German Measles (Rubella)

• caused by the rubella virus (not the same virus that causes measles)
• RNA (ribonucleic acid) virus from the family Togaviridae and the genus Rubivirus
• density of 1.085 g./cm.

Viral Specificity:

• the skin
• respiratory system
• reproductive system (testes)
• joints
• tonsils
• eyes

• humans

• may begin with 1-2 days of mild fever (99-100° F/37.2-37.8° C)
• swollen, tender lymph nodes, usually in the back of the neck or behind the ears
• rash starts on the face (fine, pink macules) spreads downward
• rash can itch and lasts up to 3 days
• can include headache and loss of appetite
• inflammation of the lining of the eyelids and eyeballs
• in a pregnant woman can cause congenital rubella syndrome
• children infected with rubella before birth are at risk for growth and mentally
• malformations of the heart and eyes (rubella syndrome)
• deafness and liver, spleen, and bone marrow problems (rubella syndrome)

• spread via respiratory transmission from human to human
• spread by contact with an infected person, through coughing and sneezing
• transmitted by droplets from the nose or throat that others breathe in
• pass through a pregnant woman's bloodstream to infect her unborn child
• when people put their fingers in their mouth after touching an infected surface
• then spread via the lymph nodes to the blood,
  • where it induces an immune response
  • leads to lasting immunity.

• Incubation: 2-3 weeks

Treatment and Prevention:

• cannot be treated with antibiotics
• Rubella virus vaccine given universally to young children
• given in two shots (at 15 months and 5 years)
• produces lasting immunity in more that 90% of recipients
• management of Rubella virus infections is typically symptomatic
• unless there are complications rubella will resolve on its own
• to relieve minor discomfort, you can use acetaminophen or ibuprofen
• giving aspirin to a child with a viral illness has been associated with the development of Reye syndrome
  • which can lead to liver failure and death
• vaccination is the best way to prevent rubella infection
• vaccine for rubella is given as part of a combined vaccination for measles, mumps, and rubella
• called MMR

• child with rubella can be contagious - infect nurses, doctors, medical students, etc
• only Togavirus known to be transmitted via the respiratory route
• can also act as a teratogen, inducing Congenital Rubella Syndrome (spread from mother to fetus in the first trimester of pregnancy)
• over 20,000 babies born with congenital rubella syndrome