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Rubella

Introduction

Rubella (also known as the German measles) is the wimpy younger brother of measles. It is caused by a different virus to the measles but has much of the same symptoms in a milder form. It is usually only last 1-3 days and may even pass unnoticed by those who have it. It is only really a serious threat if you or anyone around you is pregnant when it can pose some serious risks to an unborn child.

Rubella is also what the R stands for in the MMR vaccine. The vaccine is a great form of prevention and 99% effective so if you had your two doses of the MMR as a kid you are probably still covered today and don't need to worry about it much. However it’s best to check out the prevention section for advice on getting re-vaccinated.

What is Rubella?

Rubella is a virus and like the measles it is passed through the air, usually by the coughing and sneezing of an infected person. As a virus it is unresponsive to antibiotics and there isn't really a cure. Bed rest, fluids and paracetemol will help to relieve the symptoms and your body's immune system is pretty capable of handling the rest.

Anyone can get rubella but it’s rare in babies and those over 40. Rubella is only really a concern when you or anyone around you is pregnant. A mother can pass rubella onto a foetus and it is extremely dangerous. This is called Congenital Rubella Syndrome, the complications of which are discussed below.

Symptoms

You usually begin to show symptoms about 14-21 days after you are exposed to the virus, which means you can be contagious for a whole week and not even know it. Symptoms are very similar to those of a cold and are often accompanied by a rash. You continue to be contagious for a whole week after the rash disappears.

  • Low fever
  • Swollen glands (particularly in the neck, behind the ears and at the base of the skull)
  • Headache
  • Joint pain (this is especially true in young women)
  • Conjunctivitis
  • Rash - the rash usually lasts for about 3 days. Like in the measles it begins on the face and then spreads down the body. It will be a pink or light red colour

Treatment

As a virus there isn't really a treatment for Rubella and it is unresponsive to antibiotics. This is not really an issue as the symptoms are usually so mild that treatment is unecessary. Treatment of the symptoms is the best option:

  • Paracetemol, to help with headaches a, joint pain and to lower the fever
  • Rest
  • Fluids, to prevent dehydration

ISOLATION, rubella is fairly contagious and can be really dangerous for the health of unborn babies and pregnant women. You should avoid contact with people to prevent the spread of the virus

Congenital Rubella Syndrome

If you are pregnant and contract rubella you can pass it on to your child through your blood. If rubella is contracted in the first 11 weeks of pregnancy there is a 90% chance your baby will contract CRS. In some cases CRS will cause the pregnancy to miscarry. Otherwise CRS has some serious consequences for the future health of your child and there is a 20% chance of damage to the foetus resulting in

  • Brain damage
  • Heart defects
  • Cataracts (eye problems)
  • Deafness

Babies born with CRS are very contagious to other newborns and are often placed in isolation. It is due to the dangers of contracting CRS that those who are pregnant or who are planning to get pregnant shortly are advised not to get the MMR vaccine.

Prevention

The MMR vaccine is a very effective form of prevention and if you had both of the recommended doses at the appropriate ages, or if you have had rubella before, you are most likely immune to the virus. This alongside practicing good hygiene, not sharing food and drink and avoiding anyone you know to have rubella will make it easier to prevent yourself from getting the virus.

However, immunity from the MMR can lapse as you get older. If you are about to start 6th form college or university, or have extensive travel plans such as a gap year to less developed countries you may need to consider getting an MMR booster (another shot of the vaccine) to help ensure your immunity.

Viruses are very easily spread in the college or university environment. You live your lives on top of each other in halls and you share food and drink without thinking about it too much which puts you at a higher risk. Some universities will even require you to get the booster before you begin. Travelling to foreign less developed countries, who do not widely vaccinate against rubella, will also increase your risk of contracting the illness.

How does the MMR vaccine work?

  • The vaccine works by giving you a very weak strain of the rubella virus, one that it can fight off without you even noticing
  • It gives your body the practice for when then real virus comes along and leaves behind rubella-specificĀ  antibodies in your blood ready to react at the first sign of a new attack
    • 99% of those who get the vaccine are then fully protected from the virus

Do you need the MMR booster?

  • If you had two doses of the MMR vaccine after the age of 12 months then you are probably covered. However, if you are in one of the higher risks categories mentioned above or if you are doing work experience at a hospital you may want to get a simple blood test done, to check your immunity. If it comes back showing you are not immune it is almost definitely worth getting a booster which you can have done at your local doctors surgery.
  • If you did not have two doses of the vaccine as a child or if you had one before you were 12 months old you should definitely consider gettingĀ  a booster or at the very least a blood test to check for immunity.
  • It is never too late to get the vaccine as it will continue to be effective

Side Effects of MMR vaccine

There are very few side effects of the MMR vaccine. You cannot develop mumps, measles or rubella from the vaccine and most people who have it experience no side effects. As an adult getting the vaccination it is possible you may get:

  • A mild fever
  • A rash
  • Some joint pain and aching
  • You should not get the vaccine if:
  • You are pregnant or plan to get pregnant in the next four weeks
  • If you have a severely compromised immune system or cancer
  • If you have a life threatening allergic reaction to gelatin or the antibiotic neomycin

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