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.
Causes
The cause of rubella is a virus that's passed from person
to person. It can spread when an infected person coughs or
sneezes, or it can spread by direct contact with an
infected person's respiratory secretions, such as mucus.
It can also be transmitted from a pregnant woman to her
unborn child. A person with rubella is contagious from one
week before the onset of the rash until about one to two
weeks after the rash disappears.
Rubella is rare in the United States because most children
receive a vaccination against the infection at an early
age. However, cases of rubella do exist, mostly in
unvaccinated foreign-born adults.
The disease is still common in many parts of the world,
although more than half of all countries now use a rubella
vaccine. The prevalence of rubella in some other countries
is something to consider before going abroad, especially
if you're pregnant.
Symptoms
- Low-grade fever (102 F
or lower)
- Headache
- General discomfort or
uneasiness (malaise)
- Runny nose
- Inflammation of the
eyes (bloodshot eyes)
- Rash with skin redness
or inflammation
- Muscle or joint pain
- Encephalitis (rare)
- Bruising (from low
platelet count, rare)
Screening and
Diagnosis
The rubella rash can look like many other viral rashes. So
doctors usually confirm rubella with the help of
laboratory tests.
- A rubella serology
- A nasal or throat swab
for viral culture
If your doctor suspects that you have rubella, you may
need a virus culture or a blood test, which can detect the
presence of different types of rubella antibodies in your
blood. These antibodies indicate whether you've had a
recent or past infection or a rubella vaccine.
Treatment
There is no treatment for this disease. Acetaminophen can
be given to reduce fever. The treatment of congenital
rubella syndrome is for the defects that may be present.
Complications
- Congenital rubella
syndrome
- Encephalitis (rare)
- Otitis media (rare)
- Transient arthritis
(common in adolescents and adults with rubella)
Prevention
The rubella vaccine is usually given as a combined
measles-mumps-rubella inoculation, which contains the
safest and most effective form of each vaccine. Doctors
recommend that children receive the MMR vaccine between 12
and 15 months of age, and again between 4 and 6 years of
age — before entering school. It's particularly important
that girls receive the vaccine to prevent rubella during
future pregnancies.
Usually babies are protected from rubella for six to eight
months after birth because of the immunity passed on from
their mothers. If a child requires protection from rubella
before 12 months of age — for example, for certain foreign
travel — the vaccine can be given as early as 6 months of
age. But children who are vaccinated early still need to
be vaccinated at the recommended ages later.
Do you need the MMR vaccine?
You don't
need a vaccine if you:
- Had
two doses of the MMR vaccine after 12 months of age or
one dose of the MMR vaccine plus a second dose of
measles vaccine
-
Have blood tests that prove you're immune to measles,
mumps and rubella
- Are
a man who was born before 1957
- Are
a woman who was born before 1957 and you don't plan to
have any more children, you already had the rubella
vaccine or you have a positive rubella test
You should get a vaccine if you
don't fit the
criteria listed above and
you:
- Are a nonpregnant woman
of childbearing age
- Attend college, trade
school or postsecondary school
- Work in a hospital,
medical facility, child care center or school
- Plan to travel overseas
or take a cruise
The vaccine is not
recommended for:
-
Pregnant women or women who plan to get pregnant within
the next four weeks
-
People who have had a life-threatening allergic reaction
to gelatin or the antibiotic neomycin
If you have cancer, a blood disorder or another disease
that affects your immune system, talk to your doctor
before getting an MMR vaccine.
Side effects of the vaccine
Most people experience no side effects from the
vaccine. About 15 percent of people develop a fever
between seven and 12 days after the vaccination, and about
5 percent of people develop a mild rash. Some teens and
adult women experience temporary joint pain or stiffness
after receiving the vaccine. Less than one out of a
million doses causes a serious allergic reaction.
In recent years, some news reports have raised concerns
about a connection between the MMR vaccine and autism.
However, extensive reports from the American Academy of
Pediatrics, the Institute of Medicine, and the Centers for
Disease Control and Prevention (CDC) conclude that there
is no scientifically proven link between the MMR vaccine
and autism. In addition, there is no scientific benefit to
separating the vaccines. These organizations note that
autism is often identified in toddlers between the ages of
18 months and 30 months, which happens to be about the
time children are given their first MMR vaccine. But this
coincidence in timing shouldn't be mistaken for a
cause-and-effect relationship.
