Summary about Disease
Rubella, also known as German measles or three-day measles, is a contagious viral infection. It is typically a mild disease, especially in children. However, it poses a serious threat to pregnant women, as it can cause severe birth defects in the developing fetus (Congenital Rubella Syndrome or CRS). Eradication efforts are largely focused on vaccination to prevent CRS.
Symptoms
Symptoms are often mild and can be difficult to notice, especially in children. They may include:
Mild fever (99-101°F or 37.2-38.3°C)
Headache
Runny or stuffy nose
Inflamed, red eyes
Enlarged, tender lymph nodes at the base of the skull, behind the ears, and on the sides of the neck
A fine, pink rash that starts on the face and spreads to the rest of the body (lasts about 3 days)
Aching joints, especially in young women
Causes
Rubella is caused by the rubella virus. The virus spreads through direct contact with respiratory secretions (such as saliva, mucus, or nasal discharge) of an infected person. This can happen when someone coughs or sneezes. Pregnant women can transmit the virus to their unborn babies.
Medicine Used
There is no specific antiviral treatment for rubella. Treatment focuses on relieving symptoms.
Rest
Fluids
Fever-reducing medications (e.g., acetaminophen or ibuprofen). Aspirin should NOT be given to children or teenagers due to the risk of Reye's syndrome. The best medicine to use is the MMR vaccine to prevent rubella.
Is Communicable
Yes, rubella is highly communicable. It is usually contagious from one week before the rash appears until about one week after the rash disappears.
Precautions
Vaccination: The MMR (measles, mumps, rubella) vaccine is the most effective way to prevent rubella. Two doses are recommended, the first at 12-15 months of age and the second at 4-6 years of age.
Isolation: Infected individuals should stay home from school or work to prevent spreading the virus.
Respiratory hygiene: Cover coughs and sneezes with a tissue, and wash hands frequently.
Avoid contact: Pregnant women who are not immune to rubella should avoid contact with anyone who has the disease.
Inform healthcare providers: If you suspect you have rubella, inform your healthcare provider before going to the clinic or hospital to avoid spreading the infection.
How long does an outbreak last?
The duration of a rubella outbreak can vary depending on factors such as vaccination rates and public health measures implemented. Localized outbreaks might last weeks to months if not controlled. Without effective control measures, larger outbreaks can extend for several months or even longer.
How is it diagnosed?
Rubella is diagnosed through:
Physical exam: A doctor will assess your symptoms.
Blood tests: These tests can detect rubella-specific antibodies (IgM and IgG) in your blood. IgM antibodies indicate a recent infection, while IgG antibodies indicate past infection or immunity from vaccination.
Viral culture or PCR: A sample of your respiratory secretions (e.g., throat swab) can be tested to identify the rubella virus.
Prenatal screening: Pregnant women are routinely screened for rubella immunity.
Timeline of Symptoms
Incubation period: 14-21 days (time from exposure to the virus to the onset of symptoms).
Prodromal symptoms (1-5 days before the rash): Mild fever, headache, mild upper respiratory symptoms, enlarged lymph nodes.
Rash: Begins on the face and spreads downwards, lasting about 3 days.
Other symptoms: Joint pain may develop around the time of the rash or shortly thereafter.
Important Considerations
Congenital Rubella Syndrome (CRS): Rubella infection during pregnancy can have devastating effects on the fetus, leading to CRS. CRS can cause birth defects such as hearing loss, cataracts, heart defects, intellectual disabilities, and liver or spleen damage.
Vaccination is crucial: Vaccination is the primary way to prevent rubella and CRS.
Pregnant women: All women of childbearing age should be vaccinated against rubella before becoming pregnant. If a woman is pregnant and not immune, she should avoid exposure to rubella. Vaccination is not given during pregnancy.
Reporting: Rubella is a reportable disease, meaning healthcare providers are required to report cases to public health authorities. This helps track and control outbreaks.