Rubella
Disease Details
Family Health Simplified
- Description
- Rubella, also known as German measles, is a contagious viral infection characterized by a distinctive red rash, fever, and swollen lymph nodes, and is particularly dangerous for pregnant women due to the risk of congenital rubella syndrome in the developing fetus.
- Type
- Rubella is a viral infection. It is not transmitted genetically; instead, it spreads from person to person through respiratory droplets.
- Signs And Symptoms
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Rubella has symptoms similar to those of flu. However, the primary symptom of rubella virus infection is the appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days, which is why it is often referred to as three-day measles. The facial rash usually clears as it spreads to other parts of the body. Other symptoms include low-grade fever, swollen glands (sub-occipital and posterior cervical lymphadenopathy), joint pains, headache, and conjunctivitis.The swollen glands or lymph nodes can persist for up to a week and the fever rarely rises above 38 °C (100.4 °F). The rash of rubella is typically pink or light red. The rash causes itching and often lasts for about three days. The rash disappears after a few days with no staining or peeling of the skin. When the rash clears up, the skin might shed in very small flakes where the rash covered it. Forchheimer spots occur in 20% of cases and is characterized by small, red papules on the area of the soft palate.Rubella can affect anyone of any age. Adult females are particularly prone to arthritis and joint pains.In children, rubella normally causes symptoms that last two days and include:
Rash begins on the face which spreads to the rest of the body.
Low fever of less than 38.3 °C (100.9 °F).
Posterior cervical lymphadenopathy.In older children and adults, additional symptoms may be present, including
Swollen glands
Coryza (cold-like symptoms)
Aching joints (especially in young females)Severe complications of rubella include:
Brain inflammation (encephalitis)
Low platelet count
Ear infectionCoryza in rubella may convert to pneumonia, either direct viral pneumonia or secondary bacterial pneumonia, and bronchitis (either viral bronchitis or secondary bacterial bronchitis). - Prognosis
- Rubella infection of children and adults is usually mild, self-limiting, and often asymptomatic. The prognosis in children born with CRS is poor.
- Onset
- Rubella, also known as German measles, typically has an incubation period of 14 to 21 days. The onset of symptoms usually occurs gradually and can include mild fever, headache, malaise, and a distinctive rash that starts on the face and spreads to the rest of the body. Other symptoms may include lymphadenopathy and joint pain, particularly in adults.
- Prevalence
- Rubella, also known as German measles, has significantly diminished in prevalence due to widespread vaccination efforts. In many countries with high vaccination coverage, rubella is rare. However, in regions with lower vaccination rates, outbreaks can still occur. The World Health Organization (WHO) aims to eliminate rubella in many parts of the world through consistent immunization programs.
- Epidemiology
- Rubella occurs worldwide. The virus tends to peak during the spring in countries with temperate climates. Before the vaccine against rubella was introduced in 1969, widespread outbreaks usually occurred every 6–9 years in the United States and 3–5 years in Europe, mostly affecting children in the 5–9 year old age group. Since the introduction of vaccine, occurrences have become rare in those countries with high uptake rates.Vaccination has interrupted the transmission of rubella in the Americas: no endemic case has been observed since February 2009. Vaccination is still strongly recommended as the virus could be reintroduced from other continents should vaccination rates in the Americas drop. During the epidemic in the US between 1962 and 1965, rubella virus infections during pregnancy were estimated to have caused 30,000 stillbirths and 20,000 children to be born impaired or disabled as a result of CRS. Universal immunisation producing a high level of herd immunity is important in the control of epidemics of rubella.In the UK, there remains a large population of men susceptible to rubella who have not been vaccinated. Outbreaks of rubella occurred amongst many young men in the UK in 1993 and in 1996 the infection was transmitted to pregnant women, many of whom were immigrants and were susceptible. Outbreaks still arise, usually in developing countries where the vaccine is not as accessible. The complications encountered in pregnancy from rubella infection (miscarriage, fetal death, congenital rubella syndrome) are more common in Africa and Southeast Asia at a rate of 121 per 100,000 live births compared to 2 per 100,000 live births in the Americas and Europe.In Japan, 15,000 cases of rubella and 43 cases of congenital rubella syndrome were reported to the National Epidemiological Surveillance of Infectious Diseases between October 15, 2012, and March 2, 2014, during the 2012–13 rubella outbreak in Japan. They mainly occurred in men aged 31–51 and young adults aged 24–34.
- Intractability
- Rubella is not considered intractable. It is a contagious viral infection that is generally mild in children and adults. It can be effectively prevented through vaccination with the MMR (measles, mumps, rubella) vaccine. Recovery is usually complete, although it can cause serious complications if contracted by pregnant women, potentially leading to congenital rubella syndrome in the fetus.
- Disease Severity
- For rubella, disease_severity is typically mild. Most individuals, especially children, experience only a mild rash and low-grade fever. However, rubella can be more severe for pregnant women, potentially leading to serious congenital defects or miscarriage.
- Healthcare Professionals
- Disease Ontology ID - DOID:8781
- Pathophysiology
- Rubella, also known as German measles, is caused by the rubella virus, which is a single-stranded RNA virus. When contracted, the virus enter the respiratory tract and then spreads through the bloodstream. It infects lymph nodes and skin, leading to characteristic symptoms. Infection during pregnancy is particularly concerning, as the virus can cross the placenta, potentially causing congenital rubella syndrome (CRS) in the fetus, leading to serious congenital defects or miscarriage.
- Carrier Status
- Rubella, also known as German measles, does not have a carrier status in the same way some other infectious diseases do. It is typically an acute viral infection, meaning once a person is infected and recovers, they usually develop immunity and do not carry or spread the virus afterward.
- Mechanism
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Rubella, also known as German measles, is caused by the rubella virus, which is an enveloped, positive-strand RNA virus belonging to the Togaviridae family.
**Mechanism:**
Rubella primarily spreads through respiratory droplets when an infected person coughs or sneezes. Once the virus enters the body via the respiratory tract, it begins replicating in the nasopharyngeal mucosa and regional lymph nodes. The virus then spreads to the bloodstream, leading to viremia and systemic dissemination to various organs.
**Molecular Mechanisms:**
1. **Virus Entry:**
- The rubella virus attaches to host cell receptors, although the specific receptors are not definitively identified.
- The virus is endocytosed into the host cell through clathrin-mediated endocytosis.
2. **Replication:**
- After uncoating, the viral RNA genome is released into the cytoplasm.
- The positive-strand RNA serves directly as messenger RNA (mRNA) for the synthesis of early nonstructural proteins via the host cell's translation machinery.
- A viral RNA-dependent RNA polymerase synthesizes a complementary negative-strand RNA, which in turn serves as a template to produce new positive-strand RNA genomes.
3. **Protein Synthesis:**
- The early proteins facilitate the replication of the viral RNA.
- Structural proteins, including the capsid protein and envelope glycoproteins (E1 and E2), are synthesized later in the replication cycle.
4. **Assembly and Release:**
- New viral RNA genomes are encapsidated by capsid proteins in the host cytoplasm.
- The nucleocapsid buds through the host cell membrane, where viral glycoproteins are embedded, forming mature virions.
- The assembled virions are released from the host cell, often by budding, which allows them to infect neighboring cells.
Rubella can cause mild symptoms but is particularly dangerous during pregnancy because it can lead to congenital rubella syndrome (CRS) in the fetus, resulting in severe developmental defects, deafness, and heart problems. Vaccination is the primary method of prevention. - Treatment
- There is no specific treatment for rubella; however, management is a matter of responding to symptoms to diminish discomfort. Treatment of newborn babies is focused on management of the complications. Congenital heart defects and cataracts can be corrected by direct surgery.Management for ocular congenital rubella syndrome (CRS) is similar to that for age-related macular degeneration, including counseling, regular monitoring, and the provision of low vision devices, if required.
- Compassionate Use Treatment
- Rubella, also known as German measles, is primarily managed through vaccination as a preventive measure. There are no specific compassionate use treatments or off-label/experimental treatments widely recognized for rubella itself because it is generally a mild illness, particularly in children and adults. However, management during pregnancy is critical due to the risk of congenital rubella syndrome (CRS) in the fetus. In such cases, the focus is typically on careful monitoring and supportive care, rather than experimental treatments.
- Lifestyle Recommendations
-
To manage and prevent rubella:
1. **Vaccination**: The most effective way to prevent rubella is through vaccination with the MMR (measles, mumps, rubella) vaccine.
2. **Hygiene Practices**: Regular hand washing with soap, using hand sanitizer, and avoiding touching your face can help prevent the spread of the virus.
3. **Avoiding Contact**: Stay away from individuals who are infected, especially if you are pregnant, to prevent transmission.
4. **Rest and Hydration**: If infected, ensure adequate rest and hydration to support the immune system.
5. **Public Health Guidelines**: Follow public health guidelines and recommendations, especially during outbreaks.
6. **Infection Control in Pregnant Women**: Pregnant women should be especially cautious and consult with healthcare providers to avoid exposure due to the risk of congenital rubella syndrome in the fetus. - Medication
- There is no specific antiviral medication for treating rubella. Management primarily focuses on supportive care to relieve symptoms. Vaccination is key for prevention, with the MMR (measles, mumps, and rubella) vaccine being highly effective.
- Repurposable Drugs
- There is limited information on repurposable drugs specifically for rubella. Rubella, caused by the rubella virus, is primarily managed by prevention through vaccination with the MMR (measles, mumps, rubella) vaccine. Symptomatic treatment for rubella typically involves rest, hydration, and medications such as acetaminophen for fever and discomfort. There are no specific antiviral drugs currently approved for the treatment of rubella.
- Metabolites
- Rubella, also known as German measles, is primarily caused by the rubella virus, and there are not specific metabolites directly related to the diagnosis or progression of rubella. Diagnosis is usually performed through serological tests that detect rubella-specific antibodies (IgM and IgG) or through reverse transcription polymerase chain reaction (RT-PCR) to detect viral RNA.
- Nutraceuticals
- Nutraceuticals are not specifically recommended for treating rubella. Rubella, also known as German measles, is a viral infection best prevented through vaccination (MMR vaccine). Nutraceuticals might offer general immune support, but they are not a substitute for vaccination or standard medical care for rubella. If someone contracts rubella, the focus is usually on symptomatic relief and supportive care. It is important to consult with a healthcare provider for proper diagnosis and treatment recommendations.
- Peptides
- Rubella, also known as German measles, is a contagious viral disease caused by the rubella virus. Peptides related to rubella are often studied for their roles in diagnosis and vaccine development. For instance, synthetic peptides that mimic portions of the rubella virus can help in creating diagnostic tools or improving vaccine formulations. Nanotechnology ("nan") is not typically associated with rubella in mainstream clinical contexts, but it holds potential in vaccine delivery systems and the development of more precise diagnostic methods.