Rubella

MISSING IMAGE

Material Information

Title:
Rubella
Physical Description:
4 p. : ; 28 cm.
Language:
English
Creator:
Lin-Fu, Jane S
United States -- Children's Bureau
Publisher:
U.S. Dept. of Health, Education, and Welfare, Welfare Administration, Children's Bureau
Place of Publication:
Washington, D.C
Publication Date:

Subjects

Subjects / Keywords:
Rubella -- United States   ( lcsh )
Rubella in pregnancy -- United States   ( lcsh )
Communicable diseases -- United States   ( lcsh )
Genre:
federal government publication   ( marcgt )
non-fiction   ( marcgt )

Notes

Statement of Responsibility:
prepared by Jane S. Lin-Fu.
General Note:
Caption title.
General Note:
"August 1965."

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
aleph - 004956327
oclc - 52501838
System ID:
AA00008473:00001

Full Text







U.S.


/0


DEPARTMENT OF HEALTH,


EDUCATION,


AND WELFARE


Welfare Adminis


tration


g965


t 1965


RUBELL


Rubella,


referred


commonly


as the "three


known


as German mea


day measles,


occas


an infectious


ionally


disease


caused


a virus


plications are


1941,


when


Because


it is usually


common,


occurrence


this


a very mild


sease


receive


in pregnant women was


disease,
little
linked


and because


atte


to the


com-


nation until


development


congenital malformations


rubella


incidence
had the d


in Australia,


cataracts


sease


early


in their


. M. Gregg,


and other


in pr


egnancy.


babies.


an eye


anomalies


Following
specialis


in infants


Since thi


an epidemic


noticed


born


brilliant


a high


to mothers who


observation


the harmful


effect


of rubella on


fetuses


been well


established.


Thus,


a disease
nition as


hitherto


one of


considered
e greatest


as rather


threats


innocuous


suddenly


to pregnant women.


gained


Recently,


recog-


ru-


ella attracted attention


genital


abnormalities


born


because


to mothers


the large
infected


number


of babies with


in the nation-wide


con-


epidemic


which


started on


the East


Coast in 1963.


Although


with


some


commonly referred


frequency


in adole


as a childhood


scents


adults.


seas


incidence


rubella


amon


occurs
adults


higher


than


that


of measles


or chickenpox.


Like these


seases


single


almo


attack


st never


ally takes
val after


of spreading


provides


occurs.


from 2
exposure


the di


incubation period;


onset of
disease


symptoms.
is readily


takes place without


long


After


to 3 weeks f
is known as


sease
and he


even


lasting protection


a person


is exposed


or symptoms
the incubat
before he ha


remains


The difficulty


apparent,
anyone's


since


and a
to the


to develop.
ion period.


second
disea


infection


This sile
A person


any symptoms,


contagious for
of controlling


exposure


seve


ral days
spread


susceptible


gener-
inter-


is capable
in the


after


such


persons


often


knowledge.


Typically,


rubella


has a relatively mild


course.


In children,


appearance


parents.
and limbs


a rash may


The rash
, usually


starts
lasting


be the first sign


on the face and


about


days,


of the illne


spreads rapidly
hence the name "I


notic
down


ed by
the body


3-day measles.


It may


disappear


before


the third


day,


and occasionally,


rubella


occurs


~ *,







without


rash


resemble measles,


at all.
scarlet


appearance


fever,


roseola,


the rash


other viral


varies, a
diseases


such


the Echo


gy"
lymph
inent


virus


Low grade
glands b


part


oxsackie


fever


behind


the head


virus


is usually


infections


present


with


ears, in the neck,
generally precedes


an
the


rash


the rash.
d near th
onset of


caused


Swelling
ie posterior


Srash


aller-
of the
prom-


a few


several
but pain
a little


headache,


days.


At the


usually
longer.
loss o


beginning,


subsides


Other


in a


symptoms


appetite,


sore


these glands


or two,


such


throat,


are painful


while


as general


when


the swelling per


malaise


inflammation of


touched,


sists


ing,
are


or ill-be


eyes,


more


common


in adole


scents


and adults


than


in children.


Complications


have


been


Arthritis,


spots


reported
bleeding
blotches


of rubella,


with


increa


tendency


on the skin


though


less


frequency


generally


common
in the


evidenced


and encephalitis


than


recent
bluish


have all


in measles


epidemic.
or purplish


been


described.


when


mon


The importance
a pregnant woman
ths of pregnancy


of rubella
contracts t
is the most


lies in its damaging


he disease
dangerous


early i
period,


effect


n pregnancy.
but there i


on the fetus


The first
evidence


that


the fetus may


also


be affected


when


rubella


occurs


shortly


after


this


period.


There


nancy. it
in delivery


are several
terminate i
a stillborn


possible


outcomes


n spontaneous


baby,


a rubella-complicated


miscarriage,


in delivery


at full


or premature


term of


preg-


labor,


a malnour-


ished


baby,


or of


an affected


infant with


various


types


of anomalies,


in the


born


birth


after


a normal


a rubella-c


infant.


complicated


exact


incidence


pregnancy


of affected


known,


though


infants


i~ti.s


generally agr
From previous


eed


that


epidemics,


ie earlier the
it has been


infection,
estimated t


the higher


hat


about


the incidence.


10-20% of


infants


born
some


to mothers


kind


infected
with more


infected


of malformations.


the first


than


month


one anomaly,


in the first


3 months


e incidence
pregnancy.


are also


more


of pregnancy will


is much higher


Multiple


have


if the mother


anomalies


common when rubella


, i.e.,
occurs


infants
in the


first


2 months.


term


alies
horn


which may


"rubella


present,


syndrome"


either


refers
singly


to the


various


or in combination,


congenital


anom-


in infants


categories


loss


it is


not be








Anomalies
of which


of the Central
are abnormally


Nervous


small


size


System,


the most


of the head and


common
mental


retardation.


Following


the 1963-1964


rubella epidemic


in the


United


States,


many a
clouded


affected


infants were


in the rubella


born who


syndrome.


presented


These


features


usual


are:


Small
of the
infant


size


at birth


infants


born at


was reported
was reported.


despite a


have a


full


birth weight


term weighing


After


birth ma


as little
ny of the


term pregnancy.


below


as 2


pound
pounds


se infants


Many


ounces


gain


weight very poorly.


Bleeding
purplish


larly
number
in the


tendency,


spots


over


manifested


scattered


the face.


blood


process


platelets


of blood


over


in infants
the entire


as bluish


body,


associated with


-- a blood


element


particu-
decreased


essential


clotting.


Enlarged


liver


and spleen.


Jaundice.


Evidence


inflammation of


brain and


spinal


cord,


as indicated


a full


fontanel


and abnormal


spinal


fluid.


Lesions


which


involve


bones


of the limbs


(arms


and 1I


detectable


only


X-ray.


Infants


born of mothers


infect


ed with


rubella


during


pregnancy


apparently


weeks


are infected


thereafter,


in the throat,


thus


capable


with


even a


urine and


of spreading


feces


the virus al


year


-- rubella


of these


the infection,


At birth,
virus has


infants.
and there


These
have


and for several


been


detected


infants


been


are


reports


doctors


and nurses who


developed


rubella


after


caring


for them.


The diagnosis of
met with many pitfalls.


rubella


based


As mentioned


on symptoms
earlier, th


of the di


rubella


sease
rash


often


confused with


rashes


seen


in other


infectious


seases;


besid


there may


be no


rash


at all.


Swollen


tender


glands


in the locations


described above


cannot
called
parent


be used t
"subclini
symptoms.


are highly
o diagnose


.cal


suggest


tive


rubella with


infection"


A po


sitive


can take


diagno


rubella,


taken


certainty. Furthe
place with minimal


sis must


therefore


r


depen


alone,
more, so
or no ap-
d on either


isolation of


the rubella virus


from


the throat


or other


body


tissues


of the


patient,


or on blood


tests


Whil


isolation


of the virus proba-


indicates


a relatively recent


infection,


a single


positive


blood


- a A- -- -- A- -. .1 -. ....~ ~1


-1. -


- I I a





UNIVERSITY OF FLORIDA

3 11 262 01 1 57 159li I
3 1262 08857 1509


not,


doctors


make


two blood


tests.


Usually,


one blood


specimen


is taken


as soon as
as soon as


a person
symptoms


is exposed
suggestive


to rubella,
of rubella


or if


appear.


exposure i
A second


not known,
specimen is


taken
blood


two or more weeks


tests


indicates


later.


that


significant


the infection


difference


in the


recent.


Although


not yet


widely


available,


newly


developed


laboratory


techniques


have made


p055


ible


to obtain


the results


of blood


tests


within


several


hours


instead


two weeks


now


require


Unless


complications


occur,


rubella


rarely


requires


treatment.


Deliberate


exposure


of girls


to rubella


before


they


reach


the childbear-


ing age
danger o
or other


has been


spreading


close


advocated


by many.


the infection


contacts


However,


through


this carries


these girls


with


it the


to their mothers


pregnant.


a woman


rubella
globulin
the infe


if it will


only
cause


been,


in early pregnancy,


as soon


action.


insure


suppress
damage


as possible.


Although


a normal
symptoms


in the infant.


or is thought


usually


to have


she is given an


This provides


it prevents


baby.
without


Many


been,


infected


injection


with
gamma


temporary protection against


German measles,


ome research
preventing


scientists


it is not


h suggests that it
the infection which


believe


that


known


may
can


convalescent


gamma g
disease


gamma


lobulin
and mucd


globulin


(prepared
h higher


prepared


from blood
in potency)
from other


a person
afford


convalescing


better


from


protection


the
than


sources.


During


possibly


of bearing
nancy. Bu


20,000


epidemics


deformed


a malformed


babies


child,


t for religious,


some


request


legal,


medical


st few ye
couples,


ars,


which


unwilling


and received
1 and other


have


to face


termination
reasons, suec


resulted


the risk
of preg-
h an act


be impos


sible


or not acceptable


a great many more


persons.


Although


to date


no effective


treatment


a pregnant woman


fected


with


born normal,


rubella


recently


early


pregnancy


the picture


can insure


ecame more


that


hopeful.


er baby will
The virus of


rubella
zation
to that
before
against


was isolated.
against the di


against mea


they reach
rubella.


That
sease.


sles


is the first


When


and polio


the childbearing


step


developed,
-- will be


age.


toward


such


use


developing


a vaccine


vaccinate


Thus they will


immune


-= similar


girls


safeguarded


Infants


born after a
ned at birth


pregnancy
for possi


complicated


rubella


should


be
Since


some
has


of
been


these