Mirror Doctor: Is rubella vaccination necessary? Dear Mirror doctor, I have noticed that there is a mass vaccination of measles-rubella going on in the schools. Measles, I understand, but why rubella? Can you please educate me on what rubella is and its effects? Maame Nyarko, Spintex Road, Accra. Dear Maame Nyarko, Rubella, also known as German Measles, is a disease caused by the rubella virus. The name "rubella" is derived from Latin, meaning little red. It is commonly called German Measles because the disease was first described by German physicians in the mid 18th century. Rubella is a common childhood infection. The virus is transmitted via airborne droplet emission from the upper respiratory tract of active cases. The virus may also be present in the urine, faeces and on the skin. The disease has an incubation period (period between contact with the virus and showing clinical symptoms of the disease) of two to three weeks. In most people the virus is rapidly eliminated. However, it may persist for some months after birth, especially in infants who acquire the infection from their mother across the placenta. These children are a significant source of infection to other infants and, more importantly, to pregnant female contacts. German measles causes symptoms that are similar to the flu. The primary symptom of rubella virus infection is the appearance of a rash on the face which spreads to the trunk and limbs and usually fades after three days (that is why it is often referred to as three-day measles). The facial rash usually clears as it spreads to other parts of the body. Other symptoms include low-grade fever, swollen glands around the neck and back of head, joint pains, headache and eye discharge. The swollen glands can persist for up to a week and the fever rarely rises above 38 degrees Celsius. The rash is typically pink or light red itchy and often lasts for about three days. The rash disappears after a few days with no staining or peeling of the skin. When the rash clears up, the patient may notice that his skin sheds in very small flakes wherever the rash covered it. Rubella can affect anyone of any age and is generally a mild disease, rare in infants or those over the age of 40. The older the person is the more severe the symptoms are likely to be. Up to two-thirds of older girls or women experience joint pain or arthritic-type symptoms with rubella. The patient is contagious typically for about one week before the rash and for about one week thereafter. The most dangerous aspect of this infection is the congenital rubella syndrome. Congenital rubella syndrome (CRS) occurs in the newborn. This syndrome (CRS) follows infection by rubella virus transferred across the placenta to the developing foetus. Affected children manifest cardiac (heart), cerebral (brain), ophthalmic (eye) and auditory (hearing) defects. It may also cause prematurity, low birth weight and neonatal rash (from low platelet levels), anaemia and hepatitis. The risk of major defects is highest for infection in the first trimester during which period the major organs are being formed. CRS is the main reason a vaccine for rubella was developed. Many mothers who contract rubella within the first critical trimester either have a miscarriage or a still-born baby. If the baby survives the infection, it can be born with severe heart disorders, blindness, deafness, or other life-threatening organ disorders. Rubella infections are prevented by active immunisation programmes using live, disabled virus vaccine. The vaccine is usually given as part of the MMR vaccine. The World Health Organisation (WHO) recommends that the first dose be given at 12 to 18 months of age with a second dose at 36 months. Pregnant women are usually tested for immunity to rubella early on. Women found to be susceptible are not vaccinated until after the baby is born because the vaccine contains live virus. Immunisation of everybody, including the boys who may never get pregnant, is to boost the protection against this infection by a process called herd immunity. astom2@yahoo A member of Paediatric Society of Ghana. Source: The Mirror
Posted on: Tue, 24 Sep 2013 04:47:37 +0000
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