Rubella

Infection with Human Parvovirus B19 is the cause of “Fifth Disease”, one of the five common viral exanthems (the others are measles [rubeola], chicken pox, mumps, and German measles [rubella]). The disease is asymptomatic in about 20% of those infected. This means that one has the infection but shows no symptoms. The symptoms of Fifth Disease include fever, mild malaise, a “slapped-cheek” facial rash, a lace-like trunk rash, and arthritis-type joint pain most often felt in the hands. Since the disease is caused by a virus, there is no specific antibiotic-type treatment available for either mother or fetus. Infection with the disease usually provides lifelong immunity.

Discovered in 1975, this virus made the news when another sub-type of the virus was shown to cause stillbirth in dogs. In rare cases, the B19 type has been shown to be a factor in early and late human fetal deaths. Several studies have suggested that B19 infection is an infrequent cause of human miscarriage. And, fortunately, the risk of significant fetal infection or fetal death is low even in women known to be infected during pregnancy (about 10%).

If a pregnant woman has a known exposure to a person with Fifth Disease it is possible to draw blood and determine if antibodies indicating recent B19 infection are present. If the disease is suspected or confirmed in a pregnant woman, periodic ultrasounds may help detect an infected fetus. Fetuses who are infected and show signs of disease will often develop “hydrops”. The hydropic fetus shows signs of massive anemia, and this condition may be treated with intrauterine blood transfusion if the baby is too premature to deliver.

Fifth Disease is usually a childhood illness. Fifty percent (50%) of adults, including pregnant women, show immunity to the virus and are not at risk of infection. However, pregnant women who work around children are frequently exposed to children who have the disease. What is the risk to the fetus? If 50% of women are NOT imune and the rate of maternal infection after exposure is about 30%, the risk of maternal infection (if the woman’s immune status is unknown) is about 15%. The risk of serious fetal problems is only about 10% in pregnant women with confirmed infection. Thus, the overall risk of significant fetal problems due to parvovirus infection is about 1.5%

If a woman knows she has antibodies to the B19 virus, she and her baby are not at risk. If a pregnant woman shows evidence of infection during pregnancy, she should have periodic ultrasounds to look for signs of infection in the fetus (hydrops and intrauterine growth retardation).

Rubella
Rubella is the name of the virus which causes German measles, one of the five common viral diseases of childhood. Most American children have been immunized against German measles since the late 1960’s. Most immunizations give a person lifelong immunity. But there have been batches of the vaccine that were not completely effective and some individuals who have never received the vaccine. Immigrants from other countries may not be immunized. Anyone who does not have Rubella antibodies is a potential source of infection. Any pregnant woman who is not “Rubella immune” is susceptible to German measles.

What can you do if you are already pregnant and not immune? Unfortunately, not much, since the disease is often not recognized and is spread by the fine droplets that we cough, sneeze and breathe out. But if you know of anyone with a rash, flu-like symptoms or if you hear about an “outbreak”, avoid contact with any person or group of people who might have the disease.

If you are not pregnant now, but considering a pregnancy ANY TIME IN THE FUTURE, find out with certainty if you ever had the vaccine. OR, have your clinician draw a rubella screen on you. If you are not immune, GET THE VACCINE IMMEDIATELY…….to prevent you from having a baby affected by rubella or from passing the disease on to a pregnant woman.

When a woman is infected with the Rubella virus in the first few weeks of pregnancy, the virus may attack the developing nerves of the embryo’s head. Infection during this crucial developmental stage can cause blindness, hearing loss and other defects of the head, brain, and nervous system.

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