RUBELLA

What is it?

An infectious disease caused by a virus (classified as a togavirus of the genus Rubivirus), which infects children and adults, though it is among those considered to be typical of childhood by the physicians. It usually is a benign disease that in its course presents fever, rashes that last approximately 3 days and enlargement of lymph nodes (called lymphadenomegaly by physicians), although it may present in a “ subclinical form” (when the patient virtually doesn´t experience anything).

It can become potentially severe when affecting pregnant women, as it can cause fetal malformations, most notably when it contaminates pregnant women in the first trimester. Rarely can it be the cause of joint inflammation (arthritis) in adults. Another designation the doctors usually use for viral diseases that cause skin patches as rubella is exanthematous viral infection (that is, those that cause exanthema, a medical term to refer to skin eruptions).

How is it acquired?

Through inhalation of droplets of nasal secretion from contaminated people that carry the virus or through the blood, in the case of a fetus, from the pregnant mother. The most contaminating periods occur from 10 days prior to the rashes up to 15 days after their appearance. Children born with rubella by contagion from the pregnant mother (congenital rubella) can remain as a source of contagion for several months.

What does one experience?

After contagion, it takes on average 18 days for the first symptom to appear (incubation period). The initial presentation is in general undistinguishable from the ordinary flu and lasts 7 to 10 days with fever, pain in muscles and joints, prostration, headaches and a runny nose until the appearance of enlarged lymph nodes and, subsequently, of rashes that last 3 days and disappear without leaving sequelae, the latter two findings having their onset in the face and neck and dissemination through the chest to the periphery.

How is the diagnosis made?

The clinical diagnosis (via the set of symptoms and findings at the physical examination done by the physician) is reliable only during an epidemics, since the symptoms are common to several viral infections, including the ordinary flu, and skin eruptions are also found in a significant number of viral infections (mononucleosis, measles, dengue, etc). And that´s exactly the most common form of diagnosis. In those cases in which an accurate diagnosis is necessary (excluding more severe diseases that will entail interventions and/or treatment), tests for antibody (substances our body produces against the rubella virus) detection in the blood are available which are far more specific and sensitive.

How to treat it?

There´s no specific antiviral treatment. A few patients demand treatment for symptoms, in general ordinary analgesics manage joint and muscle pains or fever.

How to prevent it?

To reduce the circulation of the rubella virus, vaccination is quite important, which is routinely recommended at 15 months of age (MMR vaccine) and for all adults that haven´t been in contact with the disease (blocking vaccination). Pregnant mothers can´t take shots, and vaccinated women must avoid pregnancy up to the month following vaccination.

Insulation: every child and adult must stay away from other individuals during the disease period.

Pregnant women must control it via blood tests when necessary.

For hospitalized people, insulation is carried out until the cure.  

What should you ask your doctor?

When a relative is carrying rubella, the major concern will be towards pregnant and potentially pregnant women that may get in touch with the infection carrier. What to do in the event of a contact?


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