I received a query from a reader who wanted to know about the relationship between measles and rubella, sometimes called German measles after reading a recent article on measles, so I thought that it would be a good topic for this week’s column.
It is rather confusing to us simple humans to note that rubella is called German measles or “3 day measles” when in fact it is an entirely different illness from measles. To add to the muddle, the Latin name for measles is rubeola, which sounds a lot like rubella.
So here it is. What is Rubella? Rubella is an infectious disease transmitted by sneezing and coughing. It is caused by the rubella virus and characterized by a rash and fever.
The symptoms only last for two to three days usually, hence the name “3 day measles” . And they are likely to be mild. As a matter of fact 50 percent of proven cases of rubella have no symptoms. The rash starts on the face, characterized by a fine red rash that spreads to the rest of the body.
Sometimes the lymph glands get swollen, especially those glands located behind the head and behind the ears. And patients usually have a cold-like symptoms at the onset of infection. Occasionally, arthritis accompanies rubella, especially in young women, as the smaller joints in the hands and feet get swollen.
Usually the illness resolves without any problems and has no treatment. Although at times, complications may arise such as a low platelet count in the blood, encephalitis, and myocarditis but fortunately they occur in rare occasion.
However, rubella is lethal to an unborn child, as it is transmissible by a pregnant woman’s bloodstream to infect her baby. This is called a congenital infection and in rubella it causes cataracts, deafness, heart defects, mental retardation and damage to the liver and spleen. Congenital rubella has no treatment, so we depend on on immunization of children so that young women will not acquire the infection at a later date.
The vaccine for rubella is administered as the MMR (measles, mumps and rubella) and children receive two doses: the first at 12-15 months of age and the second at 4-6 years of age. This is the recommended schedule for administration of the vaccine to young children by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. But for special cases like health care workers and women of childbearing age, if they have not received the vaccine then it would be advisable for them to be vaccinated. Prevention is still better than cure.
Complete information on rubella vaccine can be found in the CDC website: 1.usa.gov/1B2tEIc. As I mentioned in the article on measles, the risk of acquiring rubella is very low – it is safer than getting measles, mumps or rubella and most people have no negative effects.
Therefore I conclude that Rubella is really quite a mild and harmless illness in children and is easily prevented with the MMR vaccine. However, rubella is very dangerous and deadly to an unborn child.
Even if Obstetricians monitor the antibody levels for immunity to rubella at the beginning or pregnancy, little can really be done because the MMR vaccine is contraindicated in pregnancy. So it is very important that young women should receive the rubella vaccine before puberty and, if they are unsure about whether they received it, that it would be sensible to arrange to have their antibody levels checked to see if they need an MMR before getting pregnant. As it is really very deadly to the unborn child if you contract the disease when pregnant.