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Rubella (also known as epidemic roseola, German measles or three-day measles) is a disease caused by the Rubella virus. It is often mild and an attack can pass unnoticed. However, this can make the virus difficult to diagnose. more...

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Rumination disorder

The virus usually enters the body through the nose or throat. The disease can last 1-5 days. Children recover more quickly than adults. Like most viruses living along the respiratory tract, it is passed from person to person by tiny droplets in the air that are breathed out. Rubella can also be transmitted from a mother to her developing baby through the bloodstream via the placenta. The virus has an incubation period of 2 to 3 weeks during which it becomes established.

The name German measles has nothing to do with Germany. It comes from the Latin germanus, meaning "similar", since rubella and measles share many symptoms.


Symptoms of rubella include:

  • swollen glands or lymph nodes (may persist for up to a week)
  • fever (rarely rises above 38 degrees Celsius )
  • rash (Appears on the face and then spreads to the trunk and limbs. It appears as pink dots under the skin. It appears on the first or third day of the illness but it disappears after a few days with no staining or peeling of the skin)
  • Forchheimer's sign occurs in 20% of cases, and is characterized by small, red papules on the area of the soft palate
  • flaking, dry skin
  • inflammation of the eyes
  • nasal congestion
  • joint pain and swelling
  • pain in the testicles
  • loss of appetite
  • headache
  • nerves become weak or numb (very rare)


Rubella can affect anyone of any age and is generally a mild disease. However, rubella can cause congenital rubella syndrome in the fetus of an infected pregnant woman.

Prevention and treatment

Symptoms are usually treated with acetaminophen until the disease has run its course. There is no treatment available for congenital rubella.

Fewer cases of rubella occur since a vaccine became available in 1969, although decreased uptake of the MMR vaccine (e.g. in the UK) is expected to lead to a rise in incidence. In most Western countries, the vast majority of people are vaccinated against rubella as children at 12 to 15 months of age. A second dose is required before age 11. The vaccine gives lifelong protection against rubella. A side-effect of the vaccine can be transient arthritis.

The immunization program has been quite successful with Cuba declaring the disease eradicated in the 1990s and the United States eradicating it in 2005 . Every minister of health in the Americas plans to eliminate the disease by 2010.


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Is there a link between MMR vaccine and autism? - Tips from Other Journals - measles, mumps, and rubella vaccine - Abstract
From American Family Physician, 2/15/03 by Bill Zepf

Concern over a possible link between the measles, mumps, and rubella (MMR) vaccine and autism has led to a number of retrospective and prospective studies; however, none has confirmed an association. The World Health Organization and other groups have called for further investigations on a population-based scale, which would have more statistical power to detect a possible link. Madsen and colleagues present data from a retrospective cohort study of more than 500,000 children born in Denmark between 1991 and 1998.

The MMR vaccine was used in Denmark beginning in 1987, and the national vaccination program recommended that children be vaccinated at 15 months and 12 years of age. The MMR vaccine used in Denmark contained the same vaccine strains as the U.S. version. Vaccination data were obtained from the Danish National Board of Health, and diagnoses of autism were obtained from the Danish Psychiatric Central Register, which tracks all psychiatric treatment centers in Denmark.

Within a study cohort of 537,303 subjects, 440,655 children received the MMR vaccine. Follow-up data were lost for 5,028 children because of death or emigration during the study period. The mean age at the time of the first dose of MMR vaccine was 17 months, and 98.5 percent of those vaccinated received their first dose before three years of age. Among children who developed autism, the mean age at diagnosis was four years and three months, while other autistic-spectrum disorders were first diagnosed at a mean age of five years and three months.

No association was detected between MMR vaccination and the development of autism or other autism-spectrum disorders. The researchers also found no association between the development of autistic disorder and the age at vaccination, time elapsed since vaccination, or time of year the vaccination was performed. After adjusting for potential confounders, such as age, sex, calendar period, socioeconomic status, birth weight, gestational age at birth, and mother's education level, only age was found to have affected the study findings.

The authors conclude that in this population-based study no association was demonstrated between MMR vaccination and later development of autism.

COPYRIGHT 2003 American Academy of Family Physicians
COPYRIGHT 2003 Gale Group

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