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Almost every adult is convinced that he has suffered from popular infectious diseases, such as chicken pox, rubella or mumps, during childhood. Nevertheless, often in contact with a sick child, doubts arise as to their own immunity to a specific disease. Over 90% of adults have protective antibodies acquired after contracting a specific viral infectious disease. Unfortunately, people who do not have protective antibodies are at risk of developing the disease, regardless of age.
Infectious diseases of the childhood period in adults are often more severe than in children, and the risk of complications increases with age. In addition, another very important problem is contracting the diseases in question by pregnant women, because they can lead to congenital defects or fetal death. The course of the disease in a pregnant woman is often very severe and has high mortality.
The most common diseases:
Common parotitis, i.e. mumps
Viral infectious disease characterized by painful enlargement of the parotid glands; illnesses are most often observed between the ages of 5 and 15; infections before 2 years of age have been rarely observed.
The course of the disease in adults – mostly mild, but complications that may occur in the acute period of the disease or during the recovery period are more frequently observed; an unfavorable symptom is the reappearance of fever and vomiting; common complications include:
– testicular and epididymitis – most often observed between the ages of 15 and 29; it can affect one or both testicles; symptoms most often appear at the end of the first week of mumps – severe pain in the testicle radiating to the perineum and loins; swelling and redness of the scrotum; nucleus significantly enlarged; often accompanied by high fever, headache and vomiting; Permanent infertility may occur in about 4% of patients with bilateral orchitis.
– inflammation of the ovaries – in about 10% of young women; single or double sided; characteristic symptoms are pain and tenderness in the lower abdomen; inflammation does not cause infertility
– pancreatitis – most often occurs late in the disease – up to several weeks after the swelling of the salivary glands; the characteristic symptoms are: sharp abdominal pain radiating to the left side of the back, nausea and vomiting, fever; in most cases the inflammation resolves spontaneously after about a week
– meningitis and encephalitis – in most cases a mild course with a rapid recovery period without leaving permanent brain damage; severe course very rarely (up to 2 cases per 100 cases) – possible permanent consequences in the form of epilepsy, deafness, hydrocephalus or paralysis of cranial nerves
– less often: thyroiditis, myocarditis, inflammation of the facial nerve, inflammation of large joints
– infection in pregnancy – in the first trimester there is a risk of miscarriage; birth defects are very rare.
Oder
Rash infectious disease caused by the measles virus; the characteristic course of the disease from fever, dry cough and conjunctivitis through changes in the mouth to maculopapular rash; almost 95% of cases occur in people under 15 years of age who are highly contagious.
Course in adults: mostly typical of children; photophobia is more often observed in the first stage of the disease
– the risk of complications occurs mainly in immunocompromised people; these people may develop: pneumonia leading to respiratory and circulatory failure, myocarditis or encephalitis (mortality up to 20%, permanent neurological damage in about 25% of patients)
– measles in a pregnant woman – risk of miscarriage in 20% of cases; damage to the fetus is not observed.
Chickenpox
Rash infectious disease, resulting from infection with a virus varicella-zosterthe hallmark is a generalized vesicular rash; most people are ill between the ages of 1 and 14, the disease is very contagious.
The course of the disease in adults:
– usually a more severe disease than in children; high fever is observed more often; rash of greater intensity with involvement of the mucous membranes of the mouth, eyelids, conjunctiva or genitals
– smallpox pneumonia – the most common complication of smallpox in adults; inflammation usually develops within 3-5 days of illness; a characteristic feature are numerous scattered small lesions in both lungs leading to respiratory failure; the highest risk of developing the disease occurs in immunocompromised people and in pregnant women in the second and third trimesters – about 40% of women die of varicella pneumonia,
– smallpox encephalitis – the incidence is 1-2 in 1000 cases of smallpox in adults; characterized by a very severe course with impaired consciousness, convulsions; in 1/3 of cases encephalitis is fatal; in about 15% of patients, after inflammation, permanent neurological damage remains, e.g. paresis, paralysis of cranial nerves, epilepsy, behavioral disorders or difficulties in remembering.
The effect of chickenpox on the fetus depends largely on the period of pregnancy;
– smallpox in the period up to the 20th week of pregnancy – the fetus usually dies or is damaged in the form of: deformation of the limbs, cataracts, microcephaly or hydrocephalus, skin scars;
– after 20 weeks of pregnancy – symptoms of congenital chickenpox are most often not observed in a child, however, there is a risk of shingles in the early stages of a child’s life
– maternal chickenpox 5 days before delivery and within 48 hours after delivery – very severe course of chickenpox in the newborn, often complicated by pneumonia and hepatitis with high mortality in the absence of antiviral treatment.
Rubella
Rash infectious disease caused by the rubella virus, mild course, with characteristic enlargement of the cervical, behind-the-ear and cervical lymph nodes, and a generalized, fine-speckled rash; often asymptomatic or oligosymptomatic
The course of the disease in adults is mild in most cases; common complications of rubella in adulthood include:
– arthritis – most common in women; there is swelling and soreness of the small joints of the hands, less often of the knee joints; symptoms of inflammation last 5-10 days and then resolve spontaneously without sequelae
– encephalitis – very rarely; symptoms appear within 6 days after the appearance of the rash; the course is usually mild; the disease resolves spontaneously after about a week, often without permanent neurological sequelae
– haemorrhagic thrombocytopenic diathesis – a characteristic low number of blood platelets in the blood count with the risk of spontaneous bleeding (e.g. from the nose, gums) and ecchymosis; most often it resolves spontaneously after a dozen or so days
The biggest problem is a pregnant woman with rubella – the severity of congenital rubella depends on the period of pregnancy in which the infection occurred; after the 22nd week of pregnancy, infection is not dangerous to the fetus.
Infectious erythema
Rash disease caused by Parvovirus B19, characterized by a feverless course and an erythematous rash; most often children between 2 and 12 years of age are ill.
Course in adults:
– most often in the form of arthritis (more often in women); inflammation most often affects the knee, wrist, ankle and interphalangeal joints; severe pain in the affected joints is characteristic; erythematous rash does not always have to be present – it is very often itchy; in most cases, after 3 weeks, the arthritis resolves without permanent damage
– in people with reduced immunity (congenital or acquired) as a result of infection, the production of red blood cells may be damaged, the effect is chronic anemia and even severe acute anemia with the risk of death
– infection in pregnant women; especially between 20 and 28 weeks it may lead to spontaneous abortion or death of the fetus as a result of severe anemia with fetal edema.
Sudden erythema, i.e. a three-day fever
A dangerous rash disease caused by a human virus Herpes type 6 (HHV-6), characterized by high fever and a fine macular rash; cases most often observed between 6 months and 4 years of age, the infectivity of the disease is low.
In adults, the disease may take the form of:
– mononucleosis syndrome – fever, sore throat, swollen glands in the neck area
– lymphadenopathy without fever
– hepatitis
– complications are very rare.
The main method of avoiding childhood infectious diseases is avoiding contact with sick children, which, unfortunately, is very difficult to implement in practice. This principle should be observed especially by people with immunodeficiency, because all available vaccines against the diseases mentioned above are contraindicated in these patients. However, it is very important and extremely important to encourage rubella vaccination in women who have not had this disease and have not been vaccinated.
Read more:
Infectious erythema
Erythema – slapped baby syndrome
Text: Mirosław Jawień, MD, PhD