This infection, although mild, is hazardous if the mother transmits it to the developing fetus. So if you want to have a baby, you should know if you have antibodies to rubella and, if not, you should get vaccinated.
Rubella is a contagious disease caused by a virus of the family of the togavirus. It affects both children and adults, but it’s true importance as a public health problem lies in the fact that if a pregnant woman is infected during the first months of pregnancy, the disease can also affect the fetus and cause severe congenital malformations.
It is an exanthematous disease, that is, it is characterized by the appearance of a rash or reddish lesions initially on the face, to later distribute to the rest of the body, along with not very high fever, characteristic lymph nodes behind the ears, headaches, of the joints and conjunctivitis.
Its incidence is higher in spring and winter. However, since the beginning of universal vaccination, it has fallen to a minimal incidence, less than 0.3 cases / 100,000 inhabitants.
However, these are maintained by migration that allows diagnosing cases in adults from countries not vaccinated. There is still a higher notification of issues in countries like Poland. The incidence of gestational rubella is also very low, less than one case per 100,000 live births.
In non-congenital cases, treatment is usually symptomatic, with therapies aimed at fever and pain. Still, the main objective is to achieve universal vaccination to avoid issues, especially in pregnant women, and eradicate its primary and most serious complication, the syndrome of congenital rubella (CRS).
How rubella is transmitted
The rubella virus is spread by droplets that are expelled with the respiratory secretions of infected individuals. During pregnancy, rubella can be transmitted from the mother to the fetus through the placenta, causing severe disorders (this is called congenital rubella).
The infectious agent reaches the pharynx thanks to the inhalation of these contaminated droplets. Once there, it passes into the bloodstream and reaches the lymphatic tissue, lodged and reproduced.
Finally, when the virus has multiplied enough, it gives back into the blood. At this time, the body begins to respond to the infection, producing antibodies capable of destroying the virus. The infected individual can spread the disease from approximately one week before the appearance of the rash to one or two weeks after.
Once a person has been infected, the antibodies that his body generates remain inactive in the lymphatic tissue for the rest of his life. Thanks to this, if an infection occurs again at any time, the human body will be able to fight it.
Epidemiology
Before introducing the rubella vaccine (in Spain, it was included in the childhood vaccination schedule in 1977), epidemics occurred periodically. The disease affects children more, especially those of school age because it is a disease.
A condition that is easily transmitted by close contact. However, the epidemics have been practically eradicated, and the disease mainly affects young adults who have not been vaccinated.
Rubella symptoms
There is a symptom-free incubation period in rubella in which the virus reproduces and usually lasts between 14 and 21 days. There may be a high proportion, around 30%, that do not present obvious symptoms, only a cold and moderate fever being a case produced by this virus.
- Prodromal phase: This phase is more common in adults than in children. It lasts for 24 or 48 hours and is characterized by a series of nonspecific symptoms such as fever, general malaise, loss of appetite, and a mild respiratory tract catarrh.
- Rash phase: in this second phase, there are three fundamental symptoms: fever, rash, and enlarged lymph nodes. It usually appears suddenly. The rash is a skin rash that begins behind the ears and spreads rapidly throughout the body, predominantly on the trunk. They are reddish-colored, oval spots with well-defined edges. Small deep red lesions, known as “Forschheimer spots,” can be found on the palate.
From a clinical point of view, the rash and other symptoms of rubella are nonspecific and can be confused with cases of measles or scarlet fever.
Rubella complications
They are rare, but some are worth highlighting. Arthritis is joint in women, often affecting the fingers, wrists, and knees. The alterations that occur in the blood can lead to bleeding due to the decrease in platelets. Both children and adults can get encephalitis after rubella. Another rare complication is mild hepatitis.
