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Rubella Symptoms and Treatment

What is rubella?

Rubella is a contagious disease caused by a virus that attacks the respiratory tract. It causes characteristic redness that first appears on the face, then spreading to the chest and the rest of the body.

The disease is usually mild in children, but it can have dangerous consequences when a pregnant woman passes it on to the fetus (congenital rubella). Once a person has been infected with the disease, they are permanently immunized.

Rubella can be prevented by a vaccine that is part of the childhood immunization program in Canada and France. The combined measles-mumps-rubella (MMR) vaccine has significantly reduced the incidence of this disease in countries where it has been included in the routine childhood immunization program.

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Transmission

Rubella is a contagious disease that is spread by tiny droplets produced by the nose and mouth. People infected with the virus are contagious about 1 or 2 weeks before the rashes and at least 4 days after the appearance of redness. The incubation period (that is, the time between the time the virus is contracted and the onset of symptoms of the disease) can last from 12 to 23 days.

Prevalence

According to the World Health Organization (WHO) the congenital rubella syndrome affects more than 100,000 babies in developing countries each year.

With routine immunization, rubella is very rare in Canada. Since 2002, fewer than 30 cases have been reported each year.

In France, rubella is monitored by the RENARUB network which, since 1976, has identified rubella infections during pregnancy and congenital infections. Their number has been declining since 2000 and is less than 10 cases per year since 2006.

Complications

Rarely, rubella can lead to:

  • A mild form of arthritis affecting the fingers, wrists and knees that usually disappears on its own after about 1 month. It affects more often adolescents and adults and more women than men (up to 70% of infected adults).
  • An ear infection (otitis ).
  • Encephalitis, affecting adults more often (1 in 6000 cases).

Pregnant women

When a woman gets the rubella virus during the first 3 months of pregnancy, this can have serious consequences for the fetus. This condition is known as congenital rubella (or congenital rubella syndrome). Problems can include:

  • A fetal death.
  • Cataracts.
  • Deafness.
  • Stunting.
  • Heart defects.
  • Problems of development.

Public health authorities recommend that all women of childbearing age ensure that they are immunized against the rubella virus before becoming pregnant. The vaccine cannot be given during pregnancy.

A new global plan to fight measles and rubella

In April 2012, the World Health Organization (WHO) announced the launch of a new global measles and rubella control plan to significantly reduce the mortality associated with both diseases. This new strategy comes mainly following the review of numerous measles epidemics, particularly in Africa, Asia, the Eastern Mediterranean and Europe. Rubella is part of this global strategy because measles and rubella vaccines are combined in a single injection.

This control plan aims to reduce global measles mortality by at least 95% by 2015 and reduce cases of congenital rubella syndrome. WHO aims to improve immunization coverage, strengthen the monitoring of the spread of both diseases through laboratory surveillance, and improved management of rubella and measles?

 

The symptoms of rubella

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The symptoms of rubella appear 2 to 3 weeks after exposure to the virus. They usually last 2 or 3 days.

  • Fever.
  • Headaches.
  • A runny nose.
  • A sore throat.
  • Swollen eyes (conjunctivitis).
  • Swollen glands at the base of the neck and behind the ears.
  • An eruption of small red or pink spots, mainly in the face, behind the ears and in the neck that can cause itching. These spots gradually extend to the arms, chest and back, reaching the legs and feet.
  • Painful joints (especially in infected adolescents and young women)

Up to 50% of people infected with the rubella virus have no symptoms.

Risk factors for Rubella

  • Do not have the rubella vaccine.
  • Traveling to a developing country where the disease is present without receiving the rubella vaccine.

Prevention

Why prevent?
When a pregnant woman contracts the rubella virus during the first 3 months of pregnancy, this can have serious consequences on the development of the fetus, and sometimes even lead to death.
Can we prevent?
The vaccine is the best way to prevent rubella infection. The MMR (MMR II) vaccine is administered to children in two doses, the first usually around 12 months and the second around 18 months. As much in France as in Canada, this vaccine is entirely reimbursed by the health insurance.

A vaccine is available for women of childbearing age who would not have received the vaccine during childhood. The vaccine cannot be given to pregnant women.

Medical treatment of rubella

No treatment can cure rubella. It is recommended to take a lot of rest and promote quiet activities. A humidifier can help clear the airways.

Some medications can, however, reduce the symptoms of the disease.

    • Analgesics. Acetaminophen (Tylenol, Panadol), ibuprofen (Advil, Motrin) or naproxen (Aleve) can treat fever. Warning. Aspirin (acetylsalicylic acid-ASA) should not be given to children since there is a risk of causing Reye’s syndrome.
    • Antibiotics. If a bacterial infection, such as an ear infection, develops as a result of rubella, a doctor may prescribe antibiotics.
  • Immunoglobulin injection. Pregnant women, children and people with weakened immune systems who are exposed to the virus can receive immunoglobulin injections. When administered within the first 6 days after exposure to the virus, these antibodies can reduce the symptoms of the disease. However, these antibodies do not eliminate the possibility of transmitting the disease to the fetus.

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