RUBELLA (German Measles)

Rubella is a virus infection, spread by direct contact and possibly by fomites. There is no information available regarding the conveyance of infection by carriers. Infectivity appears to be limited to the prodromal and early eruptive stages of the illness.
Rubella is not a notifiable disease. The incubation period is usually from 14 to 18 days, but may vary from 13 to 21 days.
Preventive Treatment.—Rubella in the first three to four months of pregnancy may cause changes in the foetus and the baby may be born with congenital defects. The common abnormalities reported have been congenital cataracts, deafness and cardiac defects. Such infants may continue to excrete virus for some weeks after birth and constitute an unsuspected source of infection of contacts. This important fact must completely alter our outlook on this trivial disease. There is need to review the traditional measures in regard to quarantine, for, especially in girls, there is now every reason for encouraging infection in childhood. Unfortunately, it is hard to interfere with established practice and school authorities are slow to adopt this new principle. When a woman in the early months of pregnancy is exposed to the disease sero-prevention should be practised. Gamma-globulin has been prepared from rubella con­valescents and may be obtained from Blood Transfusion Centres. If not available, ordinary gamma-globulin is a satisfactory substitute, but must be given in high dosage, since rubella is not an infection which all adults have experienced. A dose of 10 to 15 ml. is desirable (which represents two to three ampoules of the usual material).
Curative Treatment.—Treatment is purely symptomatic. The patient should remain in bed until the temperature has subsided and the rash faded. The illness is usually so mild that the patient can be kept on an ordinary diet and no special treatment is required. Although complications are uncommon, attention should be drawn to the frequency of polyarthritis in adults. This often involves the small joints of the hands and feet and can be most disabling for two to three weeks. Complete recovery is invariable.