Have you even ever heard of RUBELLA?
Probably not… or maybe so...maybe not because it is not as common a disease as it used to be…at least in the United States.
The reason you probably never really heard of it is due to the fact that you were more than likely vaccinated against it as a child. Maybe you never heard of the actual name Rubella, but Rubella is also known by it’s 2 other names… The German Measles, and the 3 day Measles.
You may have also heard of it by its vaccination abbreviation, as in the MMR vaccine, Measles, Mumps, and RUBELLA vaccine. Rubella is given in combination with the Measles and Mumps vaccines, and these are a combination of vaccines against these particular infectious diseases.
So what is Rubella?
RUBELLA, or The GERMAN MEASLES, or The THREE-DAY MEASLES, is a Rubivirus, and belongs to the Matonaviridae family. It is actually an enveloped, positive-stranded RNA virus…in case you were wondering! Although Rubella is also called the German Measles, it is it’s own distinct and separate virus, unrelated to the Measles.
So where did the Rubella virus come from?
Rubella was first described as far back as the middle of the eighteenth century. Rubella is from the Latin word for rubrum meaning Red, with Rubella ultimately meaning "small and red-like or Reddish”.
It is referred to as the German measles due to the German physicians who first began to describe it from the mid 1700’s to the mid 1800’s. It was known as Rötlich, which means means "reddish" or "pink" in the German language.
RUBELLA, is also not to be confused with RUBEOLA, which is another name for the MEASLES… which is a whole different and unrelated virus.
In 2004, Rubella had been considered to be eradicated from the United States, however, it has not been eradicated from the rest of the world. People who travel to other countries from the United States to where Rubella exists, or people from those countries come to visit in the U.S., that is how it keeps resurfacing to the present day. Of all the cases in the US after 2012, It was due to this worldwide travel.
History of Rubella
The Rubella virus was first isolated in 1962, and a vaccine developed in 1969. Prior to the development of the rubella Vaccine, Rubella was a common disease that mainly affected young children.
How is Rubella Transmitted, and what are the Complications of RUBELLA?
The Rubella virus, as with many, many viruses, is transmitted through the air via droplets when a person coughs, sneezes or even through talking, but also through direct contact of secretions from the mouth, throat and nose, making it highly contagious.
The most problematic form of transmission of Rubella is in a woman who is pregnant. A pregnant woman can directly pass the Rubella virus, through the bloodstream, to the unborn fetus. The Rubella virus can then cause birth defects, complications, and also death of the baby.
Prior to 1969 and with no immunization for Rubella at that time, in one year, Rubella caused 2,100 newborn deaths; almost 20,000 defects or disabilities; more than10,000 miscarriages, and 20,000 cases or Congenital Rubella Syndrome.
So what is Congenital Rubella Syndrome, also known as C R S ?
CRS occurs due to the Rubella virus being transmitted from the mother to the fetus in utero, leading to: miscarriages; brain, and heart defects; blindness, deafness, cataract formation, learning disabilities, autism, thyroid issues, and stillbirths.
It is estimated that congenital rubella syndrome (CRS) continues to affect an estimated 100, 000 infants throughout the world due to unvaccinated mothers becoming infected during pregnancy. CRS was the sole motivation for the development of the Rubella Vaccine.
Unfortunately, there is no cure for CRS, but there is the vaccination to prevent CRS, the Rubella Vaccine.
What are Signs and Symptoms of Rubella?
Signs and symptoms of Rubella can include a rash, which begins on the face and then spreads throughout the body; a mild fever, swollen glands or nodes, sore throat, ear infection, fatigue, arthritis, and encephalitis.
How long does a RUBELLA infection last?
The Rubella rash usually lasts 3 days, hence the name, the 3 day measles, and causes gland inflammation and arthritis-like pain, which may continue for a week to 2 weeks. Children may recover faster than adults, yet many people may have little to no symptoms.
How do you prevent RUBELLA?
Rubella is prevented solely through vaccination. The Rubella vaccine is usually in a combination vaccine with the Measles and Mumps vaccines as mentioned previously.
The MMR vaccine is administered in two does, and according to the CDC, has an effectiveness of 97% in Rubella prevention. You may also see the MMR vaccine combined with the varicella (or chicken-pox) vaccine in the measles-mumps-rubella-varicella Vaccine or MMRV.
The first immunization of MMR dose should be given at 12 to 18 months of age, with the second dose given at 36 months. When a Pregnant woman seeks prenatal care, she is usually tested for immunity to rubella early in pregnancy. Pregnant women with no immunity to Rubella, are not able to be vaccinated until after the baby is born as the vaccine contains the live, but attenuated virus.
Who should NOT get the Rubella vaccine?
As just mentioned, Pregnant women.
Pregnant Women should NOT get the MMR vaccine, but can receive it after giving birth. Women who want to become pregnant should also delay pregnancy for 4 weeks after being vaccinated with MMR vaccine.
A woman who is breastfeeding, can receive the Rubella vaccine.
Those taking immunosuppressants and or steroids, or medications that affect the immune system should not get the Rubella Vaccine. People who have diseases that affect the immune system such as HIV. Anyone who has ever had an allergic reaction to previous MMR vaccines.
Patients with cancer who are undergoing drug or radiation therapy.
Nursing care for Rubella patients is mostly supportive.
Nursing care would include monitoring vital signs, ensuring adequate hydration, administering antipyretic and pain medication as needed, and ensuring adequate rest.
Patient education would include ensuring good handwashing, isolate as necessary, and not touching mucosal secretions.
On a positive note…Some good news if someone does contract Rubella.
Once a person has had a Rubella infection, immunity against future infections is acquired. It is not common to become re-infected with Rubella a second time.
When you hear about the MMR vaccine, you now know what the “R” is for…what it means and what it is, and what it does, and the reason people need to be vaccinated against it.