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rubella: Definition and Much More from Answers.com

  • ️Mon May 08 2006

Definition

Rubella is a highly contagious viral disease, spread through contact with discharges from the nose and throat of an infected person. Although rubella causes only mild symptoms of low fever, swollen glands, joint pain, and a fine red rash in most children and adults, it can have severe complications for women in their first trimester of pregnancy. These complications include severe birth defects or death of the fetus.

Description

Rubella is also called German measles or three-day measles. This disease was once a common childhood illness, but its occurrence has been drastically reduced since vaccine against rubella became available in 1969. In the 20 years following the introduction of the vaccine, reported rubella cases dropped 99.6%. Only 229 cases of rubella were reported in the United States in 1996.

Rubella is spread through contact with fluid droplets expelled from the nose or throat of an infected person. A person infected with the rubella virus is contagious for about seven days before any symptoms appear and continues to be able to spread the disease for about four days after the appearance of symptoms. Rubella has an incubation period of 12–23 days.

Although rubella is generally considered a childhood illness, people of any age who have not been vaccinated or previously caught the disease can become infected. Having rubella once or being immunized against rubella normally gives lifetime immunity. This is why vaccination is so effective in reducing the number of rubella cases.

Women of childbearing age who do not have immunity against rubella should be the most concerned about getting the disease. Rubella infection during the first three months of pregnancy can cause a woman to miscarry or cause her baby to be born with birth defects. Although it has been practically eradicated in the United States, rubella is still common in less developed countries because of poor immunization penetration, creating a risk to susceptible travelers. Some countries have chosen to target rubella vaccination to females only and outbreaks in foreign-born males have occurred on cruise ships and at U.S. summer camps.

— Tish Davidson



Dictionary: ru·bel·la  (rū-bĕl'ə) pronunciation

n.

A mild contagious eruptive disease caused by a virus and capable of producing congenital defects in infants born to mothers infected during the first three months of pregnancy. Also called German measles.

[From Latin, neuter pl. of rubellus, red, from ruber.]


A benign, infectious virus disease of humans characterized by coldlike symptoms and transient, generalized rash. This disease, also known as German measles, is primarily a disease of childhood. However, maternal infection during early pregnancy may result in infection of the fetus, giving rise to serious abnormalities and malformations. The congenital infection persists in the infant, who harbors and sheds virus for many months after birth.

In rubella infection acquired by ordinary person-to-person contact, the virus is believed to enter the body through respiratory pathways. Antibodies against the virus develop as the rash fades, increase rapidly over a 2–3-week period, and then fall during the following months to levels that are maintained for life. One attack confers life-long immunity, since only one antigenic type of the virus exists. Immune mothers transfer antibodies to their offspring, who are then protected for approximately 4–6 months after birth. See also Immunity.

Live attenuated rubella vaccines have been available since 1969. The vaccine induces high antibody titers and an enduring and solid immunity. It may also induce secretory immunoglobulin (IgA) antibody in the respiratory tract and thus interfere with establishment of infection by wild virus. This vaccine is available as a single antigen or combined with measles and mumps vaccines (MMR vaccine). The vaccine induces immunity in at least 95% of recipients, and that immunity endures for at least 10 years. See also Biologicals; Vaccination.


Definition

Rubella is a highly contagious viral disease, spread through contact with discharges from the nose and throat of an infected person. A person infected with the rubella virus is contagious for about seven days before any symptoms appear and continues to spread the disease for about four days after the appearance of symptoms. Rubella has an incubation period of 12–23 days.

Description

Rubella is also called German measles or the three-day measles. This disease was once a common childhood illness, but its occurrence has been drastically reduced since vaccine against rubella became available in 1969. In the three decades following the introduction of the vaccine, reported rubella cases dropped 99.6%. Only 229 cases of rubella were reported in the United States in 1996. A recent study indicates, however, that the age group pattern of rubella is shifting. As of 2002, the number of cases reported in people aged 15 years or younger is dropping, while the number of cases in people between 25 and 45 is rising.

People of any age who have not been vaccinated or previously caught the disease can become infected. Having rubella once or being immunized against rubella normally gives lifetime immunity. This is why vaccination is so effective in reducing the number of rubella cases. The United States had a public health goal of eliminating all rubella within its borders by the year 2000; however, this goal was not attained because of new strains of the rubella virus entering the country from the Caribbean and Central America. The availability of molecular typing indicates that three separate strains of the virus caused localized outbreaks that were quickly contained. As of 2002, cases of rubella in the United States are more common among Hispanics than among Caucasians, Native Americans, or African Americans.

Women of childbearing age who do not have immunity against rubella should be the most concerned about infection. Rubella infection during the first three months of pregnancy can cause a woman to miscarry or cause the baby to be born with severe birth defects, including mental retardation and sensory impairments. In addition, recent studies indicate that infants exposed to rubella in utero (in the womb) are at increased risk of developing schizophrenia as adults.

Although it has been practically eradicated in the United States, rubella is still common in less developed countries because of poor immunization penetration, creating a risk to susceptible travelers. Some countries have chosen to target rubella vaccination to females only. As a result, outbreaks among foreign-born males have occurred on cruise ships and at summer camps in the United States. The United Kingdom is considering targeting immigrants of either sex from underdeveloped countries for rubella immunization following several cases of babies born with congenital rubella syndrome.

Causes & Symptoms

Rubella is caused by the rubella virus (Rubivirus). Symptoms are generally mild, and complications are rare in anyone who is not pregnant.

The first visible sign of rubella is a fine red rash that begins on the face and rapidly moves downward to cover the whole body within 24 hours. The rash lasts about three days, which is why rubella is sometimes called the three-day measles. A low fever and swollen glands, especially in the head (around the ears) and neck, often accompany the rash. Joint pain and sometimes joint swelling can occur, more often in women. It is quite common to get rubella and not show any symptoms (subclinical infection).

Symptoms disappear within three to four days, except for joint pain, which may linger for a week or two. Most people recover fully with no complications. Although rubella causes only mild symptoms of low fever, swollen glands, joint pain, and a fine red rash in most children and adults, it can have severe complications for women in their first trimester of pregnancy. Babies may be miscarried or stillborn and a high percentage are born with birth defects. Birth defects are reported to occur in 50% of women who contract the disease during the first month of pregnancy, 20% of those who contract it in the second month, and 10% of those who contract it in the third month. The most common birth defects resulting from congenital rubella infection are eye defects, such as cataracts, glaucoma, and blindness, deafness, congenital heart defects, and mental retardation. Taken together, these conditions are called congenital rubella syndrome (CRS). The risk of birth defects drops after the first trimester, and by the fifth month, there are rarely any complications.

Diagnosis

The rash caused by the rubella virus and the accompanying symptoms are so similar to other viral infections that it is impossible for a physician to make a confirmed diagnosis on visual examination alone. The only sure way to confirm a case of rubella is by checking for antibodies with a blood test or in a laboratory culture.

When the body is infected with the rubella virus, it produces both immunoglobulin G (IgG) and immunoglobulin

M (IgM) antibodies to fight the infection. Once IgG exists, it persists for a lifetime, but the special IgM antibody usually wanes over six months. A blood test can be used either to confirm a recent infection (IgG and IgM) or determine whether a person has immunity to rubella (IgG only). The lack of antibodies indicates that a person is susceptible to rubella.

All pregnant women should be tested for rubella early in pregnancy, whether or not they have a history of vaccination. If the woman lacks immunity, she is counseled to avoid anyone with the disease and to be vaccinated after giving birth.

Treatment

Rather than vaccinating a healthy child against rubella, some alternative practitioners recommend allowing the child to contract the disease naturally at the age of five or six years, since the immunity conferred by contracting the disease naturally lasts a lifetime. It is, however, difficult for a child to contract rubella naturally when everyone around him or her has been vaccinated.

Ayurvedic practitioners recommend making the patient comfortable and giving the patient ginger or clove tea to hasten the progress of the disease. Traditional Chinese medicine uses a similar approach. Believing that inducing the skin rash associated with rubella hastens the progress of the disease, traditional Chinese practitioners prescribe herbs such as peppermint (Mentha piperita) and chai hu (Bupleurum chinense). Cicada is often prescribed as well. Western herbal remedies may be used to alleviate rubella symptoms. Distilled witch hazel (Hamamelis virginiana) helps calm the itching associated with the skin rash and an eyewash made from a filtered diffusion of eyebright (Euphrasia officinalis) can relieve eye discomfort. Antiviral western herbal or Chinese remedies can be used to assist the immune system in establishing equilibrium during the healing process. Depending on the patient's symptoms, among the remedies a homeopath may prescribe are Belladonna, Pulsatilla, or Phytolacca. These can be used with or with out bilberry.

Allopathic Treatment

There is no drug treatment for rubella. Bed rest, fluids, and acetaminophen or Motrin for pain and temperatures over 102°F (38.9°C) are usually all that is necessary.

Babies born with suspected CRS are isolated and cared for only by people who are sure they are immune to rubella. Congenital heart defects are treated with surgery.

Expected Results

Complications from rubella infection are rare in children, pregnant women past the fifth month of pregnancy, and other adults.

Prevention

Vaccination is the best way to prevent rubella and is normally required by law for children entering school. Rubella vaccine is usually given in conjunction with measles and mumps vaccines in a shot referred to as MMR (mumps, measles, and rubella). Children receive one dose of MMR vaccine at 12–15 months and another dose at four to six years. The MMR vaccine has aroused some controversy since early 2000 because of media reports that it increases the risk of wheezing and lower respiratory tract disorders in young children. A recent study of vaccine safety has concluded, however, that there is no connection between the MMR vaccine and a reported rise in the incidence of wheezing in children.

Pregnant women should not be vaccinated; women who are not pregnant should avoid conceiving for at least three months following vaccination. To date, however, accidental rubella vaccinations during pregnancy have not clearly been associated with the same risk as the natural infection itself. Women may be vaccinated while they are breast-feeding. People whose immune systems are compromised, either by the use of such drugs as steroids or by disease, should discuss possible complications with their doctor before being vaccinated.

Resources

Books

Cooper, Louis Z. "Rubella." In Rudolph's Pediatrics, 21st ed., edited by M. M. Rudolph, J. I. E. Hoffman, and C. D. Rudolph. Stamford, CT: McGraw-Hill, 2002.

Gershon, Anne. "Rubella (German Measles)." In Harrison's Principles of Internal Medicine, 15th ed., edited by Anthony S. Fauci. New York: McGraw-Hill, 2001.

Periodicals

Brown, A. S., and E. S. Susser. "In Utero Infection and Adult Schizophrenia." Mental Retardation and Developmental Disabilities Research and Review 8 (January 2002): 51–7.

Carvill, S., and G. Marston. "People with Intellectual Disability, Sensory Impairments and Behaviour Disorder: A Case Series." Journal of Intellectual Disability Research 46 (March 2002): 264–72.

Case Definitions for Infectious Conditions under Public Health Surveillance. Morbidity and Mortality Weekly Report 46 (1997): 30.

Dixon, B. "Triple Vaccine Fears Mask Media Efforts at Balance." Current Biology 12 (March 5, 2002): R151-R152.

Mullooly, J. P., J. Pearson, L. Drew, et al. "Wheezing Lower Respiratory Disease and Vaccination of Full-Term Infants." Pharmacoepidemiology and Drug Safety 11 (January-February 2002): 21–30.

Reef, S. E., T. K. Frey, K. Theall, et al. "The Changing Epidemiology of Rubella in the 1990s: On the Verge of Elimination and New Challenges for Control and Prevention." Journal of the American Medical Association 287 (January 23, 2002): 464–72.

Sheridan E., C. Aitken, D. Jeffries, et al. "Congenital Rubella Syndrome: A Risk in Immigrant Populations." Lancet 359 (February 23, 2002): 674–675.

Organizations

March of Dimes Resource Center. 1275 Mamaroneck Avenue, White Plains, NY 10605. (888) 663-4637. .

National Organization of Rare Disorders. 55 Kenosia Avenue PO Box 1968 Danbury, CT 06813-1968. (800) 999-6673. orphan@rarediseases.org. .

[Article by: Kathleen Wright; Rebecca J. Frey, PhD]

Definition

Rubella, also called German measles or three-day measles, is a highly contagious viral disease that in most children and adults causes mild symptoms of low fever, swollen glands, joint pain, and a fine red rash. Although rubella causes only mild symptoms in child and adult sufferers, the infection can have severe complications for the fetus of a woman who becomes infected with the virus during the first trimester of pregnancy. These complications include severe birth defects or death of the fetus.

Description

Rubella is spread through contact with fluid droplets expelled from the nose or throat of an infected person. A person infected with the rubella virus is contagious for about seven days before any symptoms appear and continues to be able to spread the disease for about four days after the appearance of symptoms. Rubella has an incubation period of 12 to 23 days.

Although rubella is generally considered a childhood illness, people of any age who have not been vaccinated or previously caught the disease can become infected. Having rubella once or being immunized against rubella normally gives lifetime immunity. For this reason vaccination is highly effective in reducing the number of rubella cases.

Women of childbearing age who do not have immunity against rubella should be particularly concerned about getting the disease. Rubella infection during the first three months of pregnancy can cause a woman to miscarry or cause her baby to be born with birth defects. Although it has been practically eradicated in the United States, rubella is still common in less developed countries because of poor immunization penetration, creating a risk to susceptible travelers. Some countries have chosen to target rubella vaccination to females only and outbreaks in foreign-born males have occurred on cruise ships and at U.S. summer camps.

Demographics

Although rubella was once a common childhood illness, its occurrence has been drastically reduced since vaccine against it became available in 1969. According to statistics for 1964–1965, prior to routine rubella immunization in the United States, there were 2,100 newborn deaths and 11,250 miscarriages attributed to rubella infection of pregnant women. In addition, about 20,000 infants were born with birth defects attributable to rubella infection in utero. Of these babies, 11,600 were born deaf; 3,580 were born blind; and 1,800 suffered severe developmental delay. In the 20 years following the introduction of the vaccine, reported rubella cases dropped 99.6 percent. In 2000, there were only 152 reported cases of rubella infection and seven reported cases of congenital rubella.

Causes and Symptoms

Rubella is caused by the rubella virus (Rubivirus). Symptoms are generally mild, and complications are rare in anyone who is not pregnant.

The first visible sign of rubella is a fine red rash that begins on the face and rapidly moves downward to cover the whole body within 24 hours. The rash lasts about three days, which is why rubella is sometimes called the three-day measles. A low fever and swollen glands, especially in the head (around the ears) and neck, often accompany the rash. Joint pain and sometimes joint swelling can occur, more often in women. It is quite common to get rubella and not show any symptoms (subclinical infection).

Symptoms disappear within three to four days, except for joint pain, which may linger for a week or two. Most people recover fully with no complications. However, severe complications may arise in the unborn children of women who get rubella during the first three months of their pregnancy. These babies may be miscarried or stillborn. A high percentage is born with birth defects. Birth defects are reported to occur in 50 percent of women who contract the disease during the first month of pregnancy, 20 percent of those who contract it in the second month, and 10 percent of those who contract it in the third month.

The most common birth defects resulting from congenital rubella infection are eye defects such as cataracts, glaucoma, and blindness; deafness; congenital heart defects; and mental retardation. Taken together, these conditions are called congenital rubella syndrome (CRS). The risk of birth defects drops after the first trimester, and by the twentieth week, there are rarely any complications.

Diagnosis

The rash caused by the rubella virus and the accompanying symptoms are so similar to other viral infections that it is impossible for a physician to make a confirmed diagnosis on visual examination alone. The only sure way to confirm a case of rubella is by isolating the virus with a blood test or in a laboratory culture.

A blood test is done to check for rubella antibodies. When the body is infected with the rubella virus, it produces both immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to fight the infection. Once IgG exists, it persists for a lifetime, but the special IgM antibody usually wanes over six months. A blood test can be used either to confirm a recent infection (IgG and IgM) or determine whether a person has immunity to rubella (IgG only). The lack of antibodies indicates that a person is susceptible to rubella.

All pregnant women should be tested for rubella early in pregnancy, whether they have a history of vaccination. If the woman lacks immunity, she is counseled to avoid anyone with the disease and to be vaccinated after giving birth.

Treatment

There is no drug treatment for rubella. Bed rest, fluids, and acetaminophen for pain and temperatures over 102°F (38.9°C) are usually all that is necessary.

Babies born with suspected CRS are isolated and cared for only by people who are sure they are immune to rubella. Congenital heart defects are treated with surgery.

Prognosis

Complications from rubella infection are rare in children, pregnant women past the twentieth week of pregnancy, and other adults. For women in the first trimester of pregnancy, there is a high likelihood of the child being born with one or more birth defect. Unborn children exposed to rubella early in pregnancy are also more likely to be miscarried, stillborn, or have a low birth weight. Although the symptoms of rubella pass quickly for the mother, the consequences to the unborn child can last a lifetime.

Prevention

Vaccination is the best way to prevent rubella and is normally required by law for children entering school. Rubella vaccine is usually given in conjunction with measles and mumps vaccines in a shot referred to as MMR (mumps, measles, and rubella). Children receive one dose of MMR vaccine at 12 to 15 months and another dose at four to six years.

Pregnant women should not be vaccinated, and women who are not pregnant should avoid conceiving for at least three months following vaccination. As of 2004, however, accidental rubella vaccinations during pregnancy had not clearly been associated with the same risk as the natural infection itself. Women may be vaccinated while they are breastfeeding. People whose immune systems are compromised, either by the use of drugs such as steroids or by disease, should discuss possible complications with their doctor before being vaccinated.

Parental Concerns

While rubella infection in an older child or adult is rarely complicated, the risks of not immunizing a child against rubella are highest in the unborn. Congenital rubella is a serious, life-changing condition, and adherence to immunization recommendations is crucial to the public health.

Resources

Books

Maldonado, Yvonne A. "Rubella Virus." In Principles and Practice of Pediatric Infectious Diseases, 2nd ed. Edited by Sarah S. Long et al. St. Louis, MO: Elsevier, 2003.

Thompson, George H. "The Neck." In Nelson Textbook of Pediatrics. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2004.

Organizations

March of Dimes Birth Defects Foundation. 1275 Mamaroneck Ave., White Plains, NY 10605. Web site: www.modimes.org.

National Organization for Rare Disorders. PO Box 8923, New Fairfield, CT 06812-8923. Web site: www.rarediseases.org.

[Article by: Tish Davidson, A.M. Rosalyn Carson-DeWitt, MD]



Rubella, also known as German measles or three-day measles, is a mild, self-limited viral disease. Humans are the only known natural host. In up to 50 percent of persons who are not immune, a diffuse maculopapular red rash develops in two to three weeks after contact with secretions from the mouth or nose of an infected person. From 20 to 50 percent of those infected do not develop symptoms, however. Along with the rash, infected persons may experience enlarged lymph glands, conjunctivitis, and runny nose. Adult women may also experience joint pain or swelling.

When infection occurs early in pregnancy, the risk of the fetus being infected may be as high as 90 percent. Consequences of fetal infection include miscarriages, stillbirths, and severe birth defects, known as congenital rubella syndrome (CRS). Known defects include cataracts, heart defects, and hearing impairment. Up to 20 percent of the infants born to mothers infected during the first half of their pregnancy have CRS.

Because many people with rubella do not have symptoms, and because many rash illnesses look similar to rubella, a laboratory test is required to confirm rubella infection. A blood test can be used to detect rubella antibodies, and the virus can be cultured and isolated from a sample of blood, nasal or throat secretion, urine, spinal fluid, or body tissues such as cataracts.

Rubella circulates year-round, with a regular seasonal peak during springtime. Before the rubella vaccine was used in the United States, major epidemics occurred every six to nine years. The last major U.S. rubella epidemic occurred in 1964–1965 and caused an estimated 12.5 million cases of rubella and 20,000 cases of CRS in live-born infants. Prior to vaccine use, rubella occurred mainly among children. With the success of the U.S. rubella immunization program, the incidence of rubella has decreased by 99 percent to a reported 267 cases of rubella and six cases of CRS in 1999. In the United States, most cases of rubella now occur mainly among adults who were born in countries that do not have a long history of widespread vaccination.

In 1969, three rubella vaccines were licensed for use in the United States. In 1979, the currently used vaccine—called RA27/3—was introduced, replacing the other three. More than 95 percent of those vaccinated develop lifelong immunity. In the United States, one dose of rubella vaccine is recommended for all susceptible persons twelve months of age and older, unless vaccination is contraindicated.

Side effects following vaccination include low-grade fever, rash, joint pain and swelling, and lymphadenopathy. Joint pain and transient joint swelling tend to be more severe in vaccinated women than in men or children. Overall, joint pain and swelling tend to be more severe and last longer in persons who have the natural rubella disease than those who receive the rubella vaccine.

Although use of rubella vaccine is contraindicated in pregnant women or women planning pregnancy within three months, the U.S. registry on inadvertent vaccination in pregnancy has documented that all infants listed in the registry were free of defects associated with CRS. These data are consistent with results reported from other countries. Other groups that should not be given the vaccine include persons with immunodeficiency diseases or compromised immune systems and those who have recently received immunoglobulin or have severe fever.

(SEE ALSO: Communicable Disease Control; Contagion; Immunizations)

Bibliography

Cooper, L. Z., and Alford, C. A., Jr. (2001). "Rubella." In Infectious Diseases of the Fetus and Newborn Infant, 5th edition, eds. J. S. Remington and J. O. Klein. Philadelphia, PA: W. B. Saunders.

"Measles, Mumps, and Rubella—Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP)." Mortality and Morbidity Weekly Report 47(RR-8):1–57.

Plotkin, S. A. (1999). "Rubella Vaccine." In Vaccines, 3rd edition, eds. S. A. Plotkin and W. A. Orenstein. Philadelphia, PA: W. B. Saunders Company.

— SUSAN E. REEF



Viral disease with a usually mild course, except in women in the first 20 weeks of pregnancy, in whom it can cause fetal birth defects (of eyes, heart, brain, and large arteries) or death. Sore throat and fever are followed by swollen glands and a rash. Up to 30% of infections may have no symptoms. Lifelong immunity follows infection. Encephalitis is a rare complication. Rubella was not distinguished from measles (rubeola) until the early 19th century and was not known to be dangerous until 1941. The virus was isolated in 1962, and a vaccine became available in 1969.

For more information on rubella, visit Britannica.com.

or German measles, acute infectious disease of children and young adults. It is caused by a filterable virus that is spread by droplet spray from the respiratory tract of an infected individual. Rubella is a much milder infection than rubeola (measles) and the rash, appearing after an incubation period of two to three weeks, rarely lasts more than three days. The lymph nodes behind the ears become tender and swollen, but otherwise German measles is almost always uncomplicated. However, during the first trimester of pregnancy it is associated with an increased risk of congenital damage to the fetus, producing stillbirths, abortion, low birth weight, and such malformations as cardiac defects, eye defects (especially cataracts), and mental retardation. During the first 16 weeks of pregnancy the infection has been estimated to carry a risk of fetal damage of between 30% and 35%. Pregnant women who have been exposed to rubella are given gamma globulin in an effort to prevent the disease. Research to develop a vaccine that would confer immunity was spurred by an epidemic of rubella in 1964 and the evidently related rise in the number of birth deformities. A live attenuated vaccine has been developed and is given to girls from 15 months to puberty and often to boys as well. Approximately 13% to 15% of women develop acute arthitis from vaccination. Before the vaccine can be administered to an adult woman it must be determined that she is not pregnant, and the test for the presence of rubella antibodies (which would indicate immunity to the disease from previous exposure) is given. Birth control should be practiced for at least three months after receiving the vaccine.


Rubella
Classification & external resources
ICD-10 B06.
ICD-9 056
DiseasesDB 11719
MedlinePlus 001574
eMedicine emerg/388  peds/2025 derm/259
Rubella virus
Rubella_virus_TEM_B82-0203_lores.jpg
Virus classification
Group: Group IV ((+)ssRNA)
Family: Togaviridae
Genus: Rubivirus
Species: Rubella virus

Rubella, commonly known as German measles, is a disease caused by the rubella virus. It is often mild and an attack can pass unnoticed. However, this can make the virus difficult to diagnose. The virus usually enters the body through the nose or throat. The disease can last 1-5 days. Children recover more quickly than adults. Like most viruses living along the respiratory tract, it is passed from person to person by tiny droplets in the air that are breathed out. Rubella can pose a serious risk as it can also be transmitted from a mother to her developing baby through the bloodstream via the placenta. If the mother is infected within the first 20 weeks of pregnancy, the child may be born with congenital rubella syndrome, which includes a range of birth defects. The virus has an incubation period of 2 to 3 weeks during which it becomes established.

Symptoms

Rubella rash on the abdomen

Enlarge

Rubella rash on the abdomen

Symptoms of rubella include:

Children: Low grade fever, swollen glands, joint pain, headache, conjunctivitis, rash

Adults and children:

  • swollen glands or lymph nodes (may persist for up to a week)
  • fever (rarely rises above 38 degrees Celsius [100.4 degrees Fahrenheit])
  • rash (Appears on the face and then spreads to the trunk and limbs. It appears as pink dots under the skin. It appears on the first or third day of the illness but it disappears after a few days with no staining or peeling of the skin)
  • Forchheimer's sign occurs in 20% of cases, and is characterized by small, red papules on the area of the soft palate
  • flaking, dry skin
  • nerves become weak and numb (very rare)

Risks

Rubella can affect anyone of any age and is generally a mild disease. However, rubella can cause congenital rubella syndrome in the fetus of an infected pregnant woman. Usually occurs between 14 - 21 weeks of pregnancy.

Prevention and treatment

Symptoms are usually treated with paracetamol until the disease has run its course. There is no treatment available for congenital rubella.

Fewer cases of rubella have occurred ever since a vaccine became available in 1969, although decreased uptake of the MMR vaccine (e.g. in the UK) is expected to lead to a rise in incidence. In most Western countries, the vast majority of people are vaccinated against rubella as children at 12 to 15 months of age. A second dose is required before age 11. The vaccine may give lifelong protection against rubella. A side-effect of the vaccine can be transient arthritis.

The immunization program has been quite successful with Cuba declaring the disease eliminated in the 1990s. In 2004 the Centers for Disease Control and Prevention announced that both the congenital and acquired forms of rubella had been eliminated from the United States.[1][2]

History

Friedrich Hoffmann made a clinical description of rubella in 1740.[3] Later descriptions by de Bergen in 1752 and Orlow in 1758 supported the belief that this was a derivative of measles. In 1814, George de Maton first suggested that it be considered a disease distinct from both measles and scarlet fever. All these physicians were German, and the disease was known medically as Rötheln (from the German name Röteln), hence the common name of "German measles".[3][4][5][6][7][8]

English Royal Artillery surgeon, Henry Veale, observed an outbreak in India. He coined the euphonious name "rubella" (from the Latin, meaning "little red") in 1866.[7] It was formally recognized as an individual entity in 1881, at the International Congress of Medicine in London.[8] In 1914, Alfred Fabian Hess theorised that rubella was caused by a virus, based on work with monkeys.[9] In 1938, Hiro and Tosaka confirmed this by passing the disease to children using filtered nasal washings from acute cases.[6]

In 1940, there was a widespread epidemic of rubella in Australia. Subsequently, opthalmologist Norman McAllister Gregg found 78 cases of congenital cataracts in infants and 68 of them were born to mothers who had caught rubella in early pregnancy.[4][6] Gregg published an account, Congenital Cataract Following German Measles in the Mother, in 1941. He described a variety of problems now know as congenital rubella syndrome (CRS) and noticed that the earlier the mother was infected, the worse the damage was.[8] The virus was isolated in tissue culture in 1962 by two separate groups led by physicians Parkman and Weller.[7][4]

There was a pandemic of rubella between 1962 and 1965, starting in Europe and spreading to the United States.[7] In the years 1964-65, the United States had an estimated 12.5 million rubella cases. This led to 11,000 miscarriages or therapeutic abortions and 20,000 cases of congenital rubella syndrome. Of these, 2,100 died as neonates, 12,000 were deaf, 3,580 were blind and 1,800 were mentally retarded. In New York alone, CRS affected 1% of all births.[8]

In 1969 a live attenuated virus vaccine was licensed.[6] In the early 1970s, a triple vaccine containing attenuated measles, mumps and rubella (MMR) viruses was introduced.[7]

Rubella in popular culture

  • Agatha Christie's The Mirror Crack'd from Side to Side features a plot, possibly based on real life, in which a girl is shut in quarantine for a minor illness but climbs out of the window to meet a actress (Gene Tierney). The actress (Tierney) is pregnant and unknowingly catches rubella resulting in a child with congenital rubella syndrome. However, as this is the fan's favourite anecdote, when she meets the actress (Tierney) years later she tells her the story and the actress realises that her baby's syndrome was caused by this fan. Tierney described the event in her autobiography (Self-Portrait, 1979), but it had been publicized for years previously. The incident, as well as the circumstances under which the information is imparted to the actress is repeated almost verbatim in the story.

References

  1. ^ Dayan GH, Castillo-Solórzano C, Nava M, et al (2006). "Efforts at rubella elimination in the United States: the impact of hemispheric rubella control". Clin. Infect. Dis. 43 Suppl 3: S158–63. DOI:10.1086/505949. PMID 16998776. 
  2. ^ (2005) "Elimination of rubella and congenital rubella syndrome--United States, 1969-2004". MMWR Morb. Mortal. Wkly. Rep. 54 (11): 279–82. PMID 15788995. 
  3. ^ a b Ackerknecht, Erwin Heinz (1982). A short history of medicine. Baltimore: Johns Hopkins University Press, 129. ISBN 0-8018-2726-4. 
  4. ^ a b c Lee JY, Bowden DS (2000). "Rubella virus replication and links to teratogenicity". Clin. Microbiol. Rev. 13 (4): 571-87. PMID 11023958. 
  5. ^ Rubella. PatientPlus (2006-05-08). Retrieved on 2007-07-03.
  6. ^ a b c d Atkinson W, Hamborsky J, McIntyre L, Wolfe S, eds. (2007). "Chapter 12. Rubella", Epidemiology and Prevention of Vaccine-Preventable Diseases. 10th ed.. Centers for Disease Control and Prevention. Retrieved on 2007-07-03. 
  7. ^ a b c d e (April 2006) "Chapter 11 - Rubella", Immunisation Handbook 2006. Ministry of Health, Wellington, NZ.. ISBN 0-478-29926-5. Retrieved on 2007-07-03. 
  8. ^ a b c d EPI Newsletter Volume XX, Number 4. Pan American Health Organization (August 1998). Retrieved on 2007-07-03.
  9. ^ Hess, Alfred Fabian (1914). "German measles (rubella): an experimental study". The Archives of Internal Medicine 13: 913-916.  as cited by Enersen, Ole Daniel. Alfred Fabian Hess. WhoNamedIt. Retrieved on 2007-07-03.

External links

Viral diseases (A80-B34, 042-079)
Viral infections of the CNS Poliomyelitis (Post-polio syndrome) - Subacute sclerosing panencephalitis - Progressive multifocal leukoencephalopathy - Rabies - Encephalitis lethargica - Lymphocytic choriomeningitis - Tick-borne meningoencephalitis - Tropical spastic paraparesis
Arthropod-borne viral fevers and
viral haemorrhagic fevers
Dengue fever - Chikungunya - Rift Valley fever - Yellow fever - Argentine hemorrhagic fever - Bolivian hemorrhagic fever - Lassa fever - Crimean-Congo hemorrhagic fever - Omsk hemorrhagic fever - Kyasanur forest disease - Marburg hemorrhagic fever - Ebola
Viral infections characterized by
skin and mucous membrane lesions
Herpes simplex - Chickenpox - Herpes zoster - Smallpox - Monkeypox - Measles - Rubella - Plantar wart - Cowpox - Vaccinia - Molluscum contagiosum - Roseola - Fifth disease - Hand, foot and mouth disease - Foot-and-mouth disease
Viral hepatitis Hepatitis A - Hepatitis B - Hepatitis C - Hepatitis E
Viral infections of the respiratory system Avian influenza - Acute viral nasopharyngitis - Infectious mononucleosis - Influenza - Severe acute respiratory syndrome - Viral pneumonia
Other viral diseases Cytomegalovirus - Mumps - Bornholm disease
Sexually transmitted HIV (AIDS, AIDS dementia complex) - Genital warts - Adult T-cell leukemia
Exanthema
Measles (1st disease) - Scarlet fever (2nd disease) - Rubella (3rd disease)
Duke's disease (4th disease) - Slap cheek (5th disease) - Roseola (6th disease)

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Translations: Translations for: Rubella

Dansk (Danish)
n. - [med.] rubella, røde hunde

Nederlands (Dutch)
rodehond

Français (French)
n. - rubéole

Deutsch (German)
n. - Röteln

Ελληνική (Greek)
n. - (παθολ.) ερυθρά

Italiano (Italian)
rosolia

Português (Portuguese)
n. - rubéola (f) (Med.)

Русский (Russian)
(мед.) краснуха

Español (Spanish)
n. - rubéola

Svenska (Swedish)
n. - röda hund

中文(简体) (Chinese (Simplified))
德国麻疹, 风湿疹

中文(繁體) (Chinese (Traditional))
n. - 德國麻疹, 風濕疹

한국어 (Korean)
n. - 풍진

日本語 (Japanese)
n. - 風疹

العربيه (Arabic)
‏(الاسم) الحصبه الألمانيه‏

עברית (Hebrew)
n. - ‮אדמת, אדמדמת‬

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