Rubella- Rubella, commonly known as German measles, is a disease caused by the rubella virus.
The name
"rubella" is derived from the Latin, meaning little red. Rubella is also known as German measles because the disease
was first described by German physicians in the mid-eighteenth century. This disease is often mild and attacks often
pass unnoticed. The disease can last one to three days. Children recover more quickly than adults. Infection of the
mother by Rubella virus during pregnancy can be serious; if the mother is infected within the first 20 weeks of
pregnancy, the child may be born with congenital rubella syndrome (CRS), which entails a range of serious
incurable illnesses. Spontaneous abortion occurs in up to 20% of cases.
In most people the virus is rapidly eliminated. However, it may persist for some months post partum in infants
surviving the CRS. These children are a significant source of infection to other infants and, more importantly, to
pregnant female contacts.
SIGNS AND SYMPTOMS- After an incubation period of 14–21 days, German measles causes symptoms that are
similar to the flu. The primary symptom of rubella virus infection is the appearance of a rash (exanthem) on the face
which spreads to the trunk and limbs and usually fades after three days (that 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 & 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 oC
(100.4 oF). The rash of German measles is typically pink or light red. The rash 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 patient may notice that his skin sheds in very small flakes wherever the rash covered it. Forchheimer's sign
occurs in 20% of cases, and is characterized by small, red papules on the area of the soft palate.
Rubella can affect anyone of any age and is generally a mild disease, rare in infants or those over the age of 40. The
older the person is the more severe the symptoms are likely to be. Up to two-thirds of older girls or women
experience joint pain or arthritic type symptoms with rubella. The virus is contracted through the respiratory tract
and has an incubation period of 2 to 3 weeks. During this incubation period, the patient is contagious typically for
about one week before he develops a rash and for about one week thereafter.
Congenital rubella syndrome
Rubella can cause congenital rubella syndrome in the newly born. The syndrome (CRS) follows intrauterine
infection by Rubella virus and comprises cardiac, cerebral, ophthalmic and auditory defects. It may also cause
prematurity, low birth weight, and neonatal thrombocytopenia, anemia and hepatitis. The risk of major defects or
organogenesis is highest for infection in the first trimester. CRS is the main reason a vaccine for rubella was
developed. Many mothers who contract rubella within the first critical trimester either have a miscarriage or a still
born baby. If the baby survives the infection, it can be born with severe heart disorders (PDA being the most
common), blindness, deafness, or other life threatening organ disorders. The skin manifestations are called
"blueberry muffin lesions."
CAUSES- The disease is caused by Rubella virus, a togavirus that 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 is found in the blood 5 to 7 days after infection and spreads throughout the body. 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
