Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.
Rubella is a disease that is also known as the German measles.
Sommer said, “It is another viral infection. We’ve been talking about all the different viruses floating around. Well, they’re not floating around. This one kind of has almost been eradicated. But unlike the more severe measles cases, rubella is usually mild in children and adults. It might come with a light rash, low grade fever. Sometimes you may have swollen glands or joint pain. A lot of times it may go unnoticeable. However, rubella can carry a serious risks in a specific situation, and that is pregnancy. So in a pregnant person that gets rubella in the first trimester, the virus can cross to the fetus and cause a congenital rubella syndrome, or CRS. And that means that there could be birth defects. Well, first of all, there could be miscarriage, but then it could be defects like hearing loss, eye problems, cataracts, heart defects, developmental delays, and like I said, sometimes miscarriage or even stillbirth.”
How does rubella spread?
Sommer said, “Rubella spreads through respiratory droplets. So it’s transmitted through coughing, sneezing and close contact, anyone that has a runny nose. A person can be contagious before the rash shows up, so a few days before the rash appears, up to about eight days or after, so you might catch it from someone who looks well. Also 25% to 50% of rubella infections can be subclinical, meaning people get infected but have no noticeable symptoms. That means the transmission can happen under the radar.”
In 2004 the United States eliminated rubella as an endemic disease, which means there was no continuous local transmission under usual conditions.
Sommer said, “Rubella still exists in other parts of the world. So international travel, we’re a big hot spot for international travel. So there are areas where rubella is still more common. So globally, there are over 100 cases of congenital rubella syndrome each year. That’s the CRS. So especially in places with low vaccination coverage or weak public health infrastructure. But like we said, as for active cases, there are no large outbreaks of rubella in the US as of right now. But there is always a concern if you’re going to travel to these areas, or if these people from these areas come in to the United States, and you’re in an area that’s a highly tourist area, like Florida, we have a lot of tourists that come from all over the world. So just something to keep in the back of your mind.”
How do you diagnose rubella?
Sommer said, “If someone thinks they might have rubella, especially if they’re pregnant and they’re not sure of their vaccination status, doctors can run the urological tests, blood tests, to find out if you have antibodies to rubella, which usually in pregnancy, they do check to make sure that you’re vaccinated or that you have immunity. So IgM shows a recent infection, or an IgG will show immunity or exposure. Then sometimes they can use a PCR, that is the test used to see if you have rubella. So a pregnant person that is exposed and not sure of their immunity, they can usually get these tests, IgG means that it’s negative, and however, they might do some follow up testing. If infection is confirmed, there will be more monitoring during the pregnancy. Ultrasounds, counseling about the risks, about what could happen. Because, like I said, it can transfer to the newborn. And for newborns with congenital rubella, this is really interesting. It’s going to require supportive care, involve specialists like cardiology, ophthalmology, audiology, developmental services to make sure that there are no developmental delays. But this is interesting, infants that have CRS, so if they’re born because they were exposed during their time in the womb, they can shed the rubella virus for months, even up to a year in respiratory secretions and in urine. It takes care, especially if you’re around other children that are susceptible, either who have not yet been vaccinated, or who have chosen that they don’t want to do vaccinations. If you’re around a child with CRS, they can continually spread the virus. So something to think about.”
There’s no cure for rubella.
Sommer said, “The perspective in medicine, is there is no true cure. Well, there’s no true cure for rubella once you have it, but that goes for many, many, many things. There’s no cure for blood pressure, diabetes. We only have treatment. When we don’t have treatment, we turn to prevention. So there is no treatment for rubella, just what we can do is treat the symptoms in supportive care and that’s hydration, good hand hygiene, and if you have it, it’s contagious for a long time. So you kind of almost have to sequester yourself if you know you have it, to prevent the spread of the disease. We talk about how sometimes prevention can lead to eradication. Smallpox is the only human disease that has been eradicated worldwide. So rubella has been eliminated here in the US, but not globally. So something to think about. It can come back.”
What are the takeaways?
Sommer said, “So rubella is usually mild. Most people can, if you have it, the symptoms are mild. There’s no serious damage, there’s more serious consequences if it occurs during pregnancy. That’s really what the takeaway here is, if you have it as an adult or a child, it’s really mild symptoms, like a mild virus. The biggest concern here is pregnancy and what it could do to the unborn child. The US eliminated rubella. But the risk remains via people that travel, if you’re going to travel, or travel into this country, that come from areas where they do not have protection against rubella. Again, like I said, in medicine, where there’s no treatment, there’s prevention, is often the strongest tool that we have, because then once you have it, it’s just supportive care. There’s really no control. And the MMR vaccine, I know I said this isn’t a vaccine debate, it’s just to educate, but the MMR vaccine is an effective way to protect against the virus. There’s that saying in medicine, benefits outweigh the risk. There’s no 100% way to guarantee that you’re not going to have a problem with any medication that you take or a vaccine. But disease kills, I can tell you that.”
For more information, click here: https://www.keywestsurgicalgroup.com/