The Child With an Infectious Disease RUBELLA vs RUBEOLA ROSEOLA INFANTUM Soeroyo Machfudz

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RUBELLA = CAMPAK JERMAN

PENYAKIT MENULAR SERING PADA ANAK GEJALA : RUAM2 RINGAN, DEMAM RINGAN, PEMBESARAN & RASA NYERI PADA KELENJAR ANAK BESAR & DEWASA : LEBIH BERAT DG MANIFESTASI PD PERSENDIAN & PURPURA PADA IBU : GANGG FERTILITAS, ABORTUS HABITUALIS, PARTUS IMATUR/PREMATUR, SINDROMA RUBELA

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SINDROMA RUBELLA

PENYAKIT JANTUNG KONGENITAL KATARAKTA LENTIS KELAINAN PADA OTAK MUDAH TERKENA PNEUMONIA INTERSTISIAL PANENSEFALITIS GANGGUAN PERKEMBANGAN

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ETIOLOGI

VIRUS PLEOMORFIS YANG MENGANDUNG RNA FAMILI TOGAVIRIDAE GENUS RUBIVIRUS SELAMA SAKIT VIRUS BISA TERDAPAT DI NASOFARING, DARAH, TINJA, AIR KEMIH PENDERITA SUBKLINIS JUGA MENULAR VIRUS DI NASOFARING DITEMUKAN 7 HARI SEBELUM TIMBUL EKSANTEM

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EPIDEMIOLOGI

MANUSIA SATU2NYA PEJAMU ALAMIAH PENYEBARAN DROPLET/ TRANSPLASENTA PUNCAK INSIDEN 5-14 TH SEBELUM IMUNISSI DAN SEKARANG PD REMAJA & DWS MUDA ANAK LAKI & PEREMPUAN INSIDEN SAMA USA & NEGARA KONTINENTAL 80%, SEDANG NEGARA KEPULAUAN 20%

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MANIFESTASI KLINIS

MASA INKUBASI : 14 21 HARI FASE PRODROMAL SINGKAT KHAS : ADENOPATI RETROAURIKULER, SERVIKAL POSTERIOR, POSTOKSIPITAL ENANTEM BERUPA BERCAK MERAH MUDA TERPISAH PADA LANGIT2 LUNAK(nagayana spot) EKSANTEM MULAI DARI WAJAH DAN CEPAT MENYEBAR, EVOLUSINYA JUGA CEPAT
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MANIFESTASI KLINIS (LANJUT..)

FARING & KONJUNGTIVA PERADANGAN SPLENOMEGALI POLIARTRITIS ARTRALGIA KADANG PARESTESIA

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PENGOBATAN

SIMPTOMATIS MENINGKATKAN DAYA TAHAN AMANTADIN (ADAMANTANAMIN HIDROKLORIDA) INVITRO MENGHAMBAT INFEKSI DINI SECARA EFEKTIF TAPI INVIVO TIDAK MEMUASKAN TIDAK BOLEH DIBERIKAN PD IBU HAMIL

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PENCEGAHAN

PASIF DENGAN SERUM IMUNOGLOBULIN (SIG), DOSIS 0.25-0.50/KG 7-8 HARI SETELAH PEMAPARAN AKTIF DENGAN RUBELLA, MMR, MUMPSR, MEASLES-R. DI USA SETIAP ANAK 15 BLN-REMAJA & WANITA PUS TIDAK HAMIL

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EKSANTEMA SUBITUM ROSEOLA INFANTUM

PENYAKIT AKUT, OK VIRUS, BAYI & ANAK MUDA, DEMAM MENDADAK TAPI CEPAT MENURUN, RUAM-RUAM SELURUH TUBUH DAN CEPAT MENGHILANG, TERJADI SPORADIS, EPIDEMI MASA INKUBASI 9-10 HARI

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EPIDEMIOLOGI

TIDAK TAHU PASTI, BELUM JELAS MUSIM SEMI & GUGUR LAKI-LAKI & PEREMPUAN SAMA TERUTAMA PADA BAYI & ANAK MUDA (618 BULAN), TAPI BISA ANAK LEBIH TUA DAN ORANG DEWASA BISA BERSIFAT EPIDEMI

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MANIFESTASI KLINIS

MENDADAK DEMAM SEKITAR 40 C BISA TERJADI KEJANG PANAS TURUN, TIMBUL ERUPSI MAKULER/MAKULOPAPULER DIMULAI DARI BADAN DAN MENYEBAR KE LENGAN DAN LEHER, MUKA, TUNGKAI DAN SEBELUM 24 JAM SUDAH HILANG TIDAK ADA HIPERPIGMENTASI LIMFADENOPATI (POSTOKSIPITAL)

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PENCEGAHAN & PENGOBATAN

TIDAK ADA PENCEGAHAN SPESIFIK BAYI & ANAK KECIL DG RISIKO KEJANG MK DIBERI SEDATIVA PD AWITAN DEMAM ANTIPIRETIK MAKAN & MINUM; ISTIRAHAT PROGNOSIS BAIK

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RUBEOLA = CAMPAK

Inkubasi 9 11 hari Stadium prodormal 1-3 hari spt flu, foto pobia, konjungtivitis, batuk pilek Stadium eksantem 4-6 hari dari belakang telinga, muka, badan, ekstremitas kopliks spot Stadium rekonvalesen 7-28 hari hiperpigmentasi

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PENCEGAHAN & PENGOBATAN RUBEOLA = CAMPAK

Simptomatik Suportif Edukasi Pencegahan : imunisasi campak a MMR

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KOMPLIKASI

BRONKOPNEUMONI OMA MENINGO-ENSEFALITIS

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Sifat yang sering dari Infeksi virus

Banyak timbul rash / eksantem Sebagian ada gejala demam Sebagian ada gejala pilek/ sperti flu Sebagian transmisi kontak a droplet/ udara Sebagian bisa dicegah dg imunisasi Penderita harus diisolasi tuk cegah penyebaran Sebagian pengobatan hanya simptomatik Walau jarang, tapi bisa komplikasi ensefalitis

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Rubeola vs. Rubella

Measles Rubella

Red maculopapular rash that gradually turns brownish Begins behind ears at hairline and spreads downward toward feet Koplicks spots on buccal mucosa

Pinkish maculopapular rash Begins on face, neck, and scalp and spreads downward to feet over a 3-day period As rash develops on a new area, rash over previous area fades

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Rubeola vs. Rubella

Rubeola

Rubella

Incubation period: 8 to 12 days Infectious period: 3 to 5 days before rash appearance to 4 days after rash appearance Transmission: direct contact with droplets or airborne particles (lesser degree)

Incubation period: 14 to 21 days Infectious period: 7 days before onset of symptoms to 14 days after rash appearance Transmission: direct contact with droplets or airborne particles, transplacental transmission

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Rubeola vs. Rubella

Rubeola
Most common complication in children: secondary bacterial infections such as otitis media, croup, or bronchopneumonia Therapeutic management: treatment is symptomatic and supportive in the normal, healthy child Research supports the use of vitamin A in some cases of childhood measles

Rubella
Most common complication in children: thrombocytopenia Therapeutic management: treatment is symptomatic and supportive in the normal, healthy child

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RUBEOLA vs RUBELLA
PERAWATAN UNTUK SEMUA INFEKSI VIRUS UPAYA MENGURANGI PENULARAN PD ANAK LAIN PENGUKURAN SUHU & PEMAKAIAN OBAT PANAS PEMAKAIAN SKIN CARE TUK CEGAH KERUSAKAN REKOMENDASI BED REST SELAMA MASA PRODROMAL & FASE PANAS DARI INFEKSI LAKUKAN CUCI TANGAN UTK MENCEGAH PENYEBARAN INFEKSI

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Rubeola vs. Rubella

Child and family education: Educate parents regarding MMR vaccine Family needs to be educated regarding the length of time the child is contagious No school until period of contagion has passed Child should not be around pregnant women Teach good handwashing to prevent infection spread

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Roseola Infantum (Sixth Disease)

Incubation period: estimated at 9 to 10 days Infectious period: thought to extend from febrile stage until the rash appears Transmission: Most likely through secretions of asymptomatic contacts Most common complications in children: none reported

Erythematous maculopapular rash

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Roseola Infantum (Sixth Disease)

Family and child education:

Family needs to be taught principles of fever management Do not administer aspirin or aspirincontaining products during illness because of the potential risks of developing Reye syndrome Knowledge regarding seizure precautions in the event of a febrile seizure Teach good handwashing to prevent infection spread
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TENGKYU

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