Rubella (German Measles)

Rubella – Cause, Symptoms, Diagnosis and Treatment

Rubella, also known as German measles, is a viral infection. From being considered a devastating epidemic to an illness that causes mild little red rashes – different experiences profile the characterization of the disease. Some people also confuse rubella with rubeola, which is an alternative name for measles in English speaking countries. Although, both the diseases share some common characteristics like rashes and other symptoms, they vary in intensity and duration. Moreover, rubella is caused by a virus which belongs to the family of togavirus, while measles are caused by a virus which belongs to the family of paramyxovirus. This distinction was first made by a German physician and that is why the disease is also referred to as German measles.

The nations of Americas have been declared free of endemic transmission of rubella but the disease still manifests in other parts of the world in its original form or as its variant – the congenital rubella syndrome.

Rubella –What is it and What Causes it?

Rubella is defined as a mild infection which mostly affects children and young adults. It is contagious in nature and with the resulting rashes lasting for as little as three days (other symptoms may last for a longer period). Pink or light red rashes, enlargement of lymph nodes and low grade fever are some of the symptoms which are commonly associated with rubella. However, when the disease manifests into its alternative form as congenital rubella syndrome, the illness can be far serious and sometimes may even result in death. The virus that causes rubella is called Rubella virus, a member of family Togavirus.

Transmission and Life Cycle of Rubella Virus

Rubella is transmitted from one individual to another individual whenever the infected person coughs or sneezes. The released infected airborne droplets then enter the respiratory system of a healthy individual, thereby, completing successful transmission of the virus. The virus which is a single stranded RNA virion, uses the transcription and translation machinery of the host’s respiratory cell – replicating and infiltrating other organs of the body. Unto this date, humans are the only hosts of rubella virus. The onset of infiltration process may start a week ago, before the appearance of rashes, with the host continuing to remain contagious for up to 1-2 weeks after the rashes appear.

Symptoms of Rubella

Apart from the well documented appearance of light red or pink rashes, other symptoms of rubella include:

Mild low fever, around 39°C in temperature.
Swollen lymph nodes behind the ears and neck.
Mild conjunctivitis.
Nausea and vomiting.
Muscle and joint pain, especially in adults.
Bruising, although it is seldom experienced.

From Rubella to Congenital Rubella Syndrome

Congenital rubella syndrome is an alternate manifestation of rubella disease which occurs when the virus is transplacentally transmitted to a baby that is still in the womb. A woman infected with rubella virus carries ninety percent probability of passing the virus to the fetus, during early months of pregnancy. Congenital rubella syndrome may cause miscarriages, stillbirth or severe birth defects like blindness, deafness, mental retardation, metaphyseal defect, diabetes etc.

Congenital rubella syndrome was first discovered in 1940s after ophthalmologist Norman Gregg established the link between epidemic cataracts with intrauterine rubella. In fact, between 1963 and 1965, congenital rubella syndrome was an epidemic disease in US and Europe which severely affected the population of newborns. 12.5 million cases of rubella were reported in US, with CRS contributing to a total of 25000 cases. Currently south-east Asian and African regions are considered to carry the greatest incidence of CRS.

Diagnosis of Rubella

The rubella virus can be diagnosed in an individual by examining their cell cultures. This cell culture can be developed through a nasal or throat swab as well as from the samples of the blood. The diagnosis procedure basically revolves around the identification of specific antibodies which are produced in response to rubella infection or immunization. There are no special preparation requirements which patients must take into consideration and neither does it involve any painful practices (except when the blood sample is being drawn for laboratory study). The diagnosis test is a recommended practice for ladies who are planning to get pregnant. For others, it is only suggested if the individual is experiencing any related symptoms of the disease.

Treatment for Rubella

Once the virus has infected the body, no treatment procedures have been specified that can help an individual to fight off rubella. However, patients don’t have to worry since the symptoms of the disease gradually wear off and the individual recovers in 2-3 weeks. Meanwhile, management practices and treatments can be exercised to diminish the associated symptoms. This could be simple medications for overcoming the fever and reducing joint pains or complex procedures like direct surgery to treat congenital heart defects and cataracts in newborns suffering from CRS.

To prevent the onset of the disease, populations are administered with rubella vaccines. These vaccines can be given as monovalent formulations or in combination with other vaccines like: measles (MR), measles and mumps (MMR) and measles, mumps and varicella (MMRV). Rubella vaccination is part of national immunization programs in many countries across the world which includes China, Australia, Americas and most of Europe.

Some individuals may experience adverse reactions to the administered vaccine, like, pain at the injection site, body ache and low grade fever. However, these side effects gradually fade away within days of administration.

World Health Organization has taken aggressive steps against curbing rubella on a global level, with the plan focusing on reducing its incidence and eliminating the disease in at least 5 WHO regions by 2021. The organization aims to achieve its targets by:

Encouraging the incorporation of rubella vaccination as a part of national health program in countries across the world.
Channeling more funds to assist the researchers in devising advanced diagnosis and treatment solutions that can help in the effective elimination of the disease.

Now, the medical community is headed in the right direction so let’s hope that the set objectives are met and fulfilled.