What is German measles - Rubella?
A health article about German measles Rubella from Your Health Online the A to Z directory of dealing with Health Problems & nutritional Self Care Strategies
Measles, a highly infectious disease, is very common in childhood. It is so common at this stage
of life that nearly all children everywhere in the world go through this brief period of red spots.
The disease appears in epidemic form, often in the winter season.
Measles is an infection caused by a virus, which causes an illness displaying a characteristic skin rash known as an exanthem. Measles is also sometimes called rubeola, 5-day measles, or hard measles.
Rubella is also called German measles
Measles infections appear all over the world. Prior to the current effective immunization program, large-scale measles outbreaks occurred on a two to three-year cycle, usually in the winter and spring. Smaller outbreaks occurred during the off-years.
Babies up to about eight months of age are usually protected from contracting measles, due to immune cells they receive from their mothers in the uterus. Once someone has had measles infection, he or she can never get it again.
Signs & Symptoms of German measles Rubella
The first symptoms which appear during 7 to 14 days after exposure to the virus are
feverishness, cold, watering of the eyes and dry cough.
Rashes appear on the skin in three to
five days after the onset of these symptoms. These rashes, which consist of small rounded spots
with reddened skin in between, initially appear on the sides of the face and the neck and then
gradually spread all over the body, appearing last on the extremities. Initially pink in colour,
these rashes grow darker as time passes.
Measles is usually accompanied with slight fever and diarrhoea. In rare cases of great severity,
high fever and delirium may occur. Complication which can arise from this disease include
pneumonia, bronchitis, and ear abscess. One serious but rare complication is the inflammation
of the brain.
The first signs of measles infection are fever, extremely runny nose, red, runny eyes, and a cough. A few days later, a rash appears in the mouth, particularly on the mucous membrane which lines the cheeks. This rash consists of tiny white dots (like grains of salt or sand) on a reddish bump. These are called Koplik's spots, and are unique to measles infection. The throat becomes red, swollen, and sore.
A couple of days after the appearance of the Koplik's spots, the measles rash begins. It appears in a characteristic progression, from the head, face, and neck, to the trunk, then abdomen, and next out along the arms and legs.
The rash starts out as flat, red patches, but eventually develops some bumps. The rash may be somewhat itchy. When the rash begins to appear, the fever usually climbs higher, sometimes reaching as high as 105°F (40.5°C).
There may be nausea, vomiting, diarrhea, and multiple swollen lymph nodes. The cough is usually more problematic at this point, and the patient feels awful. The rash usually lasts about five days. As it fades, it turns a brownish color, and eventually the affected skin becomes dry and flaky.
Types of German measles Rubella
Rubella is a highly contagious viral disease, spread through contact with discharges from the nose and throat of an infected person. Although rubella causes only mild symptoms of low fever, swollen glands, joint pain, and a fine red rash in most children and adults, it can have severe complications for women in their first trimester of pregnancy. These complications include severe birth defects or death of the fetus.
Rubella is also called German measles or three-day measles. This disease was once a common childhood illness, but its occurrence has been drastically reduced since vaccine against rubella became available in 1969. In the 20 years following the introduction of the vaccine, reported rubella cases dropped 99.6%. Only 229 cases of rubella were reported in the United States in 1996.
Rubella is spread through contact with fluid droplets expelled from the nose or throat of an infected person. A person infected with the rubella virus is contagious for about seven days before any symptoms appear and continues to be able to spread the disease for about four days after the appearance of symptoms. Rubella has an incubation period of 12-23 days.
Although rubella is generally considered a childhood illness, people of any age who have not been vaccinated or previously caught the disease can become infected. Having rubella once or being immunized against rubella normally gives lifetime immunity. This is why vaccination is so effective in reducing the number of rubella cases.
Women of childbearing age who do not have immunity against rubella should be the most concerned about getting the disease. Rubella infection during the first three months of pregnancy can cause a woman to miscarry or cause her baby to be born with birth defects.
Although it has been practically eradicated in the United States, rubella is still common in less developed countries because of poor immunization penetration, creating a risk to susceptible travelers. Some countries have chosen to target rubella vaccination to females only and outbreaks in foreign-born males have occurred on cruise ships and at U.S. summer camps.
What Causes German measles Rubella?
Measles is one of the most contagious diseases, caused by a virus. The measles virus is so
infectious that in cities, children catch this disease before they reach the age of five years.
Mothers generally pass their antibodies to their children which immunize them passively.
protection, however, does not last beyond the six months. Measles is easily transmitted in the
early stages through the invisible droplets of moisture which are discharged from a patient’s
nose or mouth when he coughs or sneezes.
The real cause of this disease, like other diseases of childhood, is , however, wrong feed and
unhygienic living conditions. Measles is thus a natural healing crisis aimed at cleansing the
infant organism of the toxins and deleterious and products resulting from the assimilation of the
vast excess of starchy and sugary foods consumed by young children today.
Measles is caused by a type of virus called a paramyxovirus. It is an extremely contagious infection, spread through the tiny droplets that may spray into the air when an individual carrying the virus sneezes or coughs. About 85% of those people exposed to the virus will become infected with it. About 95% of those people infected with the virus will develop the illness called measles.
Once someone is infected with the virus, it takes about 7-18 days before he or she actually becomes ill. The most contagious time period is the three to five days before symptoms begin through about four days after the characteristic measles rash has begun to appear.
Rubell is caused by the rubella virus (Rubivirus). Symptoms are generally mild, and complications are rare in anyone who is not pregnant.
The first visible sign of rubella is a fine red rash that begins on the face and rapidly moves downward to cover the whole body within 24 hours. The rash lasts about three days, which is why rubella is sometimes called the three-day measles.
A low fever and swollen glands, especially in the head (around the ears) and neck, often accompany the rash. Joint pain and sometimes joint swelling can occur, more often in women. It is quite common to get rubella and not show any symptoms (subclinical infection).
Symptoms disappear within three to four days, except for joint pain, which may linger for a week or two. Most people recover fully with no complications. However, severe complications may arise in the unborn children of women who get rubella during the first three months of their pregnancy. These babies may be miscarried or stillborn.
A high percentage are born with birth defects. Birth defects are reported to occur in 50% of women who contract the disease during the first month of pregnancy, 20% of those who contract it in the second month, and 10% of those who contract it in the third month.
The most common birth defects resulting from congenital rubella infection are eye defects such as cataracts, glaucoma, and blindness; deafness; congenital heart defects; and mental retardation. Taken together, these conditions are called congenital rubella syndrome (CRS). The risk of birth defects drops after the first trimester, and by the 20th week, there are rarely any complications.
Many patients (about 5-15%) develop other complications. Bacterial infections, such as ear infections, sinus infections, and pneumonia are common, especially in children. Other viral infections may also strike the patient, including croup, bronchitis, laryngitis, or viral pneumonia.
Inflammation of the liver, appendix, intestine, or lymph nodes within the abdomen may cause other complications. Rarely, inflammations of the heart or kidneys, a drop in platelet count (causing episodes of difficult-to-control bleeding), or reactivation of an old tuberculosis infection can occur.
An extremely serious complication of measles infection is swelling of the brain. Called encephalitis, this can occur up to several weeks after the basic measles symptoms have resolved.
About one out of every thousand patients develops this complication, and about 10-15% of these patients die. Symptoms include fever, headache, sleepiness, seizures, and coma. Long-term problems following recovery from measles encephalitis may include seizures and mental retardation.
A very rare complication of measles can occur up to 10 years following the initial infection. Called subacute sclerosing panencephalitis, this is a slowly progressing, smoldering swelling and destruction of the entire brain.
It is most common among people who had measles infection prior to the age of two years. Symptoms include changes in personality, decreased intelligence with accompanying school problems, decreased coordination, involuntary jerks and movements of the body.
The disease progresses so that the individual becomes increasingly dependent, ultimately becoming bedridden and unaware of his or her surroundings. Blindness may develop, and the temperature may spike (rise rapidly) and fall unpredictably as the brain structures responsible for temperature regulation are affected. Death is inevitable.
Measles during pregnancy is a serious disease, leading to increased risk of a miscarriage or stillbirth. In addition, the mother's illness may progress to pneumonia.
Measles is a highly preventable infection. A very effective vaccine exists, made of live measles viruses which have been treated so that they cannot cause actual infection. The important markers on the viruses are intact, however, which causes an individual's immune system to react. Immune cells called antibodies are produced, which in the event of a future infection with measles virus will quickly recognize the organism, and kill it off.
Measles vaccines are usually given at about 15 months of age; because prior to that age, the baby's immune system is not mature enough to initiate a reaction strong enough to insure long-term protection from the virus. A repeat injection should be given at about 10 or 11 years of age. Outbreaks on college campuses have occurred among unimmunized or incorrectly immunized students.
Measles vaccine should not be given to a pregnant woman, however, in spite of the seriousness of gestational measles. The reason for not giving this particular vaccine during pregnancy is the risk of transmitting measles to the unborn child.
Surprisingly, new cases of measles began being reported in some countries-including Great Britain-in 2001 because of parents' fears about vaccine safety. The combined vaccine for measles, mumps, and rubella (MMR) was claimed to cause autism or bowel disorders in some children. However, the World Health Organization (WHO) says there is no scientific merit to these claims.
The United Nations expressed concern that unwarranted fear of the vaccine would begin spreading the disease in developing countries, and ultimately in developed countries as well. Parents in Britain began demanding the measles vaccine as a separate dose and scientists were exploring that option as an alternative to the combined MMR vaccine.
Unfortunately, several children died during an outbreak of measles in Dublin because they had not received the vaccine. Child mortality due to measles is considered largely preventable, and making the MMR vaccine widely available in developing countries is part of WHO's strategy to reduce child mortality by two-thirds by the year 2015.
Vaccination is the best way to prevent rubella and is normally required by law for children entering school. Rubella vaccine is usually given in conjunction with measles and mumps vaccines in a shot referred to as MMR (mumps, measles, and rubella). Children receive one dose of MMR vaccine at 12-15 months and another dose at four to six years.
Pregnant women should not be vaccinated, and women who are not pregnant should avoid conceiving for at least three months following vaccination. To date, however, accidental rubella vaccinations during pregnancy have not clearly been associated with the same risk as the natural infection itself.
Women may be vaccinated while they are breastfeeding. People whose immune systems are compromised, either by the use of drugs such as steroids or by disease, should discuss possible complications with their doctor before being vaccinated.
When to seek Medical Advice:
Measles infection is almost always diagnosed based on its characteristic symptoms, including Koplik's spots, and a rash which spreads from central body structures out towards the arms and legs. If there is any doubt as to the diagnosis, then a specimen of body fluids (mucus, urine) can be collected and combined with fluorescent-tagged measles virus antibodies.
Antibodies are produced by the body's immune cells that can recognize and bind to markers (antigens) on the outside of specific organisms, in this case the measles virus. Once the fluorescent antibodies have attached themselves to the measles antigens in the specimen, the specimen can be viewed under a special microscope to verify the presence of measles virus.
The rash caused by the rubella virus and the accompanying symptoms are so similar to other viral infections that it is impossible for a physician to make a confirmed diagnosis on visual examination alone. The only sure way to confirm a case of rubella is by isolating the virus with a blood test or in a laboratory culture.
A blood test is done to check for rubella antibodies. When the body is infected with the rubella virus, it produces both immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to fight the infection. Once IgG exists, it persists for a lifetime, but the special IgM antibody usually wanes over six months.
A blood test can be used either to confirm a recent infection (IgG and IgM) or determine whether a person has immunity to rubella (IgG only). The lack of antibodies indicates that a person is susceptible to rubella.
All pregnant women should be tested for rubella early in pregnancy, whether or not they have a history of vaccination. If the woman lacks immunity, she is counseled to avoid anyone with the disease and to be vaccinated after giving birth.
Because measles is caused by a virus, it cannot be treated by antibiotics. And, like most viral illnesses, a measles infection (in most cases) can simply be left to run its course.
There are no treatments available to stop measles infection. Treatment is primarily aimed at helping the patient to be as comfortable as possible, and watching carefully so that antibiotics can be started promptly if a bacterial infection develops. Fever and discomfort can be treated with acetaminophen.
Children with measles should never be given aspirin, as this has caused the fatal disease Reye's syndrome in the past. A cool-mist vaporizer may help decrease the cough. Patients should be given a lot of liquids to drink, in order to avoid dehydration from the fever.
Some studies have shown that children with measles encephalitis benefit from relatively large doses of vitamin A.
Botanical immune enhancement (with echinacea, for example) can assist the body in working through this viral infection. Homeopathic support also can be effective throughout the course of the illness. Some specific alternative treatments to soothe patients with measles include the Chinese herbs bupleurum (Bupleurum chinense) and peppermint (Mentha piperita), as well as a preparation made from empty cicada (Cryptotympana atrata) shells. The itchiness of the rash can be relieved with witch hazel (Hamamelis virginiana), chickweed (Stellaria media), or oatmeal baths. The eyes can be soothed with an eyewash made from the herb eyebright (Euphrasia officinalis). Practitioners of ayurvedic medicine recommend ginger or clove tea.
The prognosis for an otherwise healthy, well-nourished child who contracts measles is usually quite good. In developing countries, however, death rates may reach 15-25%. Adolescents and adults usually have a more difficult course. Women who contract the disease while pregnant may give birth to a baby with hearing impairment.
Although only 1 in 1,000 patients with measles will develop encephalitis, 10-15% of those who do will die, and about another 25% will be left with permanent brain damage.
There is no drug treatment for rubella. Bed rest, fluids, and acetaminophen for pain and temperatures over 102°F (38.9°C) are usually all that is necessary.
Babies born with suspected CRS are isolated and cared for only by people who are sure they are immune to rubella. Congenital heart defects are treated with surgery.
Rather than vaccinating a healthy child against rubella, many alternative practitioners recommend allowing the child to contract the disease naturally at the age of five or six years, since the immunity conferred by contracting the disease naturally lasts a lifetime. It is, however, difficult for a child to contract rubella naturally when everyone around him or her has been vaccinated.
Ayurvedic practitioners recommend making the patient comfortable and giving the patient ginger or clove tea to hasten the progress of the disease. Traditional Chinese medicine uses a similar approach. Believing that inducing the skin rash associated with rubella hastens the progress of the disease, traditional Chinese practitioners prescribe herbs such as peppermint (Mentha piperita) and chai-hu (Bupleurum chinense). Cicada is often prescribed as well.
Western herbal remedies may be used to alleviate rubella symptoms. Distilled witch hazel (Hamamelis virginiana) helps calm the itching associated with the skin rash and an eyewash made from a filtered diffusion of eyebright (Euphrasia officinalis) can relieve eye discomfort. Antiviral western herbal or Chinese remedies can be used to assist the immune system in establishing equilibrium during the healing process. Depending on the patient's symptoms, among the remedies a homeopath may prescribe are Belladonna,Pulsatilla, or Phytolacca.
Complications from rubella infection are rare in children, pregnant women past the 20th week of pregnancy, and other adults. For women in the first trimester of pregnancy, there is a high likelihood of the child being born with one or more birth defect.
Unborn children exposed to rubella early in pregnancy are also more likely to be miscarried, stillborn, or have a low birthweight. Although the symptoms of rubella pass quickly for the mother, the consequences to the unborn child can last a lifetime.
Self Care strategies for Living with German measles Rubella
In many cases, measles treatment simply involves treatment of the symptoms, with paracetamol, regular rinsing of the mouth, and plenty of fluids to drink.
If you suspect that your child has measles, contact your child's doctor. Close contact with your doctor will let you monitor your child's progress and will help identify the onset of any complications.
At home, it is important to regularly monitor the sufferer's progress and check for the onset of any complications before they have a chance to become serious or life threatening. The sufferer's temperature should be monitored, and a written record should be kept of the readings, dates, and times. If the temperature climbs above 103 degrees Fahrenheit (39.4 degrees Celsius), seek medical advice.
It is also beneficial and safe to use acetaminophen, ibuprofen, and other medications to bring down a fever.
WARNING: DO NOT USE ASPIRIN. Unless instructed by your child's doctor, don't give aspirin to a child who has a viral illness, as the use of aspirin in such cases has been associated with the development of Reyes Syndrome, a serious and potentially deadly encephalitis-like illness. Instead, use acetaminophen and ibuprofen.
As with most viral diseases, there is no specific antiviral therapy, and the basic treatment consists of providing necessary supportive therapy to control the symptoms and make the sufferer as comfortable as possible. Encourage your child to drink clear fluids: water, fruit juice, tea, and lemonade.
Fluids help the body replace water lost during the heat and sweating of fever episodes. Fluids also reduce lung infections (pneumonia) because they reduce the viscosity of lung secretions, stopping them from clogging breathing passages.
A cool-mist vaporizer will help relieve the cough and soothe the breathing passages. To avoid the formation of mold, clean the vaporizer daily. Avoid hot-water and steam vaporizers because they can cause accidental burns or scalds to children.
Vitamin A supplements are believed to improve the outcome of measles if the patient is deficient in it.
Children with measles should rest and avoid TV, busy activities, bright lights, and reading. It is usually safe for children to return to school 7 to 10 days after the fever and rash have subsided.
If a person's immune system is weakened by measles, they will be more susceptible to other bacterial infections, especially in the ears and lungs. When this happens, antibiotics should be obtained to control secondary bacterial infections.
People who have a measles rash and fever are infectious and should minimize the risk contact with other people to reduce the chances of spreading the disease to others who may be susceptible to measles.
Even in developed countries, where vaccination programs are common, there are misinformed people who refuse vaccination for themselves and/or their children. To protect these people, and visitors to your area from other countries who have not been vaccinated, contact should be limited until a medical diagnosis has been established excluding measles, or the symptoms resolve completely, or 7-10 days after the fever and rash have subsided.
Persons who are potentially infectious with measles should avoid public transport (including commercial airlines) and crowded indoor areas.
Before visiting a clinic or hospital, people who suspect they may have measles should call ahead before so that arrangements may be made to minimize the exposure of others to measles.
Diet change strategies:
Using Ayurveda Therapy:
In the beginning of the treatment, the patient should be given juices of fresh fruits like orange
and lemon frequently. This is sufficient as the child suffers from lack of appetite during this
He should be kept in a well ventilated room. As light has a detrimental effect upon the
eyes during measles, because of the weakened condition of the external eye tissues, the child
should have his eyes shaded or the room should have subdued light.
The treatment should aim at bringing down the temperature and eliminating the toxins from the
system. This can be achieved by administration of warm water enema every morning,
application of mud packs on the abdomen twice a day in the morning and evening and repeated
application of chest packs. Lukewarm water baths can be given every day to ease itching.
Addition of extracts of neem leaves to this water will prove beneficial.
As the condition improves, the child can be placed on an all fruit diet for a further few days.
Thereafter he may be allowed to gradually embark upon a well-balanced diet.
Certain home remedies have been found beneficial in the treatment of measles. The most
valuable amongst these is the use of orange. When the digestive power of the body is seriously
hampered, the patient suffers from intense toxaemia and the lack of saliva coats his tongue and
often destroys his thrust for water as well as his desire for food.
The agreeable flavour of orange
juice helps greatly in overcoming these drawbacks. Orange juice is the most ideal liquid food in
The juice of lemon is another remedy. It also makes an effective thirst-quenching drink in
measles. About 15 to 25 ml. of lemon juice , should be taken diluted with water for this purpose.
Turmeric (haldi) is beneficial in the treatment of measles.
Raw roots of turmeric should be dried
in the sun and ground to a fine powder. This powder, mixed with a few drops of honey and the
juice of a few bitter gourd leaves , should be given to the patient suffering from measles.
Powdered liquorice (mulethi) has been found valuable in relieving the cough, typical of measles.
The child patient should be given this powdered liquorice mixed with honey.
The use of barley ( Jau) water has proved beneficial in case of troublesome cough in measles.
This water should be taken frequently sweetened with the newly drawn oil of sweet almonds.
The seeds of eggplant ( baingan ) are stimulant. According to Dr. Sanyal of Calcutta, intake of
half a gram to one gram of these seeds daily for three days will help develop immunity against
measles for one year.
Children having measles should not be allowed to mixed with others. They should be given
complete rest. Hygienic condition along with the above mentioned treatment will lead to speed
recovery. Medications should be strictly avoided.
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