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The rubella virus is a genetically stable enveloped RNA virus from the Togaviridae family and is assigned to the genus Rubivirus.
Vaccination against the virus is possible, which is why, according to the World Health Organization (WHO), the number of infections fell by 660,000 to 10,000 cases worldwide between 2000 and 2016. Where the virus is not vaccinated, 80 to 90 per cent of infections occur during childhood. The regions most affected are Southeast Asia and Africa.
The only known natural reservoir for the rubella virus is humans.
The transmission of rubella viruses occurs aerogenically (via the air) through droplet infection. It can also be transmitted to the unborn child during pregnancy if the mother has the disease.
Commonly called “German measles” – because 19th century German researchers distinguished the disease from measles – rubella usually only has mild symptoms. These include headaches, raised body temperature, conjunctivitis and inflammation of the mucous membranes of the upper airways. In addition, a rash appears that spreads from the face over the body, then disappears after one to three days. In children, often only the rash appears, while in adults, other symptoms occur more severely.
However, if an unborn child becomes infected via the mother’s placenta, severe damage to the foetus can occur. Especially in the first twelve weeks of pregnancy, the risk of this is very high, but decreases significantly afterwards. The possible complications are defects of the heart, eyes and ears. An infection in the first four months of pregnancy can also lead to miscarriage or premature birth.
For inpatients, it is recommended to stay in an isolation room, and that staff use the following hygiene measures: Hand disinfection, surface disinfection, disposable gloves, disposable gowns and mouth and nose protection. According to the US Centers for Disease Control and Prevention (CDC) patients with rubella should be isolated for seven days after they develop a rash. In settings where pregnant women may be exposed, outbreak control measures should begin as soon as rubella is suspected and should not be postponed until laboratory confirmation of cases.
People at risk who cannot readily provide acceptable evidence of rubella immunity should be considered susceptible and should be vaccinated. People without evidence of immunity who are exempt from rubella vaccination for medical, religious, or other reasons should be excluded from affected institutions in the outbreak area until 23 days after the latest onset of rash from rubella.
Unvaccinated people who receive MMR vaccine as part of rubella outbreak control may immediately return to school, provided that all people without documentation of rubella immunity have been excluded.
The required spectrum of activity against rubella viruses is: limited virucidal
