Rubella

It affects both children and adults, but its real importance as a public health problem is that if a pregnant woman is infected during the first months of pregnancy, the disease can also affect the fetus and cause serious congenital malformations. Therefore, if you want to have a baby, you should know if you have antibodies to rubella and, if not, you should be vaccinated.

It’s Symptoms: 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 nodes behind the ears, headaches, joints and conjunctivitis.

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 serious disorders (this is what is called congenital rubella).

The infectious agent reaches the pharynx thanks to the inhalation of those contaminated droplets. Once there, it passes into the bloodstream and reaches the lymphatic tissue, where it is lodged and reproduced. Finally, when the virus has multiplied enough, it returns to the blood. It is at this time when the body begins to respond to the infection, producing antibodies capable of destroying the virus. The infected individual can spread the disease from about a week before the onset of the rash to one or two weeks later.

Complications of rubella:

In women, arthritis is common, which usually affects the fingers, wrists and knees. The alterations that take place at blood level can give rise to hemorrhages by the descent of platelets. Both children and adults can suffer encephalitis after rubella. Another uncommon complication is mild hepatitis.

If the mother contracts rubella during the first months of pregnancy it can be transmitted to the fetus; is what is known as congenital rubella syndrome (CRS) and can cause malformations in many organs. The risk of infection and serious sequelae decreases as the pregnancy progresses. Thus, during the first two months there is between 80 and 90 percent chance of the embryo becoming infected, and a spontaneous abortion often occurs. Among the most frequent alterations are cardiac disorders, such as stenosis of the pulmonary artery, cataracts, which can be visible at birth, or appear a few days later, glaucoma, and deafness, which is one of the manifestations most common permanent, and that can affect one or both ears. The newborn can also have a smaller head than normal (microcephaly), which usually leads to mental retardation and the child’s psychomotor development. Other manifestations of congenital rubella, although less frequent, are: jaundice, undescended testes, enlarged liver and pneumonia.

Babies born with CRS excrete the virus for one or two years, so they can infect the people who live with them.

This disease sometimes goes unnoticed by the lightness of its symptoms and, in addition, can be confused with measles, so it is important to establish the correct diagnosis of rubella. Due to this possible confusion, it is not enough just with the clinical examination to check if it is rubella.

In pregnant women it is important to know if there is infection; In this way, any malformation that occurs in the fetus can be diagnosed by ultrasound. In these cases it may be useful to study a placental tissue biopsy, which demonstrates the presence of viral particles, although the biopsy should always be performed over the 11th week of gestation to avoid complications. At present, IgG for rubella is also determined in all pregnant women, and when they do not have previous immunity, vaccination is recommended after delivery for future pregnancies.

Currently there is no cure for rubella, and the treatment that is usually administered serves to relieve fever and joint pain (paracetamol).

Some of the side effects of the rubella vaccine are joint pain and fever, although the tolerance is quite good in general. The vaccine is called ‘triple viral’ because three viruses are administered simultaneously: rubella, measles and mumps (mumps). Two doses are required: the first dose should be between 12 and 15 months, and the second dose should be at 3 years of age.

It is convenient to vaccinate those adults who did not receive the vaccine in childhood, because this helps to reduce the incidence of the disease, which is especially important in women of childbearing age.

Pregnant women can not be vaccinated against rubella (in fact, conception should be avoided until three months after the administration of the vaccine), so, if they lack antibodies (defenses) against the disease, it is essential that they avoid Contact anyone who may be infected and get vaccinated after delivery for future pregnancies.

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