Rubella: Difference between revisions

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==Prognosis==
Rubella infection of children and adults is usually mild, self-limiting and often asymptomatic. The prognosis in children born with CRS is poor.<ref name="pmid3288422">{{cite journal
|author=Freij BJ, South MA, Sever JL
|title=Maternal rubella and the congenital rubella syndrome
|journal=Clin Perinatol
|volume=15
|issue=2
|pages=247–57
|year=1988
|pmid=3288422
|doi=
}}</ref>
==Epidemiology==
==Epidemiology==
Rubella is a disease that occurs worldwide. The virus tends to peak during the spring in countries with temperate climates. Before the vaccine to rubella was introduced in 1969, widespread outbreaks usually occurred every 6-9 years in the United States and 3-5 years in Europe, mostly affecting children in the 5-9 year old age group.<ref name="pmid11798368">{{cite journal
Rubella is a disease that occurs worldwide. The virus tends to peak during the spring in countries with temperate climates. Before the vaccine to rubella was introduced in 1969, widespread outbreaks usually occurred every 6-9 years in the United States and 3-5 years in Europe, mostly affecting children in the 5-9 year old age group.<ref name="pmid11798368">{{cite journal

Revision as of 14:55, 9 February 2012

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Rubella
ICD-10 B06
ICD-9 056
DiseasesDB 11719
MedlinePlus 001574

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Epidemiology

Rubella is a disease that occurs worldwide. The virus tends to peak during the spring in countries with temperate climates. Before the vaccine to rubella was introduced in 1969, widespread outbreaks usually occurred every 6-9 years in the United States and 3-5 years in Europe, mostly affecting children in the 5-9 year old age group.[1] Since the introduction of vaccine, occurrences have become rare in those countries with high uptake rates. However, in the UK there remains a large population of men susceptible to rubella who have not been vaccinated. Outbreaks of rubella occurred amongst many young men in the UK in 1993 and in 1996 the infection was transmitted to pregnant women, many of whom were immigrants and were susceptible. Outbreaks still arise, usually in developing countries where the vaccine is not as accessible.[2]

During the epidemic in the US between 1962-1965, Rubella virus infections during pregnancy were estimated to have caused 30,000 still births and 20,000 children to be born impaired or disabled as a result of CRS.[3][4] Universal immunisation producing a high level of herd immunity is important in the control of epidemics of rubella.[5]

History

Rubella was first described in the mid-eighteenth century. Friedrich Hoffmann made the first clinical description of rubella in 1740,[6] which was confirmed by de Bergen in 1752 and Orlow in 1758.[7]

In 1814, George de Maton first suggested that it be considered a disease distinct from both measles and scarlet fever. All these physicians were German, and the disease was known as Rötheln (from the German name Röteln), hence the common name of "German measles". [8] Henry Veale, an English Royal Artillery surgeon, described an outbreak in India. He coined the name "rubella" (from the Latin, meaning "little red") in 1866.[6][9][10][11]

It was formally recognised as an individual entity in 1881, at the International Congress of Medicine in London.[12] In 1914, Alfred Fabian Hess theorised that rubella was caused by a virus, based on work with monkeys.[13] In 1938, Hiro and Tosaka confirmed this by passing the disease to children using filtered nasal washings from acute cases.[10]

In 1940, there was a widespread epidemic of rubella in Australia. Subsequently, ophthalmologist Norman McAllister Gregg found 78 cases of congenital cataracts in infants and 68 of them were born to mothers who had caught rubella in early pregnancy.[9][10] Gregg published an account, Congenital Cataract Following German Measles in the Mother, in 1941. He described a variety of problems now know as congenital rubella syndrome (CRS) and noticed that the earlier the mother was infected, the worse the damage was. The virus was isolated in tissue culture in 1962 by two separate groups led by physicians Parkman and Weller.[11][9]

There was a pandemic of rubella between 1962 and 1965, starting in Europe and spreading to the United States.[11] In the years 1964-65, the United States had an estimated 12.5 million rubella cases. This led to 11,000 miscarriages or therapeutic abortions and 20,000 cases of congenital rubella syndrome. Of these, 2,100 died as neonates, 12,000 were deaf, 3,580 were blind and 1,800 were mentally retarded. In New York alone, CRS affected 1% of all births [14]

In 1969 a live attenuated virus vaccine was licensed.[10] In the early 1970s, a triple vaccine containing attenuated measles, mumps and rubella (MMR) viruses was introduced.[11]

See also

References

  1. Reef SE, Frey TK, Theall K; et al. (2002). "The changing epidemiology of rubella in the 1990s: on the verge of elimination and new challenges for control and prevention". JAMA. 287 (4): 464–72. PMID 11798368.
  2. Reef S (2006). "Rubella mass campaigns". Curr. Top. Microbiol. Immunol. 304: 221–9. PMID 16989272.
  3. Plotkin SA (2001). "Rubella eradication". Vaccine. 19 (25–26): 3311–9. PMID 11348695.
  4. Cooper,L.Z. Congenital Rubella in the United States. 1975 In: Krugman,S Gershon,A (eds), Symposium on Infections Of the Fetus and Newborn Infant. New York, Alan R. Liss Inc.,p.1.
  5. Danovaro-Holliday MC, LeBaron CW, Allensworth C; et al. (2000). "A large rubella outbreak with spread from the workplace to the community". JAMA. 284 (21): 2733–9. PMID 11105178.
  6. 6.0 6.1 Ackerknecht, Erwin Heinz (1982). A short history of medicine. Baltimore: Johns Hopkins University Press. p. 129. ISBN 0-8018-2726-4.
  7. Wesselhoeft C (1949). "Rubella and congenital deformities". N. Engl. J. Med. 240 (7): 258–61. PMID 18109609.
  8. Best, J.M., Cooray, S., Banatvala J.E. Rubella in Topley and Wilson's Microbiology and Microbial Infections, Vol. 2, Virology, Chapter 45, p.960-92, ISBN 0 340 88562 9, 2005
  9. 9.0 9.1 9.2 Lee JY, Bowden DS (2000). "Rubella virus replication and links to teratogenicity". Clin. Microbiol. Rev. 13 (4): 571–87. PMID 11023958.
  10. 10.0 10.1 10.2 10.3 Atkinson W, Hamborsky J, McIntyre L, Wolfe S, eds. (2007). "Chapter 12. Rubella". Epidemiology and Prevention of Vaccine-Preventable Diseases. 10th ed. Centers for Disease Control and Prevention. Retrieved 2007-07-03. Unknown parameter |chapterURL= ignored (|chapterurl= suggested) (help)
  11. 11.0 11.1 11.2 11.3 "Chapter 11 - Rubella". Immunisation Handbook 2006. Ministry of Health, Wellington, NZ. 2006. ISBN 0-478-29926-5. Retrieved 2007-07-03. Unknown parameter |month= ignored (help); Unknown parameter |chapterURL= ignored (|chapterurl= suggested) (help)
  12. Smith, J. L. Contributions to the study of Rötheln. Trans. Int. Med. Congr. Phil. 4,14. 1881
  13. Hess, Alfred Fabian (1914). "German measles (rubella): an experimental study". The Archives of Internal Medicine. Chicago. 13: 913–916. as cited by Enersen, Ole Daniel. "Alfred Fabian Hess". WhoNamedIt. Retrieved 2007-07-03.
  14. J.B. Hanshaw, J.A. Dudgeon, and W.C. Marshall. Viral diseases of the fetus and newborn. W.B. Saunders Co., Philadelphia, 1985

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