubella cases confirmed in the country in 2007, 70% of them correspond to male patients. But to eliminate the virus circulation in the country is also essential vaccinate females. In all, 35.3 million women should be immunized. 

Congenital rubella

Rubella virus belongs to Rubivirus family and is transmitted by saliva droplets eliminated when the carrier of the virus or the disease speaks, coughs, sneezes. Not necessarily that individual gets sick and manifest the characteristic symptoms of rubella: fever, joint pain, rash, swollen lymph nodes. Often, the carrier is healthy but carry the virus in the throat, excretes it in saliva and transmit it to others. Most people who get rubella virus do not get sick, but develops an asymptomatic or subclinical infection and transmits the virus for a while. The transmission period begins ten days before the rash appears and persists for another fortnight after his disappearance.

The time at which transmission of the virus occurs without obvious signs of disease, is long. In fact, roughly 20% of infected people develop symptoms. The other 80% are asymptomatic, although they are transmitting the virus. The rubella virus is called teratogenic, it has the ability to cause changes in developing tissues. Therefore, the earlier in pregnancy the woman is infected with it, the greater the damage to the child. In recent months, the impact tends to be lower on the fetus. That is, in the first three months of pregnancy, fetal tissues are very immature and any viral interference causes more intense commitment than cause tissue already formed. 


These changes occur because the rubella virus crosses the placenta and fetal tissues is installed. In general, rubella virus is prevalent in tissues of the nervous system and cardiac tissues, but can also cause bone disorders. The fontanelle or soft spot of the child, which should close in time, remains open and may remain also open the ducts of the heart. As the eyes are nothing more than extensions brain - are actually part of the brain that captures the image because the other is covered by the skull - this predilection for nervous tissue can cause cataracts, blindness and microphthalmia. This involvement of the brain can also cause mental retardation.

The microphthalmia is a type of malformation of the eyes, which do not grow. Eyeballs are undeveloped do not meet the eye fossa. Today, there are already techniques for the presence of rubella virus in the bloodstream or in the amniotic fluid, which allows the doctor to identify the infection and for damage installed able to derail or compromising the child's quality of life. Ideally, all women who want to become pregnant do blood test to know if you are immunized against rubella. This exam is part of prenuptial examinations list that are not always made ​​before the start of sexual life. Therefore, all women who wish to become pregnant should make serologic testing to know how is your immunity to rubella. If it is proven that they are not immune, need to take the vaccine, which is extremely effective - effective vaccine is close to 100% - and prevent congenital rubella syndrome. 


If the blood test shows that there are protective antibodies against disease, this woman does not need to take the vaccine, because it has been vaccinated or has come into contact with the virus in the past and is immunized. Otherwise, vaccination is mandatory. Remember that the rubella vaccine is made with live virus, although attenuated in their ability to produce disease. Therefore, a woman can not be pregnant at the time of taking this vaccine because the virus can cause fetal harm. It is also important to know that once vaccinated, the ideal is that women wait four weeks to get pregnant.

MMR - a triple vaccine against measles, mumps (mumps) and Rubella VAS - anti measles vaccine VAR - anti rubella vaccine

MMR - a triple vaccine against measles, mumps (mumps) and Rubella VAS  - anti measles vaccine VAR   - anti rubella vaccine

The three components of the MMR - measles, mumps and anti-rubella - vaccines are produced from virus strains attenuated.

Vaccination against measles began in Portugal with VAS in 1973, with a campaign aimed at children up to 5 years old. In 1974 the vaccine was included in the PNV by administering a single dose at 12-15 months. In 1987 it was introduced into the PNV vaccination against parotitis (Mumps), and rubella, and these two vaccines administered in combination with measles vaccine in a trivalent vaccine, MMR. The MMR was administered as a single dose at 15 months, and the VAS vaccine began to be used only in special circumstances where it is necessary isolated measles immunization, such as in children less than 12 months in case of epidemic. In these cases remains the usual recommendation for the administration of MMR by 15 months.

The PNV 1990 introduced a 2nd dose of MMR to be administered at 11-13 years (for a theoretical discussion, see ref 21 ). In 1999 CTV reviewed the PNV and decreased age 2nd dose for 5-6 years with the aim of achieving higher immunization coverage.

At present, it is recommended to 1st dose of MMR at 15 months and, for those born after 1993, the 2nd dose at 5-6 years, before compulsory education. For infants to 1993 (inclusive) 2nd dose is given to 10-13 years of age.

In both sexes it is always a 2nd dose of MMR, regardless of age it was made the 1st dose of MMR or VAS. Between the two doses recommended a range of at least 2 months.

Peek here the impact of antibiotics and vaccination had on the number of deaths per year due to measles complications in Portugal.

Specific recommendations (DGS recommendations)

After age 18, women of childbearing age, with no previous dose of rubella vaccine (VAR or MMR) and whose immune status is unknown, should make one dose of MMR. The determination of antibodies against rubella is not required to make the decision to vaccinate.
The women not immunized or whose immune status is unknown, should also be vaccinated in the maternity or postpartum review consultation, not losing so vaccination opportunities .

Women of childbearing potential should be advised of the theoretical risk they run, if they are pregnant at the time of vaccination and if they become pregnant within three months, due mainly to the component against rubella.

The appearance of outbreaks of measles may warrant administration of a vaccine against measles - VAS (MMR the monovalent vaccine is not available) - from 6 to 11 months of age should keep the administration of the MMR by 15 months of R age.
The MMR I can be anticipated for the 12 months after an outbreak.

The measles vaccine can provide protection if administered within 72 hours after exposure to the measles virus, it is recommended vaccination with MMR or VAS to all susceptible individuals (ie no record of at least one dose of MMR and VAS or without credible previous history of measles) over 6 months and which have been contacted with measles cases.

Children with HIV positive, asymptomatic or symptomatic, without severe immunosuppression should make the MMR at 12 months of age (these children the MMR requires a prescription), followed by a second dose should be administered as early as possible (minimum interval 4 weeks from the first dose).
If measles exposure risk is high, vaccination should be carried out at an earlier age, between 6 and 9 months old, in which case it will make a new dose of MMR to 12 months and a booster four weeks later.

    

Post-vaccination reactions

Measles (VAS or included in MMR)

In about 5-15% of cases may arise fever over 39,4ºC, starting between the 5th and the 12th day after vaccination. The disease usually takes 1 to 2 days (up to 5 days). In 5% of vaccinees may create transient rash, with or without fever.

Rubella vaccine (VAR or included in MMR)

The reactions normally associated with rubella vaccine are mild and rarely occur: rash, fever and lymphadenopathy, 5-12 days after vaccination. Occasionally, there may be transitional arthralgia in the small joints between 7 and 21 days after vaccination, especially in women from puberty.

Vaccine against mumps (included in MMR)

The most common local reactions, short, are burning, ulceration and / or skin irritation. Very rarely can arise mild allergic reactions (wheal or purple spot). General reactions attributed to the component against mumps are rare, registering occasional mild fever, lymphadenopathy, cough and rhinitis.

Contraindications

An anaphylactic reaction to egg history does not imply an anaphylactic reaction to the vaccines produced in cell cultures of chick embryo as is the case of some vaccines MMR and VAS.
However, and although unlikely to be an anaphylactic reaction following administration of these vaccines it is recommended that the same arises in hospitals.

In general, severe hypersensitivity to certain antibiotics contraindicate the use of vaccines that include in their composition.
VAS, VAR and MMR may contain neomycin, being in this case contraindicated in severe hypersensitivity conditions antibiotic.

Severe hypersensitivity to gelatin contraindicates some vaccines VAS, VAR and MMR, which contain this component.

Called attention to reading the leaflet of the vaccines and the Summary of Product Characteristics (SPC) in order to verify its composition. In severe cases of hypersensitivity to a substance that is part of the composition of a vaccine available in services may be considered the occasional use of a vaccine of another brand that is free of this substance.

Pregnancy

Although no evidence of teratogenicity, live vaccines should not be given to pregnant women, mainly VAS, the VAR and the MMR.

Immune changes

In general, live vaccines (BCG, OPV, MMR) should not be administered to patients with:

- congenital immunodeficiency syndromes such as hipogamo-globulinémias or severe combined immunodeficiency;

- immunodepression states due to some malignancies, such lymphomas and other tumors of the reticulo-endothelial system and leukemias;

- immunosuppressive conditions associated with certain therapeutic. It must be ensured a minimum of 3 months after discontinuation of therapy to administer a live vaccine. The vaccination requires a prescription.

- immunosuppression states due to systemic therapy with corticosteroids at high doses (> = 2 mg / kg / day of prednisolone or 20 md / day for children weighing> 10 kg):
   * for less than 14 days ( daily or on alternate days). Live vaccines may be administered immediately after stopping the treatment, but preferably after 2 weeks.
   * for 14 days or more (daily or on alternate days). Live vaccines may be administered one month after stopping treatment.

- Organ transplants. After transplantation, they should not be administered live vaccines. Children over 12 months, should make the MMR at least one month before the transplant.

In the allogeneic and autologous bone marrow transplantation, as immunity induced by vaccination is lost after transplantation becomes necessary revaccination. The MMR administration is recommended two years after the transplant, unless the transplant recipients are the immunosuppressive therapy if they have had a relapse or if the host versus active donor disease.

Individuals with HIV-positive, asymptomatic or symptomatic, without severe immunosuppression, must comply with the immunization schedule of the PNV, but the MMR should be brought forward to 12 months of age (or exceptionally to 6-9 months of age).

Individuals with HIV positive, symptomatic and with severe immunosuppression may not receive any of the live vaccines of the PNV.

Following administration of vaccines against measles, mumps and rubella (VAS / VAR / MMR) must be ensured if a minimum of two weeks for administration of products containing immunoglobulins.

Following administration of products containing immunoglobulins, and in relation to measles, mumps and rubella, must be ensured a minimum of 3 months.
Vaccination of individuals who immunoglobulins or did transfusions were administered requires a prescription.

   Effectiveness of vaccines - the case of mumps

The efficacy of measles and rubella components of MMR is quite high - it is estimated that 95% Ronde. The anti-mumps component (-papeira), however, raised some doubts in the mid-1990s Any decline in its effectiveness was associated with mumps epidemic recorded in 1996-1997 in Portugal. An explanation on this issue is appropriate. In 1987, the market existing MMR vaccines included three strains of mumps virus: Urabe Am9 (Japanese), Rubini (Switzerland) and Jeryl Lynn (USA). In Portugal, between 1987 and 1992, MMR vaccine were used with the three strains. However, following cases of post-vaccination encephalitis occurred in the United Kingdom, Canada and Japan, apparently related to the Urabe strain Am9, the Ministry of Health decided to purchase and administration of MMR with Urabe strain Am9 (Pluserix the vaccine) in October 1992. Like many other European countries from 1993 strain in use in national PNV has become almost exclusively the MMR with Rubini (Triviraten vaccine). This strain, however, was associated for several Portuguese authors to the rise in the number of mumps cases observed 2 or 3 years after the adoption of the Rubini strain, suggesting a significant decrease in effectiveness of the MMR component. There were similar outbreaks in other European countries and subsequent studies of vaccine efficacy, and abroad in Portugal, they suggested that, in fact, this is much smaller in Rubini than in other vaccine strains. At present, the MMR used in PNV national exclusively uses the Jeryl Lynn strain.

It is crucial to have high MMR vaccination coverage - the example of congenital rubella.

The diseases against which the MMR protects are generally benign when contracted early in life. However, the likelihood of such diseases originate serious complications tends to increase with age in which they are contracted. Examples include encephalitis caused by the measles, mumps orchitis following the, or the risk of congenital rubella syndrome (CRS) in the young in age who may become pregnant. If a pregnant young rubella, the virus can infect the fetus and cause a serious neurological disease in newborn known to SRC.

When betting on a vaccination strategy that aims to interrupt the circulation of these viruses through high immunization coverage rates, decreases greatly the likelihood of a person "find" the infectious agents from the moment it is born. Thus, the incidence of these diseases greatly lower, but the few reported cases occur in older ages than occurred in the days before vaccination. It will be shown mathematically that if the vaccine coverage is not sufficiently high (say,> 85%), although lower the absolute number of cases of disease, the proportion of these cases occurs in age increases very dangerous and, in the final balance there may be more cases with serious complications than there was before vaccination.

This undesirable effect of mass population vaccination is why certain industrialized countries which experience shows to be very difficult to achieve high vaccination coverage, they chose not to administer the MMR across the board. In the UK, for example, long been the rubella vaccine was not given to children and is only recommended for young women in pre-teens ages. The goal of vaccination, in this case, was not impede the movement of the virus but rather to prevent the onset cases of congenital rubella.

Mass vaccination with MMR therefore requires very high vaccination coverage (the complete safety is above 90%) and the reasoning can be generalized to diseases in which the risk of complications increases with age when they are contracted. The introduction of vaccines against these diseases always requires consideration of the danger of vaccine coverage are not high enough.

Rubella vaccine - vaccination in children and adults

Rubella vaccine - vaccination in children and adults

Rubella and doses of the vaccine

The vaccine against rubella is the injection of live attenuated (weakened). Although there is specific rubella vaccine, vaccination is usually done with MMR, which immunizes against rubella, measles and mumps. The MMR vaccination is recommended for children between 12 and 15 months, with a second dose between 4 and 6 years old. The rubella vaccine is particularly important for women who may become pregnant not immunized because of the serious risks to the fetus if they are infected during pregnancy.

What is MMR vaccine against rubella, measles and mumps?

MMR vaccine is a mixture of three types of live attenuated viruses. It is administered via injection for immunization against rubella, measles and mumps. MMR is usually given to children after completing 1 year of age, with a second dose before entering the school, with 4 or 5 years of age. The second dose of the vaccine is not a building, it is to immunize the small number of people (2-5%) who have not acquired immunity in the first dose.

Why the MMR vaccine rubella, measles and mumps is given after the first year of the child?

Most children receive passive protection against measles, rubella and mumps as mothers antibodies. Such antibodies may destroy the vaccine viruses are present when it is administered, compromising its effectiveness. After 12 months of age most children have lost this passive protection.

Rubella vaccination in adults

The main objective of vaccination against rubella adults is to prevent congenital rubella syndrome, which can cause serious harm to the fetus. About 20% of women of reproductive age are still susceptible to rubella despite vaccination programs. Rubella virus can infect the fetus at any stage of pregnancy, but the defects to the fetus rarely occur if the infection occurs after 16 the week of pregnancy. Pregnant women should not be vaccinated against rubella, since the vaccine contains viruses.

What women wishing to become pregnant should do about rubella?

It is recommended that all women who wish to become pregnant to make test to know if they are immunized against rubella. If necessary, the woman should be immunized with the vaccine before becoming pregnant. This prevents the child contracting congenital rubella syndrome, which can be fatal to the fetus or cause serious problems. If the woman becomes pregnant without being immunized, should avoid contact with people who have symptoms suggestive of rubella, as spots on the face.

Rubella transmission

The transmission of rubella occurs through the air when coughing, talking or sneezing. The confirmation that the person has been infected by rubella is made ​​by blood test. The person with rubella can transmit the disease in about a week before the appearance of stains and about a week later.

Rubella vaccine

Rubella vaccine

It also contains hydrolyzed gelatin, sorbitol and neomycin traits. The lyophilized vaccine alone, or in combination with measles and mumps (MMR II or Trimovax), it must be kept under refrigeration at +2 to + 8 ° C and protected from light.

The application is by subcutaneous injection, from 12 months of age, a single dose. Its efficiency is around 95%, but natural infection produces four to eight times more antibodies that artificial active immunization. The most frequent adverse reactions are mild fever, mild lymphadenopathy, neck pain and arthralgia.

The biggest contraindication is pregnancy. Therefore, when vaccinating adult women must be assured absence of pregnancy at the time of application of the vaccine and during the following three months. For this reason, it is recommended the use of anovulatory during this period.

After vaccination, the vaccine virus can be found in the nasopharynx, but is not transferable. The existing works to date show that there is no risk of a pregnant purchase the vaccine virus from vaccinated individuals. The other contraindications are: individuals with malignancies, immune deficiency, use of immunosuppressants and corticosteroids, hypersensitivity to neomycin.

RUBELLA | SYMPTOMS AND DIAGNOSIS

RUBELLA | SYMPTOMS AND DIAGNOSIS

Rubella is a viral infection, highly contagious, which typically affects children. Rubella is usually a benign infection, but it can cause serious complications if acquired during pregnancy.

WHAT IS RUBELLA?

Rubella is a viral infection that usually causes fever and reddish spots in the body, calls rash . Man is the only host of this virus.

Rubella is a disease that is becoming less and less common, especially after the intensification of immunization campaigns in recent years. In Brazil, there are no cases of rubella reported since 2009.

TRANSMISSION OF RUBELLA

Rubella is transmitted by the airways through spit (saliva droplets), as with most airborne transmission of viral infections. Rubella virus is highly contagious and is usually spread by sneezing, coughing, kissing, cutlery or even through conversations if there is enough time and close contact with droplets.

The incubation period rubella, ie the time interval between the contamination and the onset of symptoms, is on average 14 to 18 days. However, since the infected individual becomes contagious one to two weeks before becoming clinically apparent infection. This means that a few days after being infected, and before any symptom, the patient is capable of passing the virus to others.

In many cases, rubella infection is so weak that goes unnoticed, which does not, however, the patient infect others. For this reason, many individuals with rubella can not identify who the contaminated.

Rubella virus normally invades the body via the airways, but five to seven days after the infection is already spread all over the body, it may be found in blood, urine, lung, cerebrospinal fluid, skin, etc.

After the appearance of the rash, the transmission rate begins to drop, leaving the patient to be infectious 5 or 7 days later.

SYMPTOMS RUBELLA

In most people, rubella has few or no symptoms. This is particularly true in children, who often have a very weak rubella frame.

In those who developed symptoms, these arise 2 to 3 weeks after being contaminated. The initial symptoms of rubella are nonspecific, similar to any viral infection, with fever, body aches, headache, sore throat, runny nose and prostration. A more careful physical examination may reveal lymph nodes (swollen lymph nodes) in the neck and behind the ears, which are very characteristic of rubella.

rubella photo

After 1-3 days of nonspecific symptoms, rash (rash) appears rubella, which are small diffuse red spots, as pictured alongside. The rash usually starts on the face and down to the rest of the body within hours. Lasts about 3 days and then disappears. Besides the skin, the rash can also occur on the palate (roof of the mouth). At this stage, one joint pain and conjunctivitis frame is also common.

The rash disappears faster, but the lymph nodes and joint pain can still last a few days. Children recover faster than adults, which may keep joint pain for up to a month.

As I said, most people do not develop symptoms after contact with the virus. Even those who develop symptoms of rubella, virtually all improve spontaneously. Rarely, on average one every 6000 cases, the virus can affect the brain, leading to what we call viral encephalitis, a serious framework and with high mortality.

Children with rubella should stay at home until the rash disappear completely, to avoid contamination of colleagues. As rubella is a disease that is about to be eradicated, all cases must be reported to the health department.

RUBELLA DIAGNOSTICS

The diagnosis of rubella is usually done through the clinical picture. The differential diagnosis should be done with parvovirus and scarlet fever (read: scarlet | Symptoms and treatment ), which have a very similar rash.

Four days after the appearance of the rash, the body already has antibodies against rubella, which allows for serology laboratory to confirm the disease. As this stage most people are already cured or healing process, and as there is no specific treatment for rubella, his laboratory confirmation is usually unnecessary (except in pregnancy. I explain below).

In serology there are two types of antibodies: IgM and IgG antibodies. The first to appear is IgM, which is the antibody attacks the virus. The IgM rubella usually longer be detectable on the 4th day of rash and remain positive for up to eight weeks. After curing, the second type of antibody arises, the IgG antibodies against rubella. The antibody is an IgG indicates that the patient has the disease and is now cured and immunized. So who's with rubella IgM positive features. Anyone who has had rubella or been vaccinated presents IgG reagent.

After curing, the IgG antibodies provide a new episodes of immunization against rubella. Therefore, rubella only caught once in life. Are rare and mild cases of reinfection. The patient may have contact again with the rubella virus, but IgG titers rise rapidly, preventing the patient develop the disease a second time.

Explained the interpretation of rubella serology in more detail in this article: RUBELLA IGG and IGM | RUBELLA DIAGNOSIS IN PREGNANCY

RUBELLA TREATMENT

There is no treatment for rubella. But that's not a problem since more than 99% of patients are cured spontaneously. Generally prescribe antipyretics and analgesics to relieve symptoms until the patient has fully recovered.

Congenital rubella syndrome

The big concern for rubella is the infection of pregnant women. In children and adults the disease is mild, in the developing fetus it can be catastrophic.

If rubella is acquired during the first trimester, the risk of malformations is higher than 80%. Besides the morphological defects, 1 in 5 infected women suffering abortion at this stage. The congenital rubella syndrome is characterized by cataracts, deafness, heart defects, liver damage and neurological injury, including delayed mental development. In many countries abortion is allowed in rubella cases in the 1st quarter.

Newborns with congenital rubella can spread the virus for up to one year, being necessary to prevent their contact with other pregnant women not immunized.

Infections contracted after the 20th week brings little risk of malformations, but there is still the chance of transmitting the virus to the fetus. Usually these children are born underweight, but no defects in the formation.

In pregnant serology gains much importance. All pregnant women should be tested for rubella; if IgG negative, must be doubled in relation to the care contacts with persons with symptoms of viral infection.

Women who are IgG Reagent are not at risk to catch rubella during pregnancy.

RUBELLA VACCINE

The rubella vaccine is comprised of live attenuated viruses, and is therefore contraindicated in pregnancy. However, in 2006 a health ministry study showed that in 26,000 women inadvertently vaccinated because they ignore the fact that they were pregnant, had no case of congenital rubella. So not vaccine pregnant women known, but if there is a vaccination by mistake, the risk of complications is low (read: VACCINE IN PREGNANCY ).

Every woman of childbearing age should conduct a serological test to know their immune status against rubella. Those with negative results (negative IgG) is to apply the vaccine. Patients who have positive IgG are immunized and are not at risk of having rubella. No need to vaccinate people who already have IgG antibodies.

It's okay to get the vaccine while breastfeeding. Also it's okay to be revaccinated. If during a vaccination campaign one does not remember to have received the vaccine once in their lives, or do not know their immune status, it can be vaccinated. This guidance applies to men and women between 20 and 39 years.

A single dose of rubella vaccine is effective to create permanent immunization in over 95% of cases.

Like any vaccine with live virus, it also should not be taken by people with active or immunocompromised febrile illness.

Rubella

Rubella

Also known as German measles , the rubella is a viral disease or very common infectious disease during childhood, but can also occur in unvaccinated adults who have never had the disease as children. Typically, infections by these viruses produce permanent immunity, ie, it occurs only once in a lifetime.

Transmitted through the respiratory tract, rubella is caused by a RNA virus called Togavirus . Rubella epidemics usually occur in cycles 06-10 years in winter and spring period, mainly reaching school children up to 9 years and adolescents after vaccination.

Symptoms

Red spots that appear on the face and behind the ear and then spread throughout the body. After infection it takes on average 18 days to have the first symptoms (incubation period) the symptoms are similar to the flu: headache and testicles; pain when swallowing; aching joints and muscles, dry skin, nasal congestion with sneezing, swollen lymph ganglia, low-grade fever (up to 38 ° C), neck, red spots that start on the face and evolve quickly by the body (usually disappear in less than 5 days ), redness or inflammation of the eyes (which is not dangerous).

The infection is usually benign and in half the cases do not produce any clinical manifestation. However, becomes dangerous when infection occurs during pregnancy (congenital rubella ie, transmitted from mother to fetus) because the virus invades the placenta and infects the embryo, usually in the first three

   
weeks of gestation in this case, rubella can cause abortion, fetal death, premature birth and congenital malformations such as visual problems (cataracts and glaucoma), deafness, congenital heart disease, microcephaly with mental retardation among others. From the 5th month of pregnancy, the risk of fetal injury is virtually nil.

Transmission

The infection occurs through the respiratory tract by direct contact with nasal secretions or air, through the suction droplets of saliva or nasal secretion.
The virus multiplies first and pharyngeal lymph organs. Then spreads through the blood and then manifests on the skin by means of reddish spots. The incubation period is two to three weeks, therefore symptoms are slow to be perceived.

Diagnosis

Because of its similarity to other viruses (common cold, measles, dengue, etc) the accurate diagnosis of rubella can only be obtained by serological examination.
Treatment

It is performed based on Antipyretics and analgesics that help lessen the discomfort, relieve headaches and body and lower fever. It is recommended that the patient rest during the critical period of the disease.

Prevention

To decrease the circulation of rubella virus, vaccination is very important, recommended at 15 months of age (MMR vaccine) and for all adults who have not had the disease (blocking vaccination). It is important to know that the child is born with rubella can spread the virus for up to one year. So they must be away from other children and pregnant women who have not had the disease.

       
The rubella vaccine, effective in almost 100% of cases, should be administered in children at 15 months of life. The vaccine comprises live attenuated virus and can be produced in monovalent form, associated with measles (double viral) or measles and mumps (MMR). The disease is not serious and male children do not need to be vaccinated, but often it occurs to prevent epidemics or avoid risk, as adults, infecting his pregnant companion unvaccinated.

Attention !

Pregnant women can not be vaccinated and vaccinated women should avoid pregnancy for one month after the date of vaccination. Thus, women who have not had the disease as children should be vaccinated before becoming pregnant. Patients with malignant disease, immune deficiency, treated with immunosuppressants, corticosteroids and chemotherapy can not be vaccinated.

Although it is believed that the effective control of this viral disease is possible, and even eradicate it with vaccination on a large scale, this disease as well as other viruses still represent a major public health aggravation in various parts of the world, especially in areas where combine precarious livelihoods and inadequate vaccination coverage.

How long you have sore breasts during pregnancy? 

Breast pain during pregnancy is a natural symptom in most women. Continue reading this article and you will know how long you have sore breasts during pregnancy and various ways to deal with it.

It is common that women experience breast pain during the first, second or third trimester of pregnancy. Breast pain can usually be an early sign of pregnancy, but can also occur in the later stages of pregnancy, when your breasts are ready to produce milk soon after birth. Usually fluctuating hormones can cause discomfort, and breast pain can be greatly reduced during pregnancy with a little knowledge and care.

Have sore breasts during pregnancy-is common?

For most women, it is common to experience sore breasts during pregnancy. One of the first signs that you are pregnant can be sensitivity, pain and tingling breasts. Breast tenderness can be experienced from the third to fourth week of her pregnancy, even before a pregnancy test.

Sometimes the sensitivity of the breasts can increase so much that clothes rubbing them can also become intolerable. Touching the breasts can also be uncomfortable for some women. This restlessness is greatly reduced after the first quarter.

While in her second trimester, you will feel your growing hormones settle down. Although breast tenderness may reduce, but still appear occasionally throughout pregnancy.

How long you have sore breasts during pregnancy?

There is no set time period for how long past sore breasts during pregnancy, it varies from woman to woman. Normally, it tends to last for the first few weeks and get better comtempo and one day you will not feel any pain. Although having the baby, breastfeeding can bring it all back, and worse than before. Still, it's worth it in the end, how your child is getting its nutritional milk.

It can vary from woman to woman, but usually more experience breast pain around 4-6 weeks of your pregnancy. Women usually relate this with the first signs of pregnancy. If you are experiencing increased pain in this area and your periods are delayed, then it is important that you should consult a doctor.

Why are your sore breasts during pregnancy?

If you are wondering the reason behind this pain is the result of increased estrogen and progesterone in your body as they prepare to support your growing baby. This is like an exaggerated side effects you experience before your period.

Normally, in addition to pain, women also notice that your breasts are also increasing in size. Although these symptoms can cause great discomfort, these changes are preparing you for the vital role of feeding your baby. Some women experience an increase at the beginning of their breast size, while others may experience throughout the duration of her pregnancy. Some may notice only at the end of your pregnancy.

Women usually tend to notice the increase in breast size during their first pregnancy. There is usually a significant change in cup size by the time you conceive your child. There is no reason to worry if you do not experience this change during pregnancy, as will happen after his son. Other changes include that during sex can feel throbbing or tingling sensation as blood rushes to her breasts.

For more information on the cause of pain in the breasts during health pregnancy, you podeclique the link below:

How to relieve breast pain during pregnancy

Methods	Descriptions
Wear a comfortable bra	To reduce pain in her breasts wear a supportive bra and avoid underwired bras, as they will cause discomfort to the increase in their breast size. You can choose to have their breasts measured by an expert in the store. If you are not comfortable with this idea, measure under your breasts for size and around the fullest part of your breast to cup. As you exercise, be sure to use a well-equipped bra and supportive, so that there is no extra pressure on your breasts. Maternity bras cotton sleep can also significantly reduce pain and help you sleep better.
Avoid contact	Sometimes the best remedy is to avoid contact. One needs to convey this to your partner in a pleasant way to avoid hurting their feelings.
Shower spray	Another method of providing comfort can be standing under a hot shower, but for some women can cause great discomfort although in some cases it is very reassuring
Use breast pads	Use breast pads, as they can help to avoid direct contact with the lining of the nipples of her bra. Bras seamless can help avoid discomfort as bras that have a seam that runs within the bra may be uncomfortable.

Important notes:

Sometimes women are concerned when the breast pain decreases, especially during the first three months of pregnancy, since it is common for sensitivity to increase in the second and third quarters. This is not a cause for concern as this pain varies with the rise of your hormones. Visit your doctor regularly and be sure to mention any changes in your breasts that are a concern for you.

Rubella: symptoms, transmission and prevention

After an incubation period, ranging from two to three weeks, the disease shows its first characteristic signals: low-grade fever, lymph nodes and appearance of pink spots, which spread the first face and then the rest of the body. Rubella is commonly confused with other diseases as symptoms such as throat and headaches are common to other infections, complicating the diagnosis. While not severe, rubella is particularly dangerous in the congenital form. In this case, you can leave irreversible consequences in the fetus such as glaucoma, cataracts, cardiac malformation, growth retardation, deafness and others.

Transmission

It is caused by a virus of the genus Rubivirus , the Rubella virus . The Rubella is an infectious disease that mainly affects children between five and nine years. Transmission occurs from person to person, usually by issuing droplets of respiratory secretions of patients. It is infrequent transmission through contact with recently contaminated objects secretions nose, mouth and throat or blood, urine or faeces of patients.Congenital rubella happens when a pregnant woman gets rubella and infect the fetus because the virus crosses the placenta.

Prevention

Immunity is acquired by natural infection or vaccination , and lasting after natural infection and remained for most of his life after vaccination .Children of immune mothers usually remain protected by maternal antibodies around six to nine months after birth. To decrease the circulation of rubella virus, vaccination is essential. Children should get two doses of vaccine combined against rubella, measles and mumps (MMR) : the first, with one year of age; the second dose four to six years. All adolescents and adults (men and women) also need to take theMMR or double viral vaccine (diphtheria and tetanus) , especially women who have had no contact with the disease. Pregnant women can not be vaccinated. Women of childbearing age should avoid pregnancy for 30 days after vaccination . In the case of infection, it is recommended that the person rubella (child or adult) who is spaced apart not contracted the disease.

Rubella symptoms

Rubella is an infectious disease whose main symptom are . red spots that appear initially on the face and behind the ear and then are directed to the whole body toward the feet Other symptoms of rubella are:

• Sore throat;
• Fever up to 38 ° C;
• Headache;
• Nasal discharge;
• Swollen glands.

Phase higher risk of contagion involves the 10 days preceding the start of the rash until 15 days after they appeared.

A person with rubella should stay at rest and isolated from contact with other family members, and their clothes and personal items should be separated until the fever cease and that the rash disappear.

Rubella photos

Treatment for rubella

The treatment for rubella is done in order to control disease symptoms. It indicates the use of paracetamol to reduce pain and fever as well as rest and hydration.

Rubella prevention

Prevention Rubella can be made by applying the triple-viral vaccine, which protects against mumps, measles and rubella.

What is rubella?

What is rubella?

 

Rubella, also known as German measles, is a contagious disease caused by virus and characterized by red skin rash.

Causes

Rubella is caused by viruses and Rubella virus is spread from person to person through sneezing, coughing and is highly contagious. A person with rubella can transmit the disease to other people from one week before the eruption until one to two weeks after their disappearance. That is, a person can transmit the disease even before knowing who has rubella.

The disease can also be congenital and can be transmitted from mother to child during pregnancy yet.

Risk factors

• Have close contact with a person infected with rubella is a major risk factor for infection
• Do not take the MMR vaccine , which also acts against measles and mumps , can make a person vulnerable to the virus that causes rubella
• Newborns tend to be the age group most at risk, since they were not vaccinated against the disease. The adults, on the other hand, are not free of rubella only because they were vaccinated. It may happen that the vaccine lose effectiveness and fail to protect the person completely, so it is advisable to take a booster vaccine a few years after the first dose.

 

Symptoms of rubella

 

The main symptoms are usually mild rubella and difficult to be noticed, especially in children. When they arise, the signs of the disease usually takes two to three weeks after exposure to the virus to manifest and last for an average of two to three days. Chief among them is the emergence of red rashes from the skin, which first appear on the face and then go spreading around the trunk, arms and legs.Among other symptoms of rubella include:

• Mild fever
• Headache
• Nasal congestion
• Inflammation of the eyes (bloodshot)
• Appearance of lumps in the neck region and behind the ears
• General discomfort and feeling of malaise constant
• Muscle and joint pain 

• Seeking medical help

• Seek medical advice if you or your child present the typical symptoms of rubella.

  If you have plans to get pregnant, see a doctor to find out about the vaccine against rubella. Contracting the disease during the first trimester of pregnancycan cause serious risks to the baby's health and may even lead to malformation of organs and termination of pregnancy. Rubella during pregnancy is the main cause of deafness congenital.

  In the medical consultation

  Take all of your questions to the doctor and describe your symptoms in detail. This will help the doctor to diagnose correctly. Also answer questions that he might do to her. Some examples:

  • You and your child received the MMR vaccine?
  • When symptoms began?
  • You had contact with someone with rubella?
  • Is there any measure that you have taken that seems to have improved or worsened the symptoms?

  Diagnostic Rubella

  The skin rashes caused by rubella resemble any other rash caused by diseases similar, so not just a physical examination to confirm the diagnosis. The doctor then will ask for laboratory tests to make sure that it is a rubella infection.

  A nasal or throat swab can be sent for culture. It can also be made a blood test to check whether the person is protected against rubella. All women who could become pregnant should take this test. If the test is negative, they will receive the vaccine.

  Treatment Rubella

  There is no treatment available to stop the rubella infection, but the symptoms are so mild that treatment is not usually necessary. However, to avoid passing the virus to others that eventually were not vaccinated or are needed to take the reinforcement of the vaccine, patients should remain indoors during the high likelihood of transmission.

  If you are pregnant, talk to your doctor about the best way to fight infection and prevent the baby from being infected too. The measures taken against the virus can reduce the symptoms, but does not eliminate the possibility of the child being born with congenital rubella.

  Living / Prognosis

  Because treatment is often not necessary, portion sizes are enough for recovery.Some measures can help speed up the process, see:

  • Rest
  • Use of non-prescription medicines to relieve fever and discomfort caused by pain
  • Avoid going to work, school, college or attend social environments in order to prevent transmission of the virus to others

  Possible complications

  Although rubella is a mild disease considered, it can happen to progress to more serious complications such as otitis media and even encephalitis.

  Pregnant women may have arthritis in fingers, wrists or knees, which can last about a month.

  The consequences of rubella for a newborn who inherited her mother's illness, however, can be severe. Among them are:

  • Intellectual Disability
  • Cataract
  • Deafness
  • Congenital heart defects
  • Defects in the operation of some organs
  • Growth retardation

  Expectations

  Once you have been infected by the rubella virus, one is permanently immune to it, or may not have rubella again.

  Treatment for rubella is usually dispensed in view of the symptoms usually disappear by themselves.

  Prevention

  Vaccination is the safest and most effective way to prevent rubella. The rubella vaccine is recommended for all children. It is usually applied in infants 12-15 months, but sometimes it is administered before and during epidemics. A second vaccination (booster) is routinely applied in children between four and six years.The MMR is a combined vaccine that protects against measles, mumps and rubella.Already the MMRV vaccine also protects against chickenpox