Rubella (रूबेला), 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 the people not realizing they are infected. 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 sometimes itchy and is not as bright as that of measles. Swollen lymph nodes are common and may last a few weeks. 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.
Rubella 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.
Rubella Complications
It is a mild infection. Some women who have had rubella experience arthritis in the fingers, wrists, and knees, which generally lasts for about one month. In rare cases, it can cause an ear infection or inflammation of the brain.
However, if you’re pregnant when you get rubella, the effect on your unborn child may be severe, and in some cases, fatal. Up to 90% of infants born to mothers with rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including:
- Growth delays
- Cataracts
- Deafness
- Problems with the development of the heart (congenital heart defects)
- Problems with the development of other organs
- Issues with mental development and learning
The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous.
Rubella Symptoms
It has symptoms similar to those of the flu. However, the primary symptom is the appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days, which is why it is often referred to as three-day measles. The facial rash usually clears as it spreads to other parts of the body. Other symptoms include low-grade fever, swollen glands (sub-occipital and posterior cervical lymphadenopathy), joint pains, headache, and conjunctivitis.
The swollen glands or lymph nodes can persist for up to a week and the fever rarely rises above 38 °C (100.4 °F). The rash is typically pink or light red, it causes itching and often lasts for about three days. The rash disappears after a few days with no staining or peeling of the skin. When the rash clears up, the skin might shed in very small flakes where the rash covers it. Forchheimer spots occur in 20% of cases and are characterized by small, red bumps on the area of the soft palate.
Affects anyone of any age
Rubella can affect anyone of any age. Adult women are particularly prone to arthritis and joint pains.
In children, it causes typically symptoms that last two days and include:
- The rash begins on the face and spreads to the rest of the body.
- Low fever of less than 38.3 °C (101 °F).
- Posterior cervical lymphadenopathy.
In older children and adults, additional symptoms may be present, including:
- Swollen glands
- Coryza (cold-like symptoms)
- Aching joints (especially in young women)
Severe complications of rubella include:
- Brain inflammation (encephalitis)
- Low platelet count
- Ear infection
Coryza in rubella may convert to pneumonia, either direct viral pneumonia or secondary bacterial pneumonia, and bronchitis (either viral bronchitis or secondary bacterial bronchitis).
Congenital rubella syndrome
Rubella can cause congenital rubella syndrome in the newborn. It is the most severe sequela of rubella. The syndrome (CRS) follows intrauterine infection by the virus and comprises cardiac, cerebral, ophthalmic, and auditory defects. It may also cause prematurity, low birth weight, neonatal thrombocytopenia, anemia, and hepatitis. The risk of major flaws in organogenesis is highest for infection in the first trimester. CRS is the main reason a vaccine for rubella was developed.
80-90% of mothers who contract rubella within the critical first trimester have either a miscarriage or a stillborn baby. If the fetus survives the infection, it can be born with severe heart disorders (patent ductus arteriosus being the most common), blindness, deafness, or other life-threatening organ disorders. The skin manifestations are called “blueberry muffin lesions”. For these reasons, rubella is included in the TORCH complex of perinatal infections.
Rubella Cause
The disease is caused by the rubella virus, in the genus Rubivirus from the family Matonaviridae, which is enveloped and has a single-stranded RNA genome. The virus is transmitted by the respiratory route and replicates in the nasopharynx and lymph nodes. The virus has teratogenic properties and is capable of crossing the placenta and infecting the fetus where it stops cells from developing or destroys them. During this incubation period, the patient is contagious typically for about one week before he/she develops a rash and for about one week after that.
Increased susceptibility to infection might be inherited as there is some indication that HLA-A1 or factors surrounding A1 on extended haplotypes are involved in virus infection or non-resolution of the disease.
Rubella Diagnosis
Rubella virus-specific IgM antibodies are present in people recently infected by the virus, but these antibodies can persist for over a year, and a positive test result needs to be interpreted with caution. The presence of these antibodies along with, or a short time after, the characteristic rash confirms the diagnosis.
Rubella Prevention
Preventing it involves both personal health practices and public health measures. Here are the key strategies:
Vaccination
- MMR Vaccine: The measles, mumps, and rubella (MMR) vaccine is the most effective way of prevention. It provides long-term immunity.
- Vaccination Schedule:
- First dose: Given at 12-15 months of age.
- Second dose: Given at 4-6 years of age or at least 28 days after the first dose.
- Adults who haven’t been vaccinated should also consider getting the MMR vaccine, especially if they are planning pregnancy or traveling to areas where rubella is prevalent.
Routine Prenatal Screening
- Women planning to become pregnant should check their immunity through a blood test. If not immune, vaccination is recommended at least a month before trying to conceive.
Herd Immunity
- Ensuring widespread community vaccination reduces the spread, protecting those who cannot be vaccinated (e.g. newborns or individuals with certain medical conditions).
Avoid Exposure
- During outbreaks, avoid contact with individuals who may have rubella, especially if you are pregnant or not vaccinated.
Educate and Advocate
- Spread awareness about the importance of the MMR vaccine.
- Advocate for public health policies supporting routine childhood immunizations.
Travel Precautions
- Check vaccination requirements when traveling to regions where the disease is still common.
By following these steps, individuals and communities can significantly reduce the risk of transmission and its complications, such as congenital rubella syndrome in newborns.
Rubella Treatment
There is no specific treatment; however, management is a matter of responding to symptoms to diminish discomfort. Treatment of newborn babies is focused on the management of the complications. Congenital heart defects 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 required.
Eradication of Rubella
On January 22, 2014, the World Health Organization (WHO) and the Pan American Health Organization declared and certified Colombia free of rubella and became the first Latin American country to eliminate the disease within its borders. On April 29, 2015, the Americas became the first WHO region to officially eradicate the disease. The last non-imported cases occurred in 2009 in Argentina and Brazil.
Pan-American Health Organization director remarked, “The fight against rubella has taken more than 15 years, but it has paid off with what I believe will be one of the most important pan-American public health achievements of the 21st Century.” The declaration was made after 165 million health records and genetically confirmed that all recent cases were caused by known imported strains of the virus.
Ayurveda treatment for Rubella
Ayurveda, a traditional system of medicine originating in India, offers holistic approaches to promote overall health and well-being. While Ayurveda can provide supportive care for various conditions, it’s important to note that it does not claim to provide a specific cure for viral infections like rubella. Rubella, also known as German measles, is a viral illness caused by the rubella virus and is typically managed through supportive measures and vaccination.
That being said, Ayurveda focuses on strengthening the immune system, promoting balance, and reducing symptoms. Here are some general Ayurvedic principles and practices that may help support the body during a Rubella infection:
Herbal Remedies
Certain Ayurvedic herbs may be beneficial in boosting the immune system and supporting the body’s natural defenses. Some commonly used herbs include tulsi (holy basil), neem, ginger, turmeric, and Amalaki (Indian gooseberry). These herbs possess antimicrobial and immunomodulatory properties.
Ayurvedic Diet
Following a healthy and balanced diet is essential for overall well-being. During a rubella infection, focus on nourishing, easily digestible foods such as soups, stews, cooked vegetables, whole grains, and fresh fruits. Avoid spicy, oily, and processed foods that may burden the digestive system.
Hydration
Staying well-hydrated is important for supporting the body’s natural detoxification processes and maintaining overall health. Drink warm water or herbal teas to stay hydrated.
Rest and Adequate Sleep
Adequate rest and sleep are crucial for the body to recover and heal. Ensure you get sufficient rest and prioritize sleep to support your immune system during infection.
Stress Reduction
Chronic stress can weaken the immune system, making it more susceptible to infections. Practicing stress reduction techniques such as yoga, meditation, deep breathing exercises, and regular exercise can help support overall well-being and immune function.
It’s important to note that Ayurvedic treatments should be pursued under the guidance of a qualified Ayurvedic practitioner who can assess your specific condition and provide personalized recommendations. Additionally, it’s essential to seek medical advice from a healthcare professional for proper diagnosis, management, and vaccination options for rubella.
Conclusion
Rubella, also known as German measles, is a viral infection that can cause significant health concerns, especially for pregnant women and their unborn babies. Vaccination is the primary method of prevention, as it helps to reduce the risk of transmission and complications associated with the disease. It is crucial to consult with a healthcare professional for accurate diagnosis, appropriate medical care, and vaccination options. The medical community emphasizes the importance of vaccination programs to control and prevent it, particularly to protect vulnerable populations, such as pregnant women and those planning pregnancy. Remember, public health measures and medical interventions are vital in addressing rubella, and healthcare professionals should be consulted for appropriate guidance and care.
Frequently Asked Questions
What is rubella?
It, commonly known as German measles, is a viral infection caused by the rubella virus. It is highly contagious and spreads through respiratory droplets from an infected person.
What are the symptoms of rubella?
The symptoms may include a mild fever, rash, sore throat, headache, swollen lymph nodes, and red eyes. However, some infected individuals, especially children, may exhibit no symptoms at all.
How is rubella diagnosed?
It is typically diagnosed through clinical symptoms, such as the characteristic rash, and laboratory tests to detect the presence of rubella-specific antibodies in the blood.
How is rubella transmitted?
It is transmitted through respiratory droplets when an infected person coughs or sneezes. It can also spread through close contact with infected individuals or, in rare cases, from an infected mother to her unborn baby during pregnancy.
Is rubella a serious infection?
While it is generally a mild illness, it can have serious consequences for pregnant women, as the virus can cause congenital rubella syndrome (CRS) in their babies. CRS can result in various birth defects, including hearing and vision impairments, heart abnormalities, and developmental disabilities.
How can rubella be prevented?
The measles, mumps, and rubella (MMR) vaccine effectively provides immunity.
Is rubella a global health concern?
Efforts to control and eliminate it are part of worldwide vaccination campaigns and public health initiatives.
What should pregnant women do to protect themselves from Rubella?
Pregnant women who are not immune should take precautions to avoid exposure to the virus. It is advisable to ensure proper immunity through vaccination before planning a pregnancy. If there is a risk of exposure, consult a healthcare professional for guidance.
Is there a specific treatment for rubella?
There is no specific antiviral treatment. Pregnant women may require specialized care to manage complications and protect the unborn baby.
It’s important to consult healthcare professionals for accurate information, diagnosis, and guidance regarding prevention, vaccination, and appropriate medical care.
Reference: https://en.wikipedia.org/wiki/Rubella