Rubella, also known as German measles or three-day measles,is an infection caused by the rubella virus.This disease is often mild with half of people not realizing that they are sick. A rash may start around two weeks after exposure and last for three days. It usually starts on the face and spreads to the rest of the body. The rash is not as bright as that of measles and is sometimes itchy. Swollen lymph nodes are common and may last a few weeks.A fever, sore throat, and fatigue may also occur. In adults joint pain is common. Complications may include bleeding problems, testicular swelling, and inflammation of nerves.Infection during early pregnancy may result in a child born with congenital rubella syndrome (CRS) or miscarriage. Symptoms of CRS include problems with the eyes such as cataracts, ears such as deafness, heart, and brain. Problems are rare after the 20th week of pregnancy.
Rubella is usually spread through the air via coughs of people who are infected.People are infectious during the week before and after the appearance of the rash. Babies with CRS may spread the virus for more than a year. Only humans are infected.Insects do not spread the disease. Once recovered, people are immune to future infections. Testing is available that can verify immunity.Diagnosis is confirmed by finding the virus in the blood, throat, or urine. Testing the blood for antibodies may also be useful.
Rubella is preventable with the rubella vaccine with a single dose being more than 95% effective.Often it is given in combination with the measles vaccine and mumps vaccine, known as the MMR vaccine.[With a population vaccination rate of less than 80%, however, more women might make it to childbearing age without developing immunity and issues could increase.Once infected there is no specific treatment.
Rubella is a common infection in many areas of the world.Each year about 100,000 cases of congenital rubella syndrome occur. Rates of disease have decreased in many areas as a result of vaccination.There are ongoing efforts to eliminate the disease globally. In April 2015 the World Health Organization declared the Americas free of rubella transmission.The name "rubella" is from Latin and means little red. It was first described as a separate disease by German physicians in 1814 resulting in the name "German measles."
PREVENTION
Rubella infections are prevented by active immunisation programs using live, disabled virus vaccines. Two live attenuated virus vaccines, RA 27/3 and Cendehill strains, were effective in the prevention of adult disease. However their use in prepubertal females did not produce a significant fall in the overall incidence rate of CRS in the UK. Reductions were only achieved by immunisation of all children.[citation needed]
The vaccine is now usually given as part of the MMR vaccine. The WHO recommends the first dose be given at 12 to 18 months of age with a second dose at 36 months. Pregnant women are usually tested for immunity to rubella early on. Women found to be susceptible are not vaccinated until after the baby is born because the vaccine contains live virus.
The immunisation program has been quite successful. Cuba declared the disease eliminated in the 1990s, and 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.
Screening for rubella susceptibility by history of vaccination or by serology is recommended in the United States for all women of childbearing age at their first preconception counseling visit to reduce incidence of congenital rubella syndrome (CRS).It is recommended that all susceptible non-pregnant women of childbearing age should be offered rubella vaccination.Due to concerns about possible teratogenicity, use of MMR vaccine is not recommended during pregnancy.Instead, susceptible pregnant women should be vaccinated as soon as possible in the postpartum period.
Treatment
There is no specific treatment for rubella; however, management is a matter of responding to symptoms to diminish discomfort. Treatment of newborn babies is focused on management of the complications. Congenital heart defects[citation needed] and cataracts can be corrected by direct surgery.
Management for ocular congenital rubella syndrome (CRS) is similar to that for age-related macular degeneration, including counseling, regular monitoring, and the provision of low vision devices, if require.
