Rubella, also known as German measles, is a contagious viral infection that is generally mild but can have serious complications if contracted during pregnancy. It spreads through the air via coughing or sneezing. While children experience mild symptoms like rash and fever, infection during pregnancy can cause fetal death or congenital defects known as congenital rubella syndrome. There is no specific treatment, but vaccination provides effective prevention. Nepal introduced the rubella vaccine in 2013 and gives two doses to children at 9 and 15 months as part of routine immunization efforts to control the disease and prevent birth defects.

1. Rubella
By: Sudip Adhikari
BPH 4th semester

2. CONTENT:
 Introduction
 Epidemiology
 Mode of transmission
 Symptoms
 Congenital rubella syndrome (CRS)
 Immunization
 Prevention , Treatment and Control

3. Rubella ( German measles)
 Rubella is a contagious, generally mild viral
infection that occurs most often in children and
young adults.
 Rubella is the leading vaccine-preventable cause
of birth defects. Rubella infection in pregnant
women may cause fetal death or congenital
defects known as congenital rubella syndrome.

4.  There is no specific treatment for rubella
but the disease is preventable by
vaccination

5.  Studies in Nepal had estimated that in
the pre-vaccination era, more than a
1000 infants were born with CRS
every year in Nepal (annual incidence
rate ~192/100,000 live births)

6. Epidemiology:
Environment
factor
Agent
factor
Host
factor

7. Agent factor:
Caugative agent : Rubella virus
 ssRNA Virus of the Togaviridae
family

8. Host
Age:
 Mainly a disease of childhood.
 Usually affect children between 3 – 10
years.

9. Environmental factor:
Disease usually occur in seasonal
pattern, during late winter and spring.

10. Mode of transmission:
 The rubella virus is transmitted by
airborne droplets when infected people
sneeze or cough. Humans are the only
known host.
 It usually occur in seasonal pattern during
late winter and spring.

11. Symptoms :
 In children, the disease is usually mild, with
symptoms including a rash, low fever
(<39°C), nausea and mild conjunctivitis.
 The rash, which occurs in 50–80% of cases,
usually starts on the face and neck before
progressing down the body, and lasts 1–3
days

12.  Swollen lymph glands behind the ears
and in the neck are the most
characteristic clinical feature.
 Infected adults, more commonly women,
may develop arthritis and painful joints
that usually last from 3–10 days.

13.  Once a person is infected, the virus
spreads throughout the body in about 5-
7 days
 Symptoms usually appear 2 to 3 weeks
after exposure.
 The most infectious period is usually 1–5
days after the appearance of the rash.

14.  When a woman is infected with the
rubella virus early in pregnancy, she
has a 90% chance of passing the virus
on to her fetus. This can cause
miscarriage, stillbirth or severe birth
defects known as CRS.

15. Congenital rubella syndrome
Children with CRS can suffer hearing
impairments, eye and heart defects
and other lifelong disabilities, including
autism, diabetes mellitus and thyroid
dysfunction – many of which require
costly therapy, surgeries and other
expensive care.

16.  The highest risk of CRS is in countries
where women of childbearing age do not
have immunity to the disease (either
through vaccination or from having had
rubella). Before the introduction of the
vaccine, up to 4 babies in every 1000
live births were born with CRS.

17. Immunization:
 The NIP (National Immunization
Program) introduced Rubella vaccine in
2013 as measles-rubella (MR) vaccine.
 Since 2015, NIP delivers two doses of
MR vaccine to all children in Nepal at 9
and 15 months of age.

19. Prevention, Treatment and
Control:
 Rubella vaccine is given to children at 15
months of age as a part of the MMR
(measles-mumps-rubella) immunization.
 No specific treatment is available
 CRS can be by effective immunization of
the young children and teenage girls,
remains the best options to prevent
CRS.