How is Rubella spread?
Rubella is spread in airborne droplets when infected with rubella virus people sneeze or cough.
The infected person has contagiousness within one to four days after the rash lasts 1 week before leaving the rash. The incubation period of the rubella between 14 and 21 days.
What are the signs and symptoms of Rubella?
Rubella symptoms such as typical rash that spread from the face to the body, mild fever, swelling of the lymph glands, loss of appetite, headache and articular pain. Sometimes can be seen reddened eyes. Not all of these complaints are always present, for example 5% rashes are not seen.
Rubella vacine (MMR)
Persons who have had the infection or those who have been vaccinated are immune to life and do not suffer from this disease again. If the Rubella IgG test is positive in the blood test, the person is immune to the disease. Very few people who are not immunized and not vaccinated are able to pass the disease.
Anyone who considers pregnancy should be tested for rubella (rubella IgG test) before being pregnant. Absolute rubella vaccination should be done for those who are not immune. It is recommended not to conceive for 1 month after vaccination, but no problems have been observed if they conceive in this mounth. This is why it is not advisable to terminate your pregnancy in people who have rubella vaccination without knowing that you are pregnant.
Rubella vaccine is a live vaccine, because of this impracticable during pregnancy. Vaccination can be done during breastfeeding period.
Is Rubella Vacine is safety? The MMR vaccine is very safe and highly effective. Slight reactions such as fever, redness, or swelling at the injection site have been reported. Women may infrequently have joint symptoms like pain and stiffness from the rubella part of the vaccine.
What are the effects of pregnancy?
Rubella infection in pregnancy can cause a variety of infant infections (anomalies) or even death or abortus.
The transmission of the virus to the fetus is %90 in the first 12 weeks of infection, %50 in the 13-16 weeks, the fetal transition after 16 weeks decreases to %35, but increases again in the last 2 months of pregnancy, %90.
Rubella infection in the first 12 weeks of pregnancy affects the baby at least as high as 50%. Some of them result in abortion, but some cause anomalies. Therefore, it is necessary to terminate your pregnancy especially during infections in the first 12 weeks. Immunoglobulin can be given to those who do not want to terminate the pregnancy, immunoglobulin can relieve the infection in the mother but it has no protective effect on the baby.
In 50% of infections between 13-16 weeks of age, the baby has a hearing problem.
Infection at 17th gestational week and later is less likely to harm the fetus.
Effects of rubella infection on infant:
The most common anomalies are eye problems, hearing loss, heart and intelligence problems, meningitis, liver and spleen growth, learning disability, anemia, poor nutrition, low birth weight. The problems that occur in the baby are called “congenital rubella syndrome“. The classic triad of congenital rubella syndrome is cataract, deafness and heart anomalies.
There are some effects of Rubella on infants below:
– Sensorineural deafness (most frequency)
– Cataract, retinopathy, congenital cataract
– Microcephaly
– Ventriculomegaly
– Intracranial calcification
– Meningoencephalitis
– Cardiac malformations
(Most commonly PDA, Most pathognomonic finding: Supravalvular pulmonary stenosis)
– Mental retardation
– Pneumonia
– IUGR
– Hepatosplenomegaly
– Jaundice
– Hemolytic anemia
– Thrombocytopenia
Rubella infection results in a %4-9 miscarriage of pregnancies and stillbirths in %2-3.
The diagnosis of Rubella infection:
Diagnosis of suspicious pregnancies The diagnosis is made by positive detection of Rubella IgM or by the onset of complaints and by the presence of a positive 4 times and more increase in IgG titers observed after 15 days or positive antibodies detected during pregnancy in a person known to be not immunized at the beginning of pregnancy.
The diagnosis of fetus infection:
Fetal infection can be detected by showing the IgM antibodies in the fetal blood or showing the virus in the amnion fluid or chorion. Even if these tests show that the fetus infected, it can not give an idea about the degree of damage to the fetus. In addition, the negative outcome of these tests can not always guarantee that there is no rubella infection on fetus.
What is the treatment for Rubella?
Unfortunately there is no specific treatment for rubella or for congenital rubella syndrome. Infected person should drink plenty of fluids and may take medication to reduce mild fever. Infants with CRS are treated for their specific problems.
Terminating the pregnancy :
In the first 12 weeks of pregnancy, it is recommended to terminate your pregnancy because of the high fetal ill effect risk. It can be decided according to using the diagnostic methods showing that the fetus infected by rubella virus between 13-16 weeks. The risk of fetal involvement after the 16th gestational week is low, but pregnancy can be terminated if the family does not take any risks.