Rubella Dangers
Rubella is an infection caused by a type of togavirus, called the Rubivirus. It is also known as German measles or 3-day measles. The virus is spread by contact with contaminated respiratory droplets or close contact with an infected person. Signs of infection include: red rash, mild fever, headache, swollen lymph nodes, sore throat, red or tearing eyes, runny nose and joint pain.

In many cases, symptoms of rubella are often very mild and up to 40 percent of patients never know they have acquired the virus. Those that develop signs of infection usually respond well to supportive care (rest, medications to reduce fever).

Rubella becomes dangerous when the virus is acquired by a woman in the early course (first trimester) of pregnancy. The virus interferes with cell division, causing incomplete, delayed or defective development of organs and body parts. In addition, the rubella virus inappropriately stimulates the fetal immune system, leading to inflammation and cellular damage. The infection can lead to fetal death, premature birth, or a variety of medical problems, known as congenital rubella syndrome, or CRS.

Researchers estimate 25 to 30 percent of infants born to rubella-infected mothers develop CRS. Children tend to be small in size and may experience hearing loss, heart problems, cataracts, glaucoma, developmental delay and/or mental retardation.

Congenital Rubella Syndrome - Late Effects
Between 1964 and 1965, a rubella epidemic broke out in the U.S. Roughly 12.5 million cases of rubella were reported and about 200,000 babies were born with congenital rubella syndrome. A little more than twenty years after the epidemic, parents began reporting a sudden onset of new, unusual symptoms in CRS children. Some of the late effects include: diabetes, glaucoma, retinal detachment, hormone and thyroid problems, swallowing/digestive problems, deterioration in cognitive performance, seizures and behavioral problems. Doctors don't understand the cause of the new symptoms.

2004 is the 40th anniversary of the 1964/1965 U.S. rubella outbreak. To mark the important date, researchers are gathering as much data as possible about the late symptoms that appear to be associated with CRS. Hopefully, the data will provide some clues about how or why patients are developing the new signs (i.e., are they the result of CRS, medication use or inherited tendencies?). The CDC will be collecting blood samples from survey volunteers to look for biomarkers of CRS. The test may eventually be useful to determine if CRS is the cause of the symptoms in patients who may been exposed to the rubella virus, but didn't develop any notable signs of infection.

Rubella vaccination began in the U.S. in 1969 and the number of cases of CRS have dramatically declined. However, from time to time, incidences are still reported. Between 1990 and 1999, 117 cases of CRS were reported. Only one of the mothers had reported receiving a rubella vaccination. Health experts say universal rubella vaccination is the only way to prevent maternal infection with the virus and reduce the risk of congenital rubella syndrome.

Resources:
For information about the study: Helen Keller National Center

For general information on rubella or congenital rubella syndrome:

Centers for Disease Control and Prevention

Directors of Health Promotion and Education

Source: Medstar