Rubella (German Measles)

Rubella, also known as German Measles or three-day measles, is thought to be a variant of measles or scarlet fever (CDC 145). The term "rubella" is Latin for "little red" which describes the rash caused by the rubella virus. It was first described as a separate disease in 1814 in the German medical literatures, which is where it got the name "German" measles. A viral etiology for the disease was first postulated for rubella following work in monkeys, and in 1938 this etiology was confirmed by infecting children with the disease using filtered nasal washings from acute cases of rubella. Congenital rubella was first recognized in Australia in 1941 following an epidemic of the disease. Infants born to mothers infected early in their pregnancy developed congenital cataracts.

The rubella virus was first isolated in 1962, and is classified as a togavirus of the genus Rubivirus (CDC, 145). The rubella virus is an RNA virus in an envelope, and is of a single antigenic type. It does not cross-react with any other togavirus, and is related to the group A arboviruses. It is unstable, and can be inactivated by lipid solvents, trypsin, formalin, ultraviolet light, low pH and heat, and amantadine.

Rubella is transmitted through the respiratory tract , and the virus is thought to replicate in the nasopharynx and the regional lymph nodes (CDC 145). Within five to seven days after exposure, viremia occurs, and the virus spreads throughout the body. During this stage, the

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cur. Congenital rubella occurs in about 25 percent of infants whose mothers contract rubella during the first trimester of pregnancy (CEPHR). They may be born with one or more birth defects considered congenital rubella syndrome. The defects affect the eyes, the heart, hearing, mental retardation, sometimes cause cerebral palsy, and may cause diabetes later in life. These children are often slow to learn to walk and perform simple tasks but many catch up and do well. Miscarriages and stillbirths are also common in mothers who contract rubella during pregnancy. The risk of birth defects drops off in the second trimester and there are rarely birth defects in the infants of mothers who contract rubella after 20 weeks of gestation. Some babies are born with milder health problems, such as low birth weight, pneumonia, meningitis, diarrhea, or anemia, but recover well. They may suffer blood abnormalities which cause easy bruising, and may have an enlarged liver or spleen. There is no specific treatment for rubella that will shorten its course, but some of the symptoms may be relieved by bed rest and acetaminophen (JAMA). There is no known treatment for congenital rubella, so the only way to guard against it is by vaccinat

Category: Medical - R