Rubella

What Is Rubella? What Are German Measles? What Causes Rubella Or German Measles?

 Rubella, also known as German measles, is an infectious disease caused by the rubella virus. The virus passes from person-to-person via droplets in the air expelled when infected people cough or sneeze - the virus may also be present in the urine, feces and on the skin. The hallmark symptoms of rubella are an elevated body temperature and a pink rash.

Although rubella can infect people of all ages, it most commonly affects young children. If a pregnant woman becomes infected with Rubella there is a serious risk of birth defects in the unborn baby. If the pregnant mother is infected within the first 20 weeks of pregnancy the child may be born with congenital rubella syndrome, which consists of a range of serious incurable illnesses. About one-fifth of infected pregnant women will miscarry.

The name "rubella" comes from the Latin word rubella meaning "little red". As the disease was first described by German doctors in the mid-eighteenth century, it is also known as German measles.

Rubella is usually mild and frequently passes unnoticed. The disease can last from one to three days. Children usually recover faster than adults.

What are the signs and symptoms of rubella?

A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

Rubella's incubation period is from 14 to 21 days. Some people may be infected and never know it.

Patients typically have flu-like symptoms. The main symptom is a rash - pink or light red - on the face, which then spreads to the chest, stomach, back, arms and legs. When the rash reaches other parts of the body it usually fades from the face. Within about three days the rash goes away with no staining or peeling of the skin. After it has cleared up the skin may shed very small flakes where the rash was.

While the rash is present there may be itching.

Patients may also have a slight fever and swollen glands (which may persist for a week), headache, conjunctivitis and joint pains.

The older the patient is the more severe symptoms tend to be.

A significant number of older girls and adult women may have arthritic type symptoms.

Infected people are contagious about one week before the rash appears and about one week after it has cleared up.

What causes rubella?

Rubella is caused by an extremely infectious virus that is transmitted from person-to-person in droplets in the air. When an infected person sneezes or coughs, those nearby are at risk of becoming infected.
It is also possible to infect another person if they come into contact with the saliva of an infected person.

The virus is capable of crossing the placenta and infecting the unborn child (feuts) where it stops cells from developing or destroys them.

Diagnosis of rubella

The National health Service (NHS), UK instructs people who suspect somebody in the household may have rubella to call their doctor - not to visit, as there is a risk others in the clinic or GP practice, including pregnant women, may become infected.

Since the rubella rash is similar in appearance to irritations caused by other viral infections, a GP will confirm the diagnosis by doing a virus culture or a blood test. The presence of different types of rubella antibodies will corroborate the diagnosis. By law, doctors have to notify the local authority of all suspected rubella cases. The child's school or nursery should be told immediately.

IgM (rubella virus specific) antibodies are found in individuals who have been recently infected. However, these antibodies may persist for a long time, sometimes for over a year. Therefore, a positive blood test result needs to be interpreted with caution.

Treatment options for rubella

In the vast majority of cases rubella infection signs and symptoms will resolve within a week or two. Patients should stay at home and avoid contact with other people, especially pregnant women. The NHS advises people to stay away from work/school for at least five days.

If there is any fever or aches an OTC (over-the-counter), such as Tylenol (paracetamol) or ibuprofen may help. Do not give aspirin to children under the age of 16 years.

To avoid dehydration it is important to consume plenty of liquids, preferably water.

Prevention of rubella

Immunization with the MMR vaccine is the most effective way to protect against rubella. It is a combined vaccine that protects children against all three conditions - measles, mumps and rubella. It contains the safest and most effective form of each vaccine. This is usually given to children between 12 and 15 months followed by a booster injection before entering school (usually between three to five years of age).

Children who are too young to have had the MMR vaccine and are exposed to the virus may be given an injection of immunoglobulin antibodies which provide short-term but immediate protection against the disease.

As a pregnant mother passes on her own immunity to her baby, the baby is protected at least during his/her first six months of life.

Despite fears of an association between the MMR vaccine and autism risk, all studies over the last decade have shown that there is no link.

Complications of rubella

Complications, if they do occur, tend to be mild and may include diarrhea, vomiting, otitis media (inner ear infection), and convulsions (if there is a fever). Much more rarely, there is a risk of encephalitis, croup, bronchitis, and pneumonia.

The most important complication is if a pregnant woman becomes infected, especially during the first 11 weeks of her pregnancy (the danger is present throughout pregnancy). Her offspring may suffer from heart defects, stunted growth, hearing problems, organ defects, eye problems (cataracts) and cognitive defects.