We don’t hear much about rubella anymore, but it’s the most common cause of vaccine-preventable birth defects on the planet.
Rubella was first described as a distinct illness in the early 1800s by German physicians leading to its common name, “German measles.” Before that, the illness was felt to be a form of either the measles or scarlet fever.
Incredibly, the first vaccines were licensed in 1969, just seven years after the identification of the virus that causes rubella. Because of our country’s high vaccination rates, most Americans are unaware of the pain and suffering rubella can cause.
Rubella spreads easily by the same means as the common cold. Typical symptoms include fever, cough, congestion, sore throat, pink eye and swollen lymph nodes. A rash similar to measles usually develops, but the rash with rubella is typically fainter and only lasts a few days. In fact, the name rubella is derived from Latin, meaning “little red” in reference to its mild rash.
The illness is relatively minor in children and adults, but complications do occur. Adult women are more likely than men or children to suffer pain in their joints for a month or two following the illness. Brain inflammation is one of the most serious complications and occurs in up to 1 in 6,000 cases. Very rarely, rubella may result in death. Infection leads to lifetime immunity and protection.
Unfortunately, if the infection occurs in a woman during pregnancy, the virus can be passed to the fetus. This can result in miscarriage, stillbirth or birth defects. Birth defects from infection include deafness, eye problems that may result in blindness, abnormal brain growth resulting in mental retardation and autism, and heart damage. The risk is greatest if the infection occurs in the first trimester of pregnancy.
Before vaccination, rubella epidemics occurred every six to nine years. An estimated 12.5 million people contracted rubella during the last major outbreak (1964-1965) in the United States. Eleven thousand pregnant women lost their babies, 2,100 newborns died and 20,000 babies were born with birth defects from the infection.
Rubella is one of the components of the measles-mumps-rubella and measles-mumps-rubella-varicella vaccines. Children routinely receive their first dose after their first birthday and the second dose after their fourth birthday. The vaccines provide lifelong protection.
Children who are severely immunocompromised shouldn’t be vaccinated, as the measles-mumps-rubella and measles-mumps-rubella-varicella vaccines contain live virus. The viruses are attenuated, or weakened versions, and don’t cause problems in people with normal immune systems. The vaccines aren’t given to pregnant women because of the theoretical risk to the fetus. In the last 50 years, many pregnant women have accidentally received these vaccines, and no problems have been identified.
As Americans, we have much to be thankful for this holiday season. Indeed, we’re fortunate to have access to vaccines that prevent diseases like rubella.