Rubella , also known as German measles or three-day measles , is an infection caused by the rubella virus. The disease is often mild with half of the people unaware that they are infected. The rash may begin about two weeks after exposure and lasts for three days. It usually starts in the face and spreads throughout the body. This rash is sometimes itchy and not as bright as measles. Swollen lymph nodes are common and may last several weeks. Fever, sore throat, and fatigue can also occur. In adults, joint pain is common. Complications may include bleeding problems, testicular swelling, and nerve inflammation. Infection during early pregnancy may result in a child born with congenital rubella syndrome (CRS) or miscarriage. The symptoms of CRS include problems with eyes such as cataracts, ears such as deafness, heart, and brain. Problems rarely occur after the 20th week of pregnancy.
Rubella usually spreads through the air through the cough of an infected person. People are infectious for a week before and after the appearance of a rash. Infants with CRS can spread the virus for more than a year. Only humans are infected. Insects do not spread disease. Once healed, people are immune to future infections. Testing is available that can verify immunity. Diagnosis is confirmed by finding the virus in the blood, throat, or urine. Testing blood for antibodies can also be useful.
Rubella can be prevented with a single-dose vaccine of more than 95% effective. Often given in combination with measles vaccine and mumps vaccine, known as MMR vaccine. When some, but fewer than 80% of those vaccinated, more women may succeed until childbearing age without developing immunity by infection or vaccination and CRS levels may increase. Once infected there is no special treatment.
Rubella is a common infection in many regions of the world. Every year about 100,000 cases of congenital rubella syndrome occur. The rate of the disease has decreased in many areas as a result of vaccination. There is an ongoing effort to eliminate this disease globally. In April 2015, the World Health Organization declared America free of rubella transmission. The name "rubella" comes from Latin and means little red . It was first described as a separate disease by German doctors in 1814 that produced the name "German measles."
Video Rubella
Signs and symptoms
Rubella has symptoms similar to flu. However, the main symptom of rubella virus infection is the appearance of a rash (exanthem) on the face that spreads to the stem and limb and usually fades after three days (that is why it is often referred to as three-day measles). Facial rash usually disappears as it spreads to other parts of the body. Other symptoms include low grade fever, swollen glands (sub-occipital and posterior cervical lymphadenopathy), joint pain, headache, and conjunctivitis.
Swollen glands or lymph nodes can last up to a week and fever rarely rises above 38 Ã, Â ° C (100.4 Ã, Â ° F). The German measles rash is usually pink or bright red. The rash causes itching and often lasts for about three days. The rash disappears after a few days without blemishes or exfoliation. When the rash is gone, the skin may drip on a very small flake where the rash covers it. Forchheimer signs occur in 20% of cases, and are characterized by small red papules in the soft palate area.
Rubella can attack anyone of any age and is generally a mild disease, infrequent in infants or those over 40 years of age. The older the person, the worse the symptoms. Up to 60% older girls or women develop joint pain or symptomatic type of arthritis with rubella.
In rubella children usually cause symptoms that last for two days and include:
- Early rashes on the face spread throughout the body.
- Low fever is less than 38.3 Ã, Â ° C (101Ã, Â ° F).
- Posterior cervical lymphadenopathy.
In older children and adults additional symptoms may be present including:
- Swollen glands
- Coryza (cold-like symptoms)
- Achieve joints (especially in young women)
Rare issues may occur including the following:
- Inflammation of the brain
- Ear infection
Coryza in rubella may turn into pneumonia, either direct viral pneumonia or secondary bacterial pneumonia, and bronchitis (either bronchitis or secondary bacterial bronchitis).
Congenital rubella syndrome
Rubella can cause congenital rubella syndrome in newborns. The syndrome (CRS) follows intrauterine infection by the rubella virus and consists of heart, cerebral, eye and hearing defects. It can also cause prematurity, low birth weight, and neonatal thrombocytopenia, anemia and hepatitis. The risk of major or organogenesis is highest for first-trimester infections. CRS is the main reason the vaccine for rubella is developed.
Many mothers who contaminate rubella in the first trimester are either critically miscarried or a stillborn baby. If the fetus survives an infection, it can be born with severe heart problems (patent ductus arteriosus being the most common), blindness, deafness, or other life-threatening organ disorders. Skin manifestations are called "blueberry muffin lesions". For this reason, rubella is included in the TORCH complex of perinatal infections.
Approximately 100,000 cases of this condition occur every year.
Maps Rubella
Cause
The disease is caused by the rubella virus, the toga virus that is enveloped and has a single stranded RNA genome. The virus is transmitted through the respiratory route and replicates in the nasopharynx and lymph nodes. This virus is found in the blood 5 to 7 days after infection and spread throughout the body. The virus has teratogenic properties and is able to cross the placenta and infect the fetus where it stops the cells from developing or destroying them. During this incubation period, the patient is usually transmitted for about a week before he or she has a rash and about one week after.
Increased susceptibility to infection may be inherited because there are some indications that HLA-A1 or A1-related factors in the extended haplotype are involved in viral or non-resolution of the disease.
Diagnosis
Specific IgM antibodies Rubella virus present in people newly infected by rubella virus, but these antibodies can last for more than a year, and positive test results need to be interpreted with caution. The presence of these antibodies together, or some time afterwards, a typical rash ensures diagnosis.
Prevention
Rubella infections are prevented by active immunization programs using live-attenuated viral vaccines. Two live attenuated virus vaccines, RA 27/3 and Cendehill strains, are effective in the prevention of adult diseases. However, its use in prepubertal women did not result in a significant reduction in the overall incidence rate of CRS in the UK. Reduction is achieved only by immunization of all children.
The vaccine is now usually given as part of the MMR vaccine. WHO recommends the first dose given at age 12 to 18 months with a second dose at 36 months. Pregnant women are usually tested for resistance to rubella early on. Women found to be vulnerable are not vaccinated until after the baby is born because the vaccine contains live viruses.
The immunization program has been quite successful. Cuba declared that the disease was eliminated in the 1990s, and in 2004 the Centers for Disease Control and Prevention announced that both forms of rubella were obtained both congenital and those that had been eliminated from the United States.
Screening for rubella vulnerability by history of vaccination or by serology is recommended in the United States for all women of childbearing age at their first preconceptional counseling visit to reduce the incidence of congenital rubella syndrome (CRS). It is recommended that all women of childbearing age who are vulnerable not pregnant should be given rubella vaccinations. Due to concerns about possible teratogenicity, the use of MMR vaccine is not recommended during pregnancy. Conversely, vulnerable pregnant women should be vaccinated as soon as possible in the postpartum period.
Treatment
There is no specific treatment for rubella; However, management is a matter of responding to symptoms to reduce discomfort. Newborn care is focused on the management of complications. Congenital heart abnormalities and cataracts can be corrected by direct surgery.
Management for ocular congenital rubella syndrome (CRS) is similar to age-related macular degeneration, including counseling, regular monitoring, and low vision device provision, if necessary.
Prognosis
Rubella infections in children and adults are usually mild, self-limiting and often asymptomatic. Prognosis in children born with CRS is poor.
Epidemiology
Rubella occurs all over the world. Viruses tend to peak during spring in countries with moderate climates. Before the vaccine against rubella was introduced in 1969, the widespread epidemic usually occurs every 6-9 years in the United States and 3-5 years in Europe, largely affecting children in the 5-9 year age group. Since the introduction of the vaccine, events have become scarce in countries with high absorption rates.
Vaccination has disrupted the transmission of rubella in the United States: no endemic cases have been observed since February 2009. Vaccination is still strongly recommended because the virus can be reintroduced from other continents if the vaccination rate in America declines. During the epidemic in the United States between 1962-1965, rubella virus infection during pregnancy is estimated to have caused 30,000 stillbirths and 20,000 children born disabled or disabled by CRS. Universal immunization that produces high level immunity is important in controlling the rubella epidemic.
In the UK, there is still a large population of males susceptible to unvaccinated rubella. The rubella outbreak occurred among many young men in the UK in 1993 and in 1996 the infection was transmitted to pregnant women, many of whom were immigrants and vulnerable. Outbreaks still appear, usually in developing countries where vaccines are inaccessible.
In Japan, 15,000 cases of rubella and 43 cases of congenital rubella syndrome are reported to the National Epidemiological Surveillance of Infectious Diseases between October 15, 2012, and March 2, 2014 during the 2012-13 rubella outbreak in Japan. They mainly occur in men aged 31 to 51 years and young adults aged 24-34 years.
History
Rubella was first described in the mid-eighteenth century. Friedrich Hoffmann made his first clinical description of rubella in 1740, which was confirmed by de Bergen in 1752 and Orlow in 1758.
In 1814, George de Maton first stated that it was considered a different disease from both measles and dengue. All of these doctors are German, and the disease is known as RÃÆ'¶theln (contemporary German RÃÆ'¶teln ), hence the common name "German measles". Henry Veale, a British Artillery surgeon, described the plague in India. He created the name "rubella" (from the Latin word, meaning "little red") in 1866.
It was officially recognized as an individual entity in 1881, at the International Congress of Medicine in London. In 1914, Alfred Fabian Hess theorized that rubella is caused by a virus, based on work with monkeys. In 1938, Hiro and Tosaka confirmed this by giving the disease to children using a nasal leaching filtered from an acute case.
In 1940, there was a widespread rubella epidemic in Australia. Furthermore, eye doctor Norman McAllister Gregg found 78 cases of congenital cataracts in infants and 68 of them born from mothers who had caught rubella early in pregnancy. Gregg published an account of Cataract's Congenital Following the German Measles in the Mother , in 1941. He described various problems now known as congenital rubella syndrome (CRS) and noticed that the earlier the mother was infected, the worse the damage. Since there is no vaccine available, some popular magazines promote the idea of ​​a "German measles party" for infected children to spread the disease to other children (especially girls) to immunize them for life and protect them from then catching the disease when pregnant. The virus was isolated in tissue culture in 1962 by two separate groups led by doctors Parkman and Weller.
There was a rubella pandemic between 1962 and 1965, beginning in Europe and spreading to the United States. In 1964-65, the United States had about 12.5 million cases of rubella. This causes 11,000 miscarriages or therapeutic abortions and 20,000 cases of congenital rubella syndrome. Of these, 2,100 die as neonates, 12,000 deaf, 3,580 blind, and 1,800 have mental retardation. In New York alone, CRS affects 1% of all births.
In 1969, live attenuated virus vaccine was licensed. In the early 1970s, triple vaccines containing an attenuated measles virus, mumps and rubella (MMR) were introduced. In 2006, confirmed cases in the United States fell below 3000 a year. However, the 2007 outbreak in Argentina, Brazil, and Chile pushed the 13,000-year-old case.
On January 22, 2014, the World Health Organization (WHO) and the Pan American Health Organization declared and certified Colombia free from rubella and became the first Latin American country to eliminate disease within its borders. On April 29, 2015, America became the first WHO region to officially combat the disease. The last non-import case occurred in 2009 in Argentina and Brazil. Director of the Pan-American Health Organization commented, "The war against rubella has taken more than 15 years, but has paid off with what I believe will be one of the most important pan-American health achievements of the 21st century." The declaration was made after 165 million health records and genetically confirmed that all recent cases were caused by known virus import strains. Rubella is still common in some parts of the world and Susan E. Reef, the team that leads rubella in the CDC's global immunization division, who joined the announcement, said there is no possibility it will be eradicated worldwide before 2020. Rubella is the third disease to be eliminated from the western hemisphere with vaccinations after smallpox and polio.
Etymology
The name rubella is sometimes confused with rubeola , the alternative name for measles in English-speaking countries; his illness has nothing to do. In some other European languages, such as Spanish, rubella and rubeola are synonyms, and 
See also
References
External links
- Rubella in Virology Wong.
- Immunization Action Coalition: Rubella
- Rubella is at risk during different pregnancy periods
- DermNet viral/rubella
- Centers for Disease Control and Prevention (2012). "Ch. 19: Rubella". At Atkinson W, Wolfe S, Hamborsky J. Epidemiology and Prevention of Vaccine-Preventable Diseases (12th ed.). Washington DC: Community Health Foundation. pp.Ã, 275-290. Archived from the original in 2017-03-10.
- " Rubella virus ". NCBI Taxonomy Browser . 11041.
Source of the article : Wikipedia
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