風(fēng)疹發(fā)病機理和病程(英文及中文對照)

1、風(fēng)疹NoImageRubella commonly known as German measles or 3-day measles is an infection that primarily affects the skin and lymph nodes. It is caused by the rubella virus (not the same virus that causes measles), which is usually transmitted by droplets from the nose or throat that others breathe in. It

2、can also pass through a pregnant womans bloodstream to infect her unborn child.Its a generally mild disease in children; the primary medical danger of rubella is the infection of pregnant women because it can cause congenital rubella syndrome in developing babies.Before a vaccine against rubella bec

3、ame available in 1969, rubella epidemics occurred every 6-9 years, most often among kids 5 to 9 years old. Many cases of congenital rubella occurred as well. Thanks to immunization, there are far fewer cases of rubella and congenital rubella.Most rubella infections today appear in young, non-immuniz

4、ed adults rather than in kids. In fact, experts estimate that 10% of young adults are currently susceptible to rubella, which could pose a danger to children they might have someday.About Rubella關(guān)于風(fēng)疹風(fēng)疹是由風(fēng)疹病毒引起的一種常見的急性傳染病，以低熱、全身皮疹為特征，常伴有耳后、枕部淋巴結(jié)腫大。由于全身癥狀輕，病程短，往往認(rèn)為本病無關(guān)緊要，但是近年來在風(fēng)疹暴發(fā)流行中，重癥病例屢有報道。如果妊娠早期婦

5、女感染風(fēng)疹，將會嚴(yán)重?fù)p害胎兒，引起先天性風(fēng)疹綜合征(congenital rubella syndrome，CRS)。中醫(yī)學(xué)稱本病為風(fēng)疹、風(fēng)痧、隱疹。認(rèn)為系感受風(fēng)熱時邪，發(fā)于膚表所致。SignsandSymptomsRubella infection may begin with 1-2 days of mild fever (99-100F,37.2-37.8C) and swollen, tender lymph nodes, usually in theback of the neck or behind the ears. A rash then begins on theface a

6、nd spreads downward. As it spreads, it usually clears onthe face. This rash is often the first sign of illness that a parentnotices.The rubella rash can look like many other viral rashes. It appearsas either pink or light red spots, which may merge to form evenlycolored patches. The rash can itch an

7、d lasts up to 3 days. As therash clears, the affected skin occasionally sheds in very fineflakes.Other symptoms of rubella (these are more common in teens andadults) can include headache, loss of appetite, mild conjunctivitis(inflammation of the lining of the eyelids and eyeballs), a stuffy orrunny

8、nose, swollen lymph nodes in other parts of the body, andpain and swelling in the joints (especially in young women). Manypeople with rubella have few or no symptoms.Rubella in a pregnant woman can cause congenital rubellasyndrome, with potentially devastating consequences for thedeveloping fetus. C

9、hildren who are infected with rubella beforebirth are at risk for growth retardation; mental retardation;malformations of the heart and eyes; deafness; and liver, spleen,and bone marrow problems.潛伏期1621天，平均18天，學(xué)齡前兒童和青少年感染風(fēng)疹病毒后常有發(fā)熱、頭痛、咽痛、流涕等輕微前驅(qū)癥狀和枕骨下、耳后、頸部淋巴結(jié)腫大，約12天從面頸部開始出現(xiàn)淡紅色斑疹、斑丘疹，24h內(nèi)蔓延軀干、四肢。皮疹特點

10、是歷時短、消失快。軀干部皮疹可融合，四肢皮疹散在不融合。一般第3天皮疹迅速消退，不留痕跡，有時可有輕度脫屑。軟腭可見針頭大小的紅色瘀點，皮疹一出現(xiàn)前驅(qū)癥即消失，但淋巴結(jié)腫大持續(xù)時間長，伴觸痛，但不化膿。風(fēng)疹是良性傳染病，一般預(yù)后良好。并發(fā)癥少見，有時可并發(fā)氣管炎、中耳炎、關(guān)節(jié)痛、紫癜等。孕婦在早期妊娠(4個月內(nèi))如患風(fēng)疹后可致流產(chǎn)、早產(chǎn)、死產(chǎn)及胎兒畸形(先天性風(fēng)疹綜合征)(表1)。癥狀體征癥狀體征ContagiousnessThe rubella virus passes from person to person through tinydrops of fluid from the nos

11、e and throat. People who have rubellaare most contagious from 1 week before to 1 week after the rash appears. Someone who is infected but has no symptoms can stillspread the virus.Infants who have congenital rubella syndrome can shed the virusin urine and fluid from the nose and throat for a year or

12、 more andmay pass the virus to people who have not been immunized.virusin生詞本英 vrsnvrsn美 vrsnvrsnn.病毒菌素urine生詞本去背誦英 jrnjrn美 jrnjrnn.尿； 小便； 下泉PreventionRubella can be prevented by the rubella vaccine. Widespreadimmunization against rubella is critical to controlling the spread ofthe disease, thereby p

13、reventing birth defects caused bycongenital rubella syndrome.The vaccine is usually given to children at 12-15 months of age aspart of the scheduled measles-mumps-rubella (MMR)immunization. A second dose of MMR is generally given at 4-6years of age. As is the case with all immunization schedules,the

14、re are important exceptions and special circumstances. Forexample, if your child will be traveling outside the United States,the vaccine can be given as early as 6 months of age. Talk to yourchilds doctor to see when the vaccine is needed.The rubella vaccine should not be given to pregnant women or

15、toa woman who may become pregnant within 1 month of receivingthe vaccine. If you are thinking about becoming pregnant, makesure that youre immune to rubella through a blood test or proofof immunization. If youre not immune, you should receive thevaccine at least 1 month before you become pregnant.Pr

16、egnant women who are not immune should avoid anyone whohas the illness and should be vaccinated after delivery so thatthey will be immune during any future pregnancies.因本病癥狀多輕，一般預(yù)后良好，故似不需要特別預(yù)防，但先天性風(fēng)疹危害大，可造成死胎、早產(chǎn)或多種先天畸形，因此預(yù)防應(yīng)著重在先天性風(fēng)疹。1.隔離檢疫 病人應(yīng)隔離至出疹后5天。但本病癥狀輕微，隱性感染者多，故易被忽略，不易做到全部隔離。一般接觸者可不進(jìn)行檢疫，但妊娠期，特

17、別妊娠早期的孕婦在風(fēng)疹流行期間應(yīng)盡量避免接觸風(fēng)疹患者。2.自動免疫 國際上經(jīng)過10余年來廣泛應(yīng)用風(fēng)疹減毒活疫苗，均證明為安全有效，接種后抗體陽轉(zhuǎn)率在95%以上，接種后僅極個別有短期發(fā)熱、皮疹，淋巴結(jié)腫大及關(guān)節(jié)腫痛等反應(yīng)，免疫后抗體持久性大多可維持在7年以上。接種對象方面不同國家尚不統(tǒng)一，例如美國主張1歲至青春期的青少年，特別是幼兒園和小學(xué)中的兒童為主要免疫對象，因為小兒風(fēng)疹發(fā)病率最多，且可傳給孕婦等成人。青春期及成年婦女，也應(yīng)接種，接種后先天性風(fēng)疹已明顯減少。盡管目前關(guān)于風(fēng)疹疫苗病毒株對人體、胎兒的影響了解得不夠，但活疫苗的弱病毒確能通過胎盤感染胎兒畸形，因此孕婦不宜接受此類活疫苗。風(fēng)疹疫苗早

18、已與麻疹、腮腺炎疫苗聯(lián)合使用。我國有些地方如上海、武漢、山東早已能制備風(fēng)疹減毒活疫苗，均可產(chǎn)生較高的抗體陽性率。上海已開始使用風(fēng)疹減毒活疫苗并將逐步納入計劃免疫執(zhí)行，重點免疫對象中除小兒外還包括婚前育齡婦女，含高、初中畢業(yè)班女生。有關(guān)風(fēng)疹疫苗的保護(hù)效果、維持時間等研究還在不斷深入。 預(yù)防護(hù)理IncubationThe incubation period for rubella is 14-23 days, with an averageincubation period of 16-18 days. This means that it can take 2-3weeks for a chil

19、d to get rubella after they are exposed tosomeone with the disease.DurationThe rubella rash usually lasts 3 days. Lymph nodes may remain swollen for a week or more, and joint pain can last for more than 2 weeks. Children who have rubella usually recover within 1 week, but adults may take longer.TreatmentRubella cannot be tr