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Rubella
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Causative agent
Rubella infection is also known as "German Measles" and is caused by Rubella virus.
Clinical features
Children usually present with a diffuse rash and enlargement of lymph nodes, but adults may experience a 1-5 day history of low-grade fever, headache, malaise, mild cough and conjunctivitis followed by a skin rash as in children. The rash may last for 5 days, but some patients may not have rash at all. Rubella infection also produces anomalies in the developing fetus. Congenital rubella syndrome characterized by deafness, eye lesions, heart malformations and mental retardation is likely to occur in infants born to women who got infected during the first 3 months of pregnancy.
Mode of transmission
It can be transmitted by contact with secretions from nose and pharynx of infected persons through droplet spread or direct contact with patients. This is a highly infectious disease and the patient can pass the disease to other persons from 1 week before to at least 4 days after onset of rash.
Incubation period
It ranges from 14 to 23 days, usually 16 to 18 days.
Management
There is no specific treatment but drugs may be prescribed to reduce discomfort.
Prevention
1. Maintain good personal and environmental hygiene.
2. Maintain good indoor ventilation.
3. Keep hands clean and wash hands properly.
4. Wash hands when they are dirtied by respiratory secretions e.g. after sneezing.
5. Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly.
6. Cleanse used toys and furniture properly.
7. Affected persons should stay away from school for 7 days from the appearance of rash and avoid contact with pregnant women. This is because pregnant women who do not have the immunity to rubella would contract the disease and their fetus could also be affected as well. Therefore, close pregnant contacts should be traced and their immunity status checked.
8. Immunization with rubella vaccine is effective in preventing the disease. It is given together with measles and mumps vaccines in Hong Kong to children. (Please refer to programme of immunization)
9. Child bearing age women who are not immunized preferably should check their immunity status before pregnancy and receive rubella vaccine accordingly.
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