Rubella is dangerous Watch out, ladies!
Rubella is a viral infection, first recognised by German authors in the eighteenth century and known by its popular name as German measles or scarlet fever. It was originally considered a mild self-limiting disease. But later it was identified as one of the most common infections of the unborn baby, with severe potential for physical and mental damage (teratogenesis).
The commonly used name, German measles, was misleading in the sense that it created a false sense of security as far as India was considered. Although exact data are not available, it is believed to be extremely common in India. Many studies have reported that 50-94% of the children and young adults are exposed to Rubella.
The most susceptible age groups are, therefore, children and young adults. Humans are apparently the only host for the Rubella virus and thus continued cycling in them is the only means whereby the virus is maintained in nature.
The Rubella virus enters the body through the nasopharynx, replicates in the local lymph nodes and is released in the blood stream after seven days. At this time the only symptom may be mild fever and other flu — like symptoms. About two weeks later, there is the appearance of rash and the enlargement of the local lymph nodes. Upto this point the patient can pass infection to others unknowingly.
The symptoms of the Rubella infection are mild, easily missed and so remain undiagnosed. But it is the growing, unborn foetus that bears the brunt of the infection. The highest risk of infection is thus in the pregnant women. Infected, especially in the first three months of pregnancy, there is a 60-75% chance of the baby having hearing loss. About 50-90% of the babies have eye defects like congenital cataract and blindness and 40-50% are born with heart defects. About 40% have psychomotor retardation.
Of all the malformations that constitute the Congenital Rubella Syndrome, microcephaly (small head) is the only one that can be diagnosed on ultrasound of the pregnant patient. But the failure to document microcephaly does not rule out other malformations of the baby. Having such a baby can be devastating for the entire family and is a burden to society in general.
Once infected, there is no treatment. The only way out is to prevent the infection. There has been a strong plea by several authorities for the immunisation of girls with the Rubella vaccine between the age group of 10-14 years as the MMR (Measles, Mumps, Rubella) vaccine given in infancy may have lost its protective efficacy. The Rubella vaccine is very cheap and easily available. It provides life-long protection to the mothers-to-be.
We, as parents, should try to prevent a heartbreak for our girls later on. Rubella vaccination is a vital part of the school immunisation programme in several countries. Till it becomes so of our country’s policy, all adolescent girls should be vaccinated at the individual or school level.