Rubella Virus
(German Measles)

Biology 201A
Anatomy & Physiology I
Professor Debra Dutton
August 1, 2012

Rubella infections in the United States are reported in people who are all mostly foreign-born or unimmunized. These reported rubella cases are right now at a record low levels; however, outbreaks and cases have struck, mainly between the unvaccinated foreign-born adults. This is the one of the reasons why Filipinos traveling abroad and or back to their native homeland of the Philippines should use precaution by getting vaccinated with the rubella vaccine prior to traveling to the Philippines. The Philippines is still a rising and evolving country that lacks a basic healthcare access in most of the rural areas, which also generally lacks a rubella vaccination program.
The Rubella virus is the causative agent of the disease rubella. The earliest possible description of rubella dates back to when the clinical manifestations of the disease were described by two German physicians, de Bergan in 1752 and Orlow in 1758. During that period of time, the disease was considered to be an outgrowth of measles. They were also known as German measles. German physician George de Maton, documented the disease as distinct from measles in 1814. Henry Veale, a British Army surgeon later renamed rubella (from the Latin word red) after the distinct red, rash-like symptoms. In 1881, rubella was formally recognized as a distinct individual entity.
Rubella Virus is the only member of the genus Rubivirus and is from the family Togaviridae. The typically only known hosts of this virus are humans. The virus is covered by a lipid membrane and has a positive-stranded single RNA genome. Chemical agents, low pH, heat, and cold readily inactivate the Rubella virus. Cell-mediated immunity develops 2 to 4 weeks after infection and hemagglutination inhibition. Neutralizing antibodies directed against the virus peak at approximately 4 weeks. After infection to rubella, immunity usually persists for life.
Rubella is transmitted from human to human only by direct or droplet contact with infected body fluids. Most commonly are nasopharyngeal secretions. Patients cam shed infectious virus from 7 to 30 days after infection (from 1 week before to 2 weeks after the beginning of the rash). The average incubation period for the virus is about 14 days (ranges from 2 to 23 days). During this period, the virus replicates in the nasopharynx and local lymph nodes and then spreads hematogenously throughout the entire body. Most women who contract rubella during the first trimester of pregnancy, have a greater risk of passing the virus on to their baby congenitally. Babies who obtain the rubella virus congenitally are at risk for Congenital Rubella Syndrome (CRS) and may result in serious birth defects.
The most common method of confirming the diagnosis of rubella is through a serological titer. Acute rubella infection can be serologically confirmed by a significant rise in rubella antibody titer in acute and convalescent serum specimens or by the presence of serum rubella IgM. Rubella virus can be isolated from throat, nasal, urine, blood and cerebrospinal fluid specimens from rubella and Congenital Rubella Syndrome cases.
Children and adults with the rubella infection may begin with 1-2 days with a low-grade fever (1010 or lower), swollen glands behind the ears or in the neck, and can possibly have upper respiratory infection before they start developing a rash. The red rash usually starts at the face and works its way progressing towards the extremities. Children with rubella usually exhibit just the red rash starting at the face progressing down the body. Adult women with the red rash exhibit stiffness and pain in the wrist, knee joints and finger, which usually lasts a month. Other symptoms in adults include: headache, tiredness, pinkeye, and muscle and body aches.
Symptoms of rubella may not be present at all, even if infected with the rubella virus. A pregnant woman who develops rubella, but has no rubella symptoms, may still pose a threat for her baby developing serious Congenital Rubella Syndrome symptoms. The Consequences of rubella infection include: Stillbirths, abortions, and miscarriages. Problems that can occur because of CRS include: cataracts, deafness, mental retardation, pneumonia, heart defects, and spleen and liver damage.
Treatment of rubella generally consists of fluids, rest, and medication. No treatment will shorten the course of rubella infection. Symptoms of rubella are so mild that treatment usually isn't necessary. Nonsteroidal