Rubella

Disease Description

Rubella is an acute viral disease that causes a rash and fever, along with widespread enlargement of lymph nodes. In children, rubella presents as a mild, self-limiting illness that very rarely leads to complications. However, if mothers contract rubella during the early months of pregnancy, their babies can develop congenital defects.

Causative Agent

The rubella virus, which belongs to the genus Rubivirus, quickly dies in the environment when exposed to drying, ultraviolet light, or disinfectants. This virus has teratogenic effects, so pregnant women who contract rubella face a high risk of giving birth to infants with congenital defects.

Prevalence

People infected with rubella act as the source of the virus, with humans being the only known hosts. The virus spreads through direct contact and respiratory droplets. Transmission to the fetus can occur through the placenta. Susceptibility to the virus is universal, but school-aged children and susceptible adults are most commonly affected. An infected individual becomes contagious about one week before the rash appears and remains contagious for at least four days after. After infection, individuals typically develop long-term immunity. Rubella is most prevalent in winter and spring and often occurs in outbreaks.

Symptoms

Rubella symptoms appear 11-24 days after infection. They are usually mild, with the first noticeable symptom often being a rash. The rash starts as fine pink spots on the face and spreads downward. On the first day, it resembles a measles rash but without the staged progression. Small red spots may also appear on the soft palate. The skin rash can merge and sometimes itch. Before the rash, patients may experience fever, general weakness, mild headaches, and occasionally muscle and joint pain. A red throat, eyes, and cough are also common. Swollen lymph nodes behind the ears and in the neck are typical, and sometimes the spleen enlarges. Once the rash appears, the fever usually subsides, and the rash lasts for 1-5 days before disappearing completely.

Diagnosis

Doctors can confirm a rubella diagnosis by detecting specific IgM and IgG antibodies, isolating the virus from nasopharyngeal secretions, blood, cerebrospinal fluid, or urine, or identifying the rubella virus nucleic acid in clinical samples.

Treatment

There are no specific antiviral medications for rubella. Patients receive treatment at home. To reduce fever and detoxify, doctors recommend drinking plenty of warm fluids. In severe cases, patients may need intravenous crystalloid infusions. In cases of hemorrhagic syndrome, doctors may administer prednisolone.

Prevention

Vaccination is the primary and only effective method of rubella prevention. The MMR (measles, mumps, and rubella) vaccine is typically administered in the second year of life, with a second dose given to children aged 6-7 years. The vaccine helps prevent cases of congenital rubella.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology