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Rubella

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Rubella is a mild disease that affects children. It is an airborne infection that spreads by coming in contact with an infected person or thing. Let us learn more about this contagious disease in the following paragraphs.

Definition

Rubella is also called as German measles. Some also know it as three-day measles. The term ‘rubella’ is a Latin word that simply means ‘little red’. The term German measles was coined as it was described by German doctors in 18th century. As it usually lasts for about 3 days, it is called three-day measles. This disease is usually mild and one does not even realize at times that the child is infected.

The disease is very dangerous in case of a woman who is pregnant. If the infection occurs within 20 weeks of pregnancy, it could lead to serious and permanent complications in the child born. In some, it leads to spontaneous abortions.

Causes

Rubella is caused by a virus called the rubella virus, a type togavirus. It is a single-stranded RNA virus. Rubella is not similar rubeola (measles). Both are caused by a virus and lead to red rash. But, rubella is a milder disease compared to measles.

How Does Rubella Spread?

Rubella can spread from person to person. It is an airborne disease that spreads in respiratory droplets released after an infected person sneezes or coughs. It can even spread after coming in contact with infected mucus. The virus then enters the respiratory tract and starts to replicate in the nasopharynx and lymph nodes. Within 5 to 7 days the virus can be found in the blood. In case it infects a pregnant woman in the first 20 weeks of pregnacy, it shows teratogenic characteristics. This means, it has the ability to cross the placenta and infect the growing fetus. This leads to many complications in the fetus and may even lead to spontaneous abortions.

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What is Congenital Rubella Syndrome?

When a pregnant women who is not immunized against rubella by a previous infection or vaccination gets infected with rubella virus, it could lead to congenital rubella syndrome.

This means the virus enters the placental barrier and infects the growing cells. This leads to mutation or destruction of cells leading to congenital rubella syndrome (CRS).

The child affected with this syndrome shows many defects. This depends on which stage of pregnancy the mother is infected. If the mother is infected in the initial stages, the risk is higher. This means if the infection occurs within 10 weeks of pregnancy, there is 90% chance of multiple birth defects in the baby.

It is very rare to observe birth defects in children, if the mother catches the infection after 16 weeks of pregnancy. It could however lead to deafness.

Babies with congenital rubella syndrome show the following birth defects:

  • Premature birth
  • Low birth weight
  • Anaemia
  • Hepatitis
  • Blindness
  • Deafness
  • Cataract
  • Severe heart defects like Patent ductus arteriosus
  • Skin problems
  • Mental retardation
  • Microcephaly
  • Thrombocytopenic purpura
  • Developmental delay
  • Diabetes
  • Learning disabilities
  • Glaucoma
  • Schizophrenia

Symptoms of Rubella

The virus takes 14-21 days of incubation. Then, it leads to appearance of symptoms at times so mild that one never notices them. If the symptoms do appear, they occur within 2 to 3 weeks of exposure to the virus. The symptoms remain for 2-3 days.

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The symptoms are very similar to flu. A rash will appear on the face that will spread to the trunk and limbs. The rash will gradually disappear in 3 days. The rash is light red or pink in color. It will disappear without peeling or leaving marks on the skin. Small flakes will be formed on the skin where the rash appeared. Other symptoms include:

Diagnosis

The doctor may conduct a blood test to check for antibodies against rubella. This will indicate if the rash is caused due to rubella.

Treatment

There is no specific treatment for rubella. The symptoms are very mild and does not need medical intervention. Isolation is advised to avoid spread of infection to others. Preganant women may be given hyperimmune globulin for the infection. Otherwise the end of pregnancy may be advised in case of multiple birth defects suspected in the baby. Children with congenital rubella syndrome may be supported and treated based on their complications.

Prognosis

Rubella is usually a mild infection and is self-limiting. The prognosis is not very bright for children with congenital rubella syndrome.

Vaccination

Children an adults are given a combination vaccine called MMR. It protects them against mumps, measles and rubella. This is a live, attenuated vaccine of viruses that cause mumps, measles and rubella. An injection is given in the fatty layer under the skin. The first dose is given after the first birthday of the child. It should ideally be given within 12-15 months of age. The second shot is given when the child is 4-6 years of age.

This was all about rubella. A mild infection generally gets resolved on its own. Pregnant women who are not immunised against rubella should be very careful. Speak to your GP for more details.

Written by: Saptakee sengupta
Date last updated: March 13, 2015