health talk:with Dr Johannes Marisa
A lot of people seem unaware about rubella, a contagious viral infection best known by its distinctive red rash. Lately in Zimbabwe from September 23 to 27, children were getting vaccinated for rubella and measles and that was a national programme coordinated by the Health and Child Care ministry. This was recommended after the World Health Organisation reported outbreaks of measles and rubella. While some parents appreciated the move by government, other sceptical parents abstained from the vaccination campaign citing numerous reasons, including inept myths, religious beliefs and so forth. Everyone ought to appreciate what rubella is all about.
What is rubella?
This is called German measles and is not the same as measles though the two do share some characteristics. The causative viruses are completely different. The virus can pass through the placenta. In around half of rubella cases, there are few symptoms which include a rash, a runny nose, headache and fever.
Symptoms of rubella
Symptoms of rubella may be very mild and difficult to notice. Symptoms may appear between two to three weeks after exposure to the virus. They typically last about one to five days and they include:
lA fine pink rash that begins on the face and quickly spreads to the trunk and then arms and legs before disappearing in the same sequence.
lEnlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears.
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lSwollen, red eyes.
lStuffy or runny nose.
lMild fever.
lAching joints, especially in young women.
Transmission of rubella
lA person with rubella is contagious for one to two weeks before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before a patient realises that he/she has it. This calls for isolation of suspected cases. Do not send your child to school with fresh, reddish and fine rash you suspect to be rubella or measles. The chances of transmitting to other pupils will be very high with contact.
lThe cause of rubella is a virus that is passed from person to person. This can occur when an infected person coughs or sneezes. It can also occur by direct contact with an infected person’s respiratory secretions, such as mucus. This, therefore, calls for advanced hygiene when dealing with suspected cases.
lTransmission can also occur from pregnant mothers to the unborn babies via the placenta. This calls for rubella screening and precautionary measures during pregnancy.
lThe rate of transmission of the virus is very low with vaccination against the infection at an early age. This is what the government is doing.
Complications
The most worrisome complications come when pregnant women contract rubella. Up to 80% of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This is a very serious syndrome, therefore, those planning to be pregnant ought to have immunity to rubella.
Below are some of the complications:
lMiscarriages
lGrowth retardation
lDeafness
lCongenital heart defects
lIntellectual disabilities
lCataracts
NB**Mothers can get rubella vaccination at least a month before they get pregnant. This gives them protection in case of susceptibility during pregnancy. The highest risk to the foetus is during the first trimester. If you contract rubella during pregnancy, discuss the risk with your doctor. If you wish to continue with your pregnancy, you may get antibodies called Hyperimmune Globulin that can fight off the infection.
Who then should get rubella vaccine?
lNon-pregnant woman of child-bearing age.
lThose attending colleges or universities.
lThose working in medical facilities, schools, hospitals or child care centres.
lThose who are planning to travel overseas.
lThe young ones below six years. It is recommended that children receive the rubella vaccine through the mumps-mumps-rubella (MMR) combined vaccine between 12 and 15 months and again between four and six years of age.
Diagnosis
The rubella rash looks like many other viral rashes, so diagnosis is done with the assistance of laboratory tests. A virus culture or a blood test is done to detect the presence of different types of rubella antibodies. These antibodies indicate whether you had a recent or past infection.
Let us be alert about rubella. Tell others about it and the dangers that are associated with it especially during pregnancy. Do not run away from vaccination centres. Take your kids as well for vaccination. Preserve the future generation of young girls when they fall pregnant later!
Till we meet again next week.
lJohannes Marisa is a private practitioner who can be accessed on [email protected].
