Rubella is a contagious viral illness. Once you have had rubella, you will not get sick with it again.

Babies whose mothers have rubella during pregnancy (especially during the first trimester) can be born with severe birth defects, including:

• Mental retardation and/or behavior problems

• Hearing problems

• Vision abnormalities, blindness., and/or cataracts

• Heart defects

• Increased risk of diabetes throughout early life

• Death in utero

Causes

Rubella is caused by a virus. It is passed from person-to-person through tiny droplets in the air.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. You're more likely to get rubella if you've never had rubella or have never been immunized against it.

Symptoms

Rubella is usually a mild febrile rash illness in adults and children. Other symptoms include lymphadenopathy, malaise, or conjunctivitis. Arthralgia and arthritis can occur in <70% of infected adult and adolescent females. Rare complications are thrombocytopenic purpura, encephalitis, neuritis, and orchitis. The incubation period for rubella is 12--23 days, and 20%--50% of rubella infections are asymptomatic. Persons with rubella are most infectious when rash is erupting, but can shed virus from 7 days before to 5--7 days after rash onset (i.e., the infectious period). Symptoms are usually mild and include:

• Fatigue, low energy

• Swollen lymph nodes

• Flushed face

• Red throat (although not sore)

• Fever

• Headache

• Achy joints and arthritis (especially in adults)

• Rose-colored spots in the mouth (called Koplik's spots)

• Red, spotty rash all over the body

The danger of rubella is not the symptoms it causes in adults or children, but its risk to a baby when the mother becomes infected with rubella during early pregnancy.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Rubella is diagnosed by blood tests.

Treatment

There is no treatment for rubella, other than giving acetaminophen (Tylenol) to make you more comfortable. Vitamin A supplementation improves the outcome of measles among children with vitamin A deficiency and the American Academy of Pediatrics recommends vitamin A in certain circumstances.

Prevention

Persons who are potentially infectious with measles should minimize the risk of spread of the disease by limiting contact with other people who may be susceptible to measles. Contact should be limited until a medical diagnosis has been established excluding measles or 4 days have passed since the onset of the rash. Persons who are potentially infectious with measles should especially avoid public transportation (including commercial airlines) and crowded indoor areas. Patients who suspect they may have measles should call ahead before visiting a clinic or hospital so that arrangements may be made for the health-care provider to attend to the patient without exposing others in the facility to measles.

Measles vaccine contains live, attenuated measles virus. It is available as a monovalent formulation and in combination formulations, such as measles-rubella (MR), measles-mumps-rubella (MMR), and measles-mumps-rubella-varicella (MMRV). Combined MMR or MMRV vaccines are recommended whenever one or more of the individual components are indicated to also provide optimal protection against mumps, rubella, and varicella. Measles vaccine, as a combination or as a single-antigen, is given subcutaneously in a dose of 0.5 mL. A single dose of measles-containing vaccine administered in the second year of life induces immunity in about 95% of vaccinees (9). More than 99% of individuals who receive two doses separated by at least 28 days, with the first dose administered after the first birthday, develop serologic evidence of measles immunity (1,10).

Women who are not sure whether they have been immunized should be tested to see if they have immunity to rubella, particularly if they are in occupations with high risk of exposure to rubella (such as healthcare workers, teachers, child care personnel). Immunization can be given to women of childbearing age, although they should avoid getting pregnant within three months of receiving the vaccine. The rubella vaccine offers most persons who receive it lifelong protection against rubella infection.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

References:

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