Rubella virus (RuV), also known scientifically as Rubivirus “rubellae“, is responsible for transmitting rubella, a disease exclusively passed between humans through respiratory means. Of particular concern is its impact during early pregnancy, potentially leading to congenital rubella syndrome.
As part of the Matonaviridae family, Rubella virus shares common features with other members, characterized by a single-stranded RNA genome with positive polarity housed within an icosahedral capsid.
Although the exact molecular mechanisms underlying congenital rubella syndrome were not fully understood as of 1999, studies using cell lines have suggested that Rubella virus triggers apoptosis in specific cell types, possibly via a p53-dependent pathway.
Rubella, alternatively known as German measles or three-day measles, manifests with a rash similar to measles. However, it is caused by a distinct virus from the one responsible for measles.
What is congenital rubella syndrome?
Congenital rubella syndrome (CRS) represents the severe manifestation of rubella, occurring when a pregnant individual transmits the rubella virus to the fetus. This transmission can result in various complications affecting the skin, hearing, vision, heart, and brain functions of newborns.
Who does rubella affect?
Rubella can affect anyone, but the most severe form, congenital rubella syndrome, primarily impacts newborns born to mothers who contracted rubella during pregnancy. Although the United States eradicated continuous transmission of rubella in 2004, the virus remains prevalent in other regions globally.
Understanding Rubella: Causes and Symptoms
Rubella typically presents with a rash, commonly starting on the face and spreading downwards. It may be the first symptom in young children, while in older individuals, it can emerge a few days after other symptoms. Additionally, up to 50% of individuals may show no symptoms but can still transmit the virus.
Rubella symptoms
Skin rash.
Mild fever.
Coughing.
Sore throat.
Nasal congestion.
Headaches.
Conjunctivitis.
Joint discomfort.
Enlarged lymph nodes.
What are the signs of congenital rubella syndrome (CRS)?
Symptoms of congenital rubella syndrome manifest at birth. If a pregnant individual contracts rubella, their baby may be born with one or more CRS symptoms, such as:
Potential consequences of congenital rubella syndrome include:
Vision impairment due to eye conditions like cataracts and glaucoma.
Hearing impairment.
Heart abnormalities.
Neurological variations, such as microcephaly (underdeveloped brain), brain inflammation, and cognitive or behavioral differences.
Skeletal issues.
Reduced blood cell counts (thrombocytopenia, hemolytic anemia).
Thyroid disorders.
Enlargement of the liver and spleen (hepatosplenomegaly).
Onset of type 1 diabetes (insulin-dependent diabetes mellitus).
Vaccination for Rubella
The most effective defense against rubella is the MMR (measles-mumps-and-rubella) vaccine. The majority of individuals who receive the MMR vaccine will gain protection against rubella.
Prevention of rubella is possible through the MMR vaccine, which guards against three illnesses: measles, mumps, and rubella. According to the CDC, children should receive two doses of the MMR vaccine, with the first administered between 12 and 15 months of age, followed by the second dose between 4 and 6 years of age. Additionally, teens and adults should ensure they are up to date with their MMR vaccination.
The MMR vaccine is highly safe and efficient. A single dose of the MMR vaccine offers approximately 97% effectiveness in preventing rubella.
Response from the World Health Organization (WHO)
SAGE recommends swift integration of rubella vaccination into immunization programs to bolster rubella control efforts. As a founding member of the Measles & Rubella Initiative, WHO assists governments and communities in improving routine immunization and conducting targeted vaccination campaigns. The WHO Global Measles and Rubella Laboratory Network aids in diagnosing rubella and CRS cases and tracking rubella virus spread.