VPMD: German Measles (Rubella)

What is Rubella?

Rubella is a virus that is known to cause the infectious disease, German measles, that can cause mild symptoms in children while causing more siginificant disease in pregnant women and their fetus. In pregnant women whom are infected within the first trimester of their pregnancy, rubella infection can lead to miscarriage, still birth or several birth defects affecting the hematologic, cardiovascular and nervous system. As a result of the various defects that may result from fetal infection of rubella, the child will likely have developmental delays and/or disabilities.

Rubella is transmitted from person to person through respiratory droplets and perinatally through the placenta. Rubella disease burden is greater outside of the United States, though the risk for transmission in the U.S. still exists due to international travel.

What are the symptoms of a Rubella infection?

German Measles: Fever, rash (starts on face and moves downward), sore throat, cough, conjunctivitis, joint pain

Congenital Rubella Syndrome:

Eyes: Cataracts, glaucoma, microophthalmia, chorioretinitis, pigmentary retinitis,

Ears: Sensorineural deafness

Heart: Peripheral pulmonary eatery stenosis, patent ductus arteriosus, ventricular septal defect

GI: Enlarged spleen and/or liver

Brain: Microcephaly, meningoencephalitis

Hematologic: low platelets (bruising), extramedullary hematopoesis (blueberry muffin rash)

How is a Rubella diagnosed?

Clinical findings in addition to laboratory findings confirm the diagnosis of a Rubella infection. In those infected with rubella, the virus can be detected most commonly in pharyngeal, nasopharyngeal, urine and blood specimens.

How is Rubella treated?

There is no medication available that targets the virus. Treatment is focused on symptom managment and prevention of complications. In those with congenital rubella syndrome, management of sequelae of the infection is key.

How do you prevent Rubella?

Since the introduction of the Rubella vaccine, infection has decreased significantly in the United States, while its transmission is still significant in other countries. In the US, Rubella is included in the MM(R) vaccine that is initially given at 12-15 months old, followed by a booster given at 4-5 years old.

Sources: CDC, WHO, Cleveland Clinic