rubella /ro̅o̅bel″ə/ [L, rubellus, somewhat red] , a contagious viral disease that is spread by droplet infection and has an incubation time of 12 to 23 days. It is characterized by fever, symptoms of a mild upper respiratory tract infection, lymph node enlargement, arthralgia, and a diffuse fine red maculopapular rash. Rubella virus is a togavirus belonging to the genus Rubivirus. It is most closely related to group A arboviruses. It is an undeveloped RNA virus that does not cross-react with other togaviruses. The virus is spread by droplet infection, and the incubation time is from 12 to 23 days. Also called German measles, 3-day measles. Compare measles, scarlet fever. Should not be confused with rubeola. ▪ OBSERVATIONS: The symptoms usually last only 2 or 3 days except for arthralgia, which may persist longer or recur. One attack confers lifelong immunity. If a woman acquires rubella in the first trimester of pregnancy, fetal anomalies may result, including heart defects, cataracts, deafness, and cognitive impairment. An infant exposed to the virus in utero at any time during gestation may shed the virus for up to 12 months after birth. Complications of postnatal rubella are rare. Complications due to rubella infection occur more frequently in adults and include conjunctivitis, testalgia, orchitis, arthralgia or arthritis, encephalitis, and hemorrhagic manifestations. ▪ INTERVENTIONS: The illness itself is mild and needs no special treatment. Live attenuated rubella vaccine is advised for all children to reduce chances of an epidemic and thus to protect pregnant women. The vaccine is not given to women already pregnant, and it is recommended that pregnancy be avoided for 3 months after the administration of rubella vaccine. Spread of the virus from a recently vaccinated individual rarely occurs. Immune serum globulin containing rubella antibodies may help prevent fetal infection in exposed susceptible pregnant women, but ordinary gamma globulin will not protect the fetus.
