What is Rubella Virus: its symptoms, complication’s, diagnosis, and treatment?

Rubella is a viral infection caused by a rubella virus and is commonly referred to as German measles. It mainly affects children and adults mildly but can be detrimental to pregnant women as it gives rise to Congenital Rubella Syndrome (CRS). Therefore, understanding the mode of transmission, symptoms, complications, treatment, and prevention is important to mitigate rubella’s spread.

History of Rubella

Rubella is derived from the German physicians who first described it in the 18th century, hence the name German measles. In 1814, George de Maton introduced the difference between measles, rubella, and scarlet fever. Dr. Paul Parkman and Dr. Thomas H. Weller managed to isolate the virus in 1962 and made the first rubella vaccine in 1969. Prior to the vaccination, rubella had epidemics every 6–9 years, with harsh outbreaks during the 1960s, which led to thousands of birth defects because of congenital rubella syndrome. Now, a lot of regions are Rubella-free because of the MMR vaccine, which has successfully reduced the cases worldwide.

Transmission of Rubella

Rubella spreads primarily through respiratory droplets, making it highly contagious. The virus can be transmitted in the following ways:

1. Person-to-Person Contact: When an infected person coughs or sneezes, tiny respiratory droplets containing the virus become airborne, and others can inhale them.
2. Direct Contact: Touching the nasal or throat secretions of an infected person can lead to transmission.
3. Vertical Transmission (Mother to Baby): If a pregnant woman contracts rubella, she can pass it to her unborn child, leading to Congenital Rubella Syndrome (CRS).
4. Surface Contamination: Though less common, the virus can remain on surfaces that an infected person has touched, potentially leading to transmission if another person touches the contaminated surface and then their mouth, nose, or eyes.

The incubation period for rubella is 14–21 days, meaning symptoms may take up to three weeks to appear after exposure. A person infected with rubella is most contagious from a few days before the rash appears to about a week after it fades.

Symptoms of Rubella

Rubella is often mild, particularly in children, but can cause more discomfort in adults. The most common symptoms include:

1. Mild Fever: A low-grade fever (99–101°F) often appears before other symptoms.
2. Pink or Red Rash: The rubella rash starts on the face and spreads to the trunk, arms, and legs, typically lasting about three days.
3. Swollen Lymph Nodes: Lymph nodes behind the ears and around the neck become tender and swollen.
4. Joint Pain: Adults, particularly women, often experience joint pain or stiffness.
5. Headache: A mild to moderate headache is common.
6. Sore throat and mild conjunctivitis: Some people experience throat irritation and mild redness in the eyes.
7. Fatigue and Muscle Pain: General body weakness and muscle aches may occur.

Since rubella symptoms resemble those of other viral infections, laboratory testing may be necessary for an accurate diagnosis.

Complications of Rubella

Although rubella is generally mild, it can lead to severe complications, particularly in pregnant women.

1. Congenital Rubella Syndrome (CRS): If a woman contracts rubella during pregnancy, her baby may develop CRS, leading to severe birth defects such as:
   • Deafness
   • Blindness or Cataracts
   • Heart Defects
   • Intellectual Disabilities
   • Low Birth Weight or Stillbirth
   • Liver and Spleen Damage
2. Arthritis: Women infected with rubella often develop arthritis, particularly in the fingers, wrists, and knees.
3. Encephalitis (Brain Inflammation): Rarely, rubella can cause swelling in the brain, leading to seizures and neurological damage.
4. Bleeding Problems (Thrombocytopenia): A decrease in blood platelets may cause excessive bleeding and bruising.

Diagnosis of Rubella

Rubella is diagnosed through:

1. Clinical Examination: Doctors assess symptoms like rash and swollen lymph nodes.
2. Blood Tests: Checking for rubella-specific IgM and IgG antibodies to confirm recent or past infection.
3. PCR Test: Detects the virus’s genetic material in nasal or throat swabs.

Treatment of Rubella

There is no specific antiviral treatment for rubella. Management focuses on relieving symptoms, such as:

• Rest: Avoiding strenuous activities helps recovery.
• Hydration: Drinking fluids prevents dehydration.
• Fever and Pain Management: Acetaminophen or ibuprofen can reduce fever and discomfort.
• Isolation: Infected individuals should avoid contact with pregnant women and unvaccinated individuals.

Prevention of Rubella

The most effective way to prevent rubella is through vaccination.

MMR Vaccine (Measles, Mumps, and Rubella)

The MMR vaccine provides lifelong immunity against rubella. It is administered in two doses:

• First dose: 12–15 months of age
• Second dose: 4–6 years old

For adults, particularly women of childbearing age, testing for rubella immunity and vaccination before pregnancy is essential.

Additional Preventive Measures

• Avoid contact with infected individuals: especially for pregnant women.
• Hand hygiene: Regular handwashing reduces the risk of transmission.
• Screening before pregnancy: Women planning to conceive should check their immunity status.

Conclusion

Rubella is a preventable viral disease that remains a threat, particularly to unborn babies. The MMR vaccine is the most effective way to prevent infection and its severe consequences. Public awareness, vaccination programs, and proper screening before pregnancy can help eliminate rubella globally.

If you are planning pregnancy or unsure about your immunity status, consult a healthcare provider for testing and vaccination options. Protecting yourself and others is essential in the fight against rubella.