Rubella

Several factors may increase the likelihood of contracting rubella:

Lack of vaccination

• Unvaccinated children and adults—especially pregnant women—are more susceptible to rubella and its complications.

International travel

• Visiting regions where rubella is still widespread raises the risk of exposure.

Outbreaks or post-disaster regions

• Countries experiencing rubella outbreaks or recovering from natural disasters are at higher risk due to disrupted healthcare systems and vaccination efforts.

Close contact with infected individuals

• Being around someone who has rubella increases the chance of transmission due to the droplet-based spread.

Prompt identification of rubella is vital to controlling its spread. Diagnosis involves the following steps:

Clinical assessment

• Doctors often suspect rubella based on characteristic symptoms—especially the spotted rash starting from the face and spreading downward. Travel history and vaccination status can provide additional clues.

Laboratory tests

• IgM antibody: A positive IgM result indicates a recent infection. Levels are highest around day 14 and typically fade by day 30.
• IgG antibody: A significant rise in IgG levels between acute and recovery stages confirms rubella exposure.
• Cell culture: Rubella can be identified by isolating the virus from respiratory, blood, urine, or conjunctival samples.
• Biopsy: Giant cells in respiratory samples or tissues confirm infection.
• RT-PCR: This test detects rubella RNA and is highly sensitive—even in low-viral-load samples. Samples can be collected from serum or throat swabs.
• Urine analysis: Urine samples often contain detectable virus and can help confirm infection.

Specialist to Visit

People showing symptoms of rubella should consult a general physician for initial evaluation. If complications arise or if further evaluation is required, the doctor may refer to:

• Pediatrician: A specialist in child health who treats infections and developmental conditions.
• Infectious disease expert: A physician with specialized training in diagnosing and managing infectious conditions.

MMR Vaccine (Measles, Mumps, Rubella)

Vaccination is the most effective method to protect against rubella. You can receive either the MMR vaccine or the combined MMRV (which includes varicella). Booster doses may be necessary over time to maintain immunity.

People who should be vaccinated include:

• Those who have never had rubella.
• Children receiving their routine immunizations — the first MMR dose is recommended between 12–15 months of age, and a second dose 4 weeks later, usually by age 4–6 years.
• Individuals unsure of their immunization history.

In Special Situations

Under certain conditions, such as during an outbreak, exposure to the virus, or travel to areas where rubella is prevalent, children older than 6 months can be given an early dose of the MMR vaccine.

Isolation

To curb the spread of rubella, infected individuals should be kept away from others during their infectious period, which can range from several days to weeks, until it is safe to resume normal contact.

Hygiene Measures

Maintaining good personal hygiene is crucial. Preventive steps include:

• Avoid touching your face, especially the nose and mouth.
• Use a tissue while sneezing or coughing.
• Regularly sanitize your hands.

There is no specific antiviral treatment for rubella, as it typically resolves on its own within a week to ten days. To minimize the spread, avoid contact with pregnant women, immunocompromised individuals, and children. It's recommended to stay home for at least 4 days after the rash appears.

Management mainly involves easing symptoms while the body fights the virus:

Managing Fever and Pain

• Medications such as paracetamol or ibuprofen can help lower fever and alleviate discomfort. Liquid formulations are suitable for children.

Staying Hydrated

• Increased fluid intake is essential, particularly if the patient has a fever, to prevent dehydration.

Eye Care

• If eyes are irritated, gently clean the eyelids and reduce light exposure by dimming the room or closing curtains.

Relieving Cold Symptoms

• Warm drinks (honey-infused for those over one year old) and steam inhalation can ease congestion and soothe a sore throat or cough.

Handling Severe Illness

• If symptoms worsen — such as shortness of breath, seizures, or sharp chest pain — medical attention should be sought immediately.

Use of Immunoglobulins

• Immunoglobulins are not routinely used to prevent rubella post-exposure. However, in rare instances — such as when a pregnant woman is exposed and refuses termination — they may be administered within 72 hours to potentially reduce the risk, though they do not guarantee prevention.

Common Effects

Joint pain and swelling — particularly polyarthritis and polyarthralgia — are frequent in adolescents and adult women, affecting up to 70%.

Serious Risks for Pregnant Women and Infants

Pregnancy-related rubella infections carry a high risk of miscarriage, stillbirth, or severe congenital defects. Infants may develop congenital rubella syndrome (CRS), which can result in heart issues, sensory impairments, and organ damage.

Rare Complications

Less common but severe conditions linked to rubella include:

• Thrombocytopenia: A drop in platelet count, affecting blood clotting.
• Hemolytic Anemia: Premature destruction of red blood cells.
• Myocarditis: Inflammation of the heart muscle, impairing function.
• Pericarditis: Swelling of the heart's outer lining, often causing chest pain.
• Hepatitis: Liver inflammation affecting function and metabolism.
• Orchitis: Swelling and pain in the testicles.
• Retinopathy: Damage to the retina, leading to vision problems.
• Uveitis: Inflammation of the eye’s middle layer.
• Guillain-Barré Syndrome: A rare autoimmune disorder attacking nerves.
• Post-infectious Encephalitis: Brain inflammation caused by an abnormal immune response after infection.

Dietary Changes

• Aim to drink at least 8 glasses of water every day.
• Steer clear of processed foods like white sugar, white bread, and refined pasta.
• Choose healthier cooking oils such as olive oil, ghee, or coconut oil.
• Cut back on foods high in trans fats, often found in packaged snacks like cakes, biscuits, and fried namkeens.
• Reduce consumption of caffeinated drinks such as coffee.
• Avoid alcohol and refrain from using tobacco products.

Nutritional Supplements

• A daily multivitamin that includes antioxidants and key nutrients like vitamins A, B, C, and E, along with minerals like calcium, magnesium, zinc, and selenium, can support recovery.
• Omega-3 fatty acids from fish oil or flaxseed oil can help reduce inflammation and boost immune function.
• Probiotics can be taken to promote gut health and support the immune system.

Certain home treatments may help manage rubella symptoms:

1. Aloe Vera: Applying the gel can help reduce inflammation and soothe skin irritation.
2. Neem Leaves: With antibacterial and anti-itch properties, neem paste applied to rashes can offer relief.
3. Licorice Root: Used in herbal teas, it may help ease rubella-related cough.
4. Baking Soda: Adding it to bathwater may relieve itchy skin.
5. Coconut Water: Hydrating and detoxifying, it supports recovery and fluid balance.
6. Turmeric: Known for its healing properties, turmeric mixed with hot water and honey can ease discomfort.
7. Green Tea: A caffeine-free variety offers antioxidant and immune-boosting benefits.

There’s no specialized treatment at home for rubella, but proper care, medication when needed, and certain precautions can help manage the condition as it runs its course.

• Resting adequately is essential.
• Taking a sponge bath may ease fever-related discomfort.
• Stay well-hydrated by drinking plenty of fluids.
• Use over-the-counter pain relievers like acetaminophen to manage pain.
• For rash-related itching, applying witch hazel or taking an oatmeal bath can provide relief.
• Stay in touch with a healthcare provider for any queries or concerns about the illness.
• Manage stress levels to aid recovery.
• Ensure you get enough sleep.