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German measles,acute infectious disease of children and young adults. It is caused by a filterable virus that is spread by droplet spray from the respiratory tract of an infected individual. Rubella is a much milder infection than rubeola (measles) and the rash, appearing after an incubation period of two to three weeks, rarely lasts more than three days. The lymph nodes behind the ears become tender and swollen, but otherwise German measles is almost always uncomplicated. However, during the first trimester of pregnancy it is associated with an increased risk of congenital damage to the fetus, producing stillbirths, abortion, low birth weight, and such malformations as cardiac defects, eye defects (especially cataracts), and mental retardation. During the first 16 weeks of pregnancy the infection has been estimated to carry a risk of fetal damage of between 30% and 35%. Pregnant women who have been exposed to rubella are given gamma globulin in an effort to prevent the disease. Research to develop a vaccine that would confer immunity was spurred by an epidemic of rubella in 1964 and the evidently related rise in the number of birth deformities. A live attenuated vaccine has been developed and is given to girls from 15 months to puberty and often to boys as well. Approximately 13% to 15% of women develop acute arthitis from vaccination. Before the vaccine can be administered to an adult woman it must be determined that she is not pregnant, and the test for the presence of rubella antibodies (which would indicate immunity to the disease from previous exposure) is given. Birth control should be practiced for at least three months after receiving the vaccine. Vaccination has eliminated endemic rubella in the Western Hemisphere.
A benign, infectious virus disease of humans characterized by coldlike symptoms and transient, generalized rash. This disease, also known as German measles, is primarily a disease of childhood. However, maternal infection during early pregnancy may result in infection of the fetus, giving rise to serious abnormalities and malformations. The congenital infection persists in the infant, who harbors and sheds virus for many months after birth.
In rubella infection acquired by ordinary person-to-person contact, the virus is believed to enter the body through respiratory pathways. Antibodies against the virus develop as the rash fades, increase rapidly over a 2–3-week period, and then fall during the following months to levels that are maintained for life. One attack confers life-long immunity, since only one antigenic type of the virus exists. Immune mothers transfer antibodies to their offspring, who are then protected for approximately 4–6 months after birth. See Immunity
Live attenuated rubella vaccines have been available since 1969. The vaccine induces high antibody titers and an enduring and solid immunity. It may also induce secretory immunoglobulin (IgA) antibody in the respiratory tract and thus interfere with establishment of infection by wild virus. This vaccine is available as a single antigen or combined with measles and mumps vaccines (MMR vaccine). The vaccine induces immunity in at least 95% of recipients, and that immunity endures for at least 10 years. See Biologicals, Vaccination
German measles, an acute infectious disease, accompanied by a rash. It is caused by a filterable virus that was discovered in 1938 by the Japanese scientists D. Hiro and S. Tasaka. The infection spreads from a sick person by air-droplets (with sneezing, coughing). The highest incidence occurs between ages two and ten. Persistent immunity follows infection with rubella. The incubation period is 11–23 days.
The typical manifestation of rubella is slight swelling and tenderness of the posterior cervical, occipital, and other lymph nodes; at the same time (or one or two days later) a pale pink micromacular rash appears on the face and the entire body, which disappears without a trace after two or three days. The eruption is accompanied by a slight fever and often by slight catarrh of the respiratory passages. The patient usually feels well. Rubella often proceeds asymptomatically; complications are extremely rare. Infection in the first months of pregnancy in women may cause severe developmental defects in the infant (microcephalia, deafness, cataracts, or heart defects).
Treatment is symptomatic. Sick children are isolated from their peer groups for five days from the beginning of the eruption for prophylactic purposes. Those who have been in contact with a patient are not isolated. Successful methods of prophylactic vaccination are being further developed.
REFERENCELibov, A. L. “Korevaia krasnukha.” In Rukovodstvo po infektsionnym bolezniam. Moscow, 1967.
S. D. NOSOV