Rubella overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms: German measles; 3 day measles
Overview
Rubella is a common childhood infection usually with minimal systemic upset although transient arthropathy may occur in adults. Serious complications are very rare. If it were not for the effects of transplacental infection on the developing foetus, rubella is a relatively trivial infection.
Historical Perspective
Pathophysiology
The pathophysiology of rubella is not completely understood. Viral replication in the respiratory epithelium occurs following transmission of the virus via contact with droplet secretions from an infected person. Viremia subsequently ensues, with the onset of the rubella rash occurring at the peak of viremia.
Causes
The disease is caused by Rubella virus, a togavirus that is enveloped and has a single-stranded RNA genome.[1] The virus is transmitted by the respiratory route and replicates in the nasopharynx and lymph nodes. The virus is found in the blood 5 to 7 days after infection and spreads throughout the body. It is capable of crossing the placenta and infecting the fetus where it stops cells from developing or destroys them.[2]
Differentiating Rubella from other Diseases
There are dermatological conditions that are similar in appearance to Rubella. These diseases need to be accounted for when diagnosing Rubella.
Epidemiology and Demographics
Risk Factors
Screening
Rubella on its own is not a very life threatening disease. The biggest problem with Rubella is called congenital rubella syndrome. Since it is possible for a mother with Rubella to transmit it to her child, routine screening needs to be done. It is important to screen susceptible women, who may become pregnant, to help avoid the possibility of congenital rubella syndrome.
Natural History and Complications
Diagnosis
History and Symptoms
Physical Examination
Laboratory Diagnosis
Treatment
Medical Therapy
There is currently no antiviral therapy for rubella. Most of the support during rubella infection is supportive and includes treatments such as painkillers.
Surgical Therapy
Prevention
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
When considering the financial costs of a certain disease, many different factors have to be taken into account. If there is a disease without a vaccination program, some of the costs ensued are expenditures made for treatment of acute illness, lost money from missing work, complications and chronic sequelae, and lost savings due to retardation or even death.[3]
On the other hand, diseases such as rubella, have vaccination programs in place, and a vaccination program has different costs associated with it. There are certain expenditures to make the vaccine itself as well as its administration, treatment of complications associated with the vaccine, and the cost of implementing the vaccine program.[3]
References
- ↑ Frey TK (1994). "Molecular biology of rubella virus". Adv. Virus Res. 44: 69–160. PMID 7817880.
- ↑ Edlich RF, Winters KL, Long WB, Gubler KD (2005). "Rubella and congenital rubella (German measles)". J Long Term Eff Med Implants. 15 (3): 319–28. PMID 16022642.
- ↑ 3.0 3.1 White CC, Koplan JP, Orenstein WA (1985). "Benefits, risks and costs of immunization for measles, mumps and rubella". American Journal of Public Health. 75 (7): 739–44. PMC 1646302. PMID 3923849. Unknown parameter
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