Rubella, commonly referred to as the German measles, is an air-borne and highly contagious virus. While most individuals recover from the disease without treatment, the illness can wreak havoc on children born to infected mothers. In the mid-1960s a vaccination was developed and rubella cases quickly diminished in Europe and the United States after vaccine campaigns were initiated.
By 2004, the U.S. was almost completely free of the virus and by 2015, the World Health Organization (WHO) announced that the virus had been completely eradicated in North and South America. However, Rubella is still common in many developing regions of the world including areas of East Asia and Africa. Outbreaks still occasionally occur in developed countries as well but has become quite rare as more groups are vaccinated.
Causes of Rubella
Rubella, caused by a single-strand RNA virus from the Rubivirus genus of the viral family of Matonaviridae, can be detected in the bloodstream within 5-7 days of infection. Transmitted through the respiratory system, the virus replicates in the lymph nodes and nasopharynx and then spreads to other parts of the body.
When the virus is contracted during pregnancy, rubella can cross the placenta where it infects the fetus and prohibits cell development and may cause cell destruction. This form of the disease is called congenital rubella syndrome (CRS).
The infection is most commonly spread by inhaling air-borne particles after an infected individual coughs or sneezes. The virus can also be contracted by direct contact from excretions, such as saliva or mucus. Pregnant women also infect their unborn children when the virus is transmitted via the placenta through the bloodstream.
Individuals typically remain contagious for approximately 5-7 days before signs of disease develop and remain contagious for up to one week after developing the tell-tale rash associated with rubella.
Signs and Symptoms of Rubella
Some infected individuals do not show any signs or experience symptoms after becoming infected with the rubella virus, though it is uncommon. Usually the first sign of infection is the rapid development of a rash with itching that starts on the face. As the pink or red rash fades from the face, it spreads to other parts of the body, including the torso and limbs. The rash usually disappears within 3 days. However, swollen lymph nodes may be noticeable for up to a week. Like many viruses, Rubella can cause flu or cold-like symptoms which may or may not be present:
- Low fever up to 101 degrees
- Swollen glands
- Aching joints
- Excess mucus production
In cases of severe complications, rubella may cause a low platelet count, brain inflammation, ear infection or death. Rubella may also cause co-existing infections of viral or bacterial bronchitis or pneumonia.
Newborns who contract congenital rubella syndrome may suffer brain damage, hearing loss, cataracts, blindness, and heart defects. Low birth weight, hepatitis, and anemia may also be present.
Generally, there are no specific treatments available for rubella. In most cases the disease causes illness for several days to several weeks and then subsides after the immune system has eliminated the virus. Palliative care such as bed rest and over-the-counter medications may help to alleviate some of the symptoms while the disease runs its course.
Instead, prevention through immunization is the first line of defense. Two vaccines have been effective to prevent the onset of disease and to control regional outbreaks. Rubella vaccinations were first given to adults but it was quickly discovered that the vaccines were more effective when administered to babies or young children, especially when preventing congenital rubella.
Treatments for congenital rubella are targeted mostly to combat the defects caused when unborn children contract the disease early in development while still in the womb. The defects, such as heart deformities and cataracts that can lead to blindness, are treated with surgery.