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Diseases / Rubella

Rubella

What is it?: 

Rubella is also known as "German Measles" and is caused by rubella virus.2

Rubella is an acute, usually mild viral disease traditionally affecting susceptible children and young adults worldwide. Rubella usually occurs in a seasonal pattern, with epidemics every 5–9 years. However, the extent and periodicity of rubella epidemics is highly variable in both industrialized and developing countries.1

Rubella infection occurring just before conception and during early pregnancy may result in miscarriage, fetal death, or congenital defects known as congenital rubella syndrome (CRS). The highest risk of CRS is found in countries with high rates of susceptibility to rubella among women of childbearing age. These rates may vary considerably among and within countries, mainly reflecting epidemiological and socioeconomic differences, and urban versus rural settings.1

Before the introduction of rubella vaccine, the incidence of CRS varied from 0.1–0.2/1000 live births during endemic periods, and from 0.8–4/1000 live births during rubella epidemics.1

Clinical features: 

People usually present with a diffuse rash, fever, headache, malaise, enlargement of lymph nodes, upper respiratory symptoms and conjunctivitis. The rash usually lasts for about 3 days, but some patients may not have rash at all. Arthralgia or arthritis occurs more commonly in adult women with rubella. Rubella infection can also cause anomalies in the developing foetus. Congenital rubella syndrome, characterised by deafness, cataract, heart malformations, mental retardation etc., is likely to occur in infants born to women who got infected during the first 3 months of pregnancy.2

Mode of transmission: 

It can be transmitted by contact with secretions from nose and throat 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 1 week after onset of rash.2

Incubation period: 

It ranges from 12 – 23 days, usually 14 days.2

Prevention: 

Maintain good personal hygiene2

  • Perform hand hygiene frequently, especially before touching the mouth, nose or eyes, after touching public installations such as handrails or door knobs or when hands are contaminated by respiratory secretion after coughing or sneezing
  • Cover your mouth and nose with tissue paper when sneezing or coughing
  • When having respiratory symptoms, wear a surgical mask, refrain from work or school, avoid going to crowded places and seek medical advice promptly
  • Affected persons should be advised to stay at home for 7 days from the appearance of rash and avoid contact with any susceptible persons, particularly pregnant women and women preparing for pregnancy. 

Maintain good environmental hygiene2

  • Regularly clean and disinfect frequently touched surfaces such as furniture, toys and commonly shared items with 1:99 diluted household bleach
  • Use absorbent disposable towels to wipe away obvious contaminants such as respiratory secretions, and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach
  • Maintain good indoor ventilation

Immunization2

  • Immunisation with rubella-containing vaccine is effective in preventing the disease. Under the Hong Kong Childhood Immunisation Programme, children receive a two-dose course of rubella vaccination (Please refer to the Hong Kong Childhood Immunisation Programme).
  • Women of childbearing age who are not immunised should check their immune status before planning for pregnancy and receive rubella-containing vaccine if necessary.
Managment: 

There is no specific treatment but drugs may be prescribed to reduce discomfort.2

Reference:

  1. World Health Organization. Weekly epidemiological record. Rubella vaccines: WHO position paper – June 2020. 2020;27(95):301-324.
  2. Centre for Health Protection. Communicable diseases – Rubella. 9 Jul 2019. https://www.chp.gov.hk/en/healthtopics/content/24/40.html [ONLINE] Accessed 15 Mar 2021.

 

MAT-HK-2100320-1.0-03/2021