What is Rubella Virus?
Rubella is a viral disease that manifests itself mainly during childhood. Rubella usually occurs with fever, characteristic rash and swollen lymph nodes (lymphadenopathy). It often produces no symptoms and goes unnoticed.
Rubella is a very contagious disease. The causative viruses are transmitted by droplets of saliva, for example through coughing or sneezing. Complications are very rare, as long as rubella does not occur during pregnancy. In the first trimester of pregnancy it becomes a threat to the embryo as it can cause serious damage to its organs which can constitute a medical justification for abortion. For this reason, all girls should be vaccinated against rubella until puberty. But young people also need to be vaccinated against rubella to prevent the spread of the disease.
What causes to rubella?
Rubella is caused by infection with a virus belonging to the rubivirus genus. This virus has RNA as a genetic material, and belongs to the togavirus family. The rubella virus is spread all over the world. Man is his only known guest. Whoever has been affected once by the pathogen is immune for life.
The period from the contagion to the outbreak (incubation time) in rubella is two to three weeks.
Viruses responsible for rubella can only survive briefly outside the body. They are transmitted by inhalation by droplets, by sneezing and coughing. They can also be spread by kissing and sharing dishes or cutlery. Also, rubella can be transmitted to the fetus during pregnancy through the placenta. The infection can last up to a week or after the onset of a typical rash.
What are the symptoms of rubella?
Rubella produces only mild symptoms such as inflamed and painful lymph nodes, inflammation of the mucous membranes and mild fever in most cases. After a short period of time, the characteristic rash appears. The rash begins behind the ears and quickly runs down the face and neck to the rest of the body. In this phase inflamed and painful lymph nodes also often appear, especially in the neck and behind the ears. Other symptoms of rubella may be joint pain, inflammation of the conjunctiva (conjunctivitis), and enlargement of the spleen (splenomegaly).
The rash arises one to three days after the onset of symptoms. Children should stay home during this time.
How to diagnose and treat the rubella?
Rubella can not be diagnosed solely on the basis of the clinical picture because typical symptoms of rubella, such as rash may manifest in other diseases such as erythema, measles, or scarlet fever. Therefore, rubella can only be diagnosed conclusively if specific antibodies are detected in the blood, or directly the RNA of the causative virus.
The RNA test is applied in prenatal diagnosis when it is desired to determine if rubella exists during pregnancy. In these cases a sample of the amniotic fluid is usually extracted in order to detect the virus directly. As of the 22nd week of pregnancy you can also examine your blood blood to detect antibodies in the fetus. These scans can only be performed by experienced medical specialists.
The treatment used against rubella is aimed at relieving symptoms. Antipyretic drugs (paracetamol, for example) and anti-inflammatories to treat inflammation of the joints (arthritis) are used to reduce the fever.
Children affected by rubella should rest in bed. Patients should be isolated to avoid infecting others with this highly contagious virus. The insulation lasts until the rash of the skin has completely disappeared.
How does rubella evolve?
In general the rubella shows good evolution, even in case of complications. In half of the children rubella goes without discomfort.
Once you have had rubella, you do not have to worry about a repeated infection. After passing the infection, there is permanent immunity to rubella throughout life. Only if the initial infection or vaccination lasts a long time, it can occasionally arise again, but this so-called reinfection is rare. Many people experience this reinfection even without symptoms or with mild symptoms such as upper respiratory tract infection, after which patients enjoy safe protection against rubella.
Rarely a patient with rubella develops complications although the frequency of complications increases with age. The most frequent complications are:
- Prolonged inflammation of the joints (arthritis)
- Brain inflammation (encephalitis): in one out of every 6,000 cases
- Mild vascular damage that causes bleeding under the skin (purple)
The most feared complication is infection with rubella virus during pregnancy. If the mother is infected with rubella the virus can cross the placenta and infect the fetus. This can cause malformations in the organs of the embryo (embryopathy). Some of these malformations of the fetus are the following:
- Anomalies in the eyes (cataracts)
- Malformation of the heart, like communications between the cardiac cavities because the walls of the heart do not completely close
- Mental damage
- Rubella during pregnancy also increases the risk of premature delivery or miscarriage
How to prevent rubella?
Vaccination against rubella is the best measure to prevent virus infection. In United States, vaccination against rubella is widespread and vaccination rates are up to 90% as part of the measles-mumps-rubella vaccine.
The first active immunization is usually applied to children between 11 and 14 months of age. The second vaccine should be done by the end of the second year of life. If it is not done, the vaccine must necessarily take place before school starts. Make sure that two doses of the vaccine are administered correctly before the youth. If vaccination is not given, especially girls, for lack of an available vaccine, immunization can be completed, although it is most advisable to follow the vaccination schedule.
In case of incomplete or unclear vaccination against rubella, the following recommendations apply:
- Women of childbearing potential who are not vaccinated or whose vaccination status is not clear should receive two doses of the vaccine one month apart from another dose.
- Women of childbearing age who have received only one dose of the vaccine should receive a second dose.
- Individuals working in paediatrics, obstetrics, prenatal care and community services who are not vaccinated or whose vaccination status is doubtful should also receive a dose of the vaccine.
- Before vaccination, pregnancy should always be ruled out and avoided for at least three months after the vaccination. Pregnant women are not vaccinated against rubella. Vaccination must be done at least three months before conception. To plan a pregnancy, it is advisable to consult the gynecologist well in advance to protect against rubella or to determine the concentration of antibodies in the blood.
- If it is suspected that pregnant women without adequate vaccination have been infected with the rubella virus, they can be vaccinated passively within four days after possible infection. With this way, we can act on antibodies against rubella virus in pregnant women.
What parents can do at home:
- Isolate the child so he does not infect other children. Avoid especially contact with pregnant women or women who are not vaccinated against rubella.
- Have the child rest in bed, unless the child feels fit to get up.
- The risk of infection remains until about five to seven days after the onset of symptoms.
- Leave your child at home for as long as possible.