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Rubella

Category: Illness or disabilities

Type

Involuntary

Introduction and description

 

Rubella is also known as German measles or three-day measles.

It is a disease caused by the rubella virus. The name "rubella" was derived from Latin, meaning little red. Rubella is also known as German measles because the disease was first described by German physicians in the mid-eighteenth century. This disease is often mild and attacks often pass unnoticed. The disease can last one to three days. Children recover more quickly than adults.

Infection of the mother by rubella virus during pregnancy can be serious; if the mother is infected within the first 20 weeks of pregnancy, the child may be born with congenital rubella syndrome (CRS), which entails a range of serious incurable illnesses including cardiac, cerebral, ophthalmic and auditory defects.

Miscarriage occurs in up to 20% of these cases. 

There was a pandemic of rubella between 1962 and 1965, starting in Europe and spreading to the United States. In the years 1964–65, the United States had an estimated 12.5 million rubella cases. This led to 11,000 miscarriages or therapeutic abortions and 20,000 cases of congenital rubella syndrome. Of these, 2,100 died as neonates, 12,000 were deaf, 3,580 were blind, and 1,800 were mentally retarded. In New York alone, CRS affected 1% of all births.

Transmission

 

Rubella is usually spread through the air via coughs of people who are infected.

The virus is transmitted by the respiratory route and replicates in the nasopharynx and lymph nodes. The virus is found in the blood 5 to 7 days after infection and spreads throughout the body.

People are infectious during the week before and after the appearance of the rash. Babies with CRS may spread the virus for more than a year.

The virus has teratogenic properties and is capable of crossing the placenta and infecting the fetus where it stops cells from developing or destroys them.

Virus latency

Virus latency (or viral latency) is the ability of a pathogenic virus to lie dormant (latent) within a cell. A latent viral infection is thus a type of persistent viral infection. Latency is then the phase in certain viruses' life cycles in which, after initial infection, proliferation of virus particles ceases. However, the viral genome is not fully eradicated. The result of this is that the virus can reactivate and begin producing large amounts of viral progeny without the host being infected by new outside virus, denoted as the lytic part of the viral life cycle, and stays within the host indefinitely.

The Rubella virus has this ability.  It may never be eradicated and may re-emerge later to produce extremely serious diseases, one of which is multiple sclerosis.  A paper on this is provided in the observations.  This too is relevant

Cerebrospinal fluid (CSF) is an outstanding source of specific markers related to MS pathology. Molecules reflecting specific pathological processes, such as inflammation, cellular damage, and loss of blood-brain-barrier integrity, are detectable in CSF. Clinically used biomarkers of CSF MS are oligoclonal bands, IgG-index, measles-rubella-zoster-reaction, anti-aquaporin 4 antibodies, and antibodies against John Cunningham virus. PMID: 26071103

It is thus incorrect to claim that having had the disease or the vaccination one is 'immune' to the disease.  One is not immune, one has built up anti-bodies to fight it, if it re-emerges. 

In 1969 a live attenuated virus vaccine was licensed. An attenuated vaccine is a vaccine created by reducing the virulence of a pathogen, but still keeping it viable (or "live").   These vaccines contrast to those produced by "killing" the virus (inactivated vaccine).

In the early 1970s, a triple vaccine containing attenuated measles, mumps and rubella (MMR) viruses was introduced.  The MMR vaccine is  a mixture of live attenuated viruses of the three diseases, administered via injection.

As at the time the following paper was written in 2012 this was still the case

Critical to avoiding a rubella virus infection is the immune prophylaxis, for which a live attenuated vaccine, usually given as trivalent vaccine against measles, mumps and rubella (MMR vaccine), is available. PMID:  22332308

Thus those who claim that the MMR vaccine prevents rubella are incorrect. 

It may temporarily prevent infection with the virus, but the injected virus [if live]  is quite likely to become latent and re-emerge at a later date.  Furthermore, anyone given the MMR vaccine could be carriers of the disease if a live virus is used.  If the person is a baby they are a carrier for a year.

The important thing to realise about re-emergence is that it does not emerge as German measles.  Later stages of infection re-emerge as a host of apparently unrelated diseases.  Thus whilst those who promote vaccines may be applauding their apparent success in that German measles may appear to be on the decline, the re-emergent diseases in the countries in which vaccination has taken place are significantly on the rise - for example rheumatoid arthritis and heart disease.  More details are provided  below.

Symptoms

Rubella can affect anyone of any age.    The older the person is the more severe the symptoms are likely to be.  

Short term symptoms

  • Rash - A rash may start around two weeks after exposure and last for three days. It usually starts on the face and spreads to the rest of the body. The rash is not as bright as that of measles and is sometimes itchy.
  • Swollen lymph nodes are common and may last a few weeks.
  • A fever, sore throat, and fatigue may also occur.
  • Joint pain - In adults joint pain is common.
  • Forchheimer's sign occurs in 20% of cases, and is characterized by small, red papules on the area of the soft palate.
  • Other symptoms include bleeding, testicular swelling, and inflammation of nerves.

Re-emerging symtoms

 

As anyone given the MMR vaccine could be carriers of the Rubella virus if a live virus is used [and in the case of small children they could be a carrier for a year], then it is always difficult to establish whether diseases that emerge in adults are re-emergent or have been caught from, for example, their recently vaccinated grandchildren or children.  If we ignore this complication to diagnosis, the following are re-emergent symptoms:

Arthritis - Up to 60% of older girls or women experience joint pain or arthritic type symptoms with rubella.  In effect, the rubella virus is one virus implicated in the development of rheumatoid arthritis.

In reading the following it needs to be remembered that the vaccines used a live virus, which, because it is a latent virus could re-emerge at any time.

Antibody activity against mumps, measles, polio, and rubella viruses was determined in patients with juvenile rheumatoid arthritis (J.R.A.), rubella-vaccine associated arthritis, adult rheumatoid arthritis, other chronic systemic disorders (e.g., systemic lupus and dermatomyositis), and in a matched population of normal, non-rheumatoid (control) children. .... The mean rubella-antibody levels in rubella-vaccine arthritis were 4 times higher than in controls. The IgM and IgG rubella-antibody levels in J.R.A. were found to be 4-6 times higher when compared to titres observed in the controls. Highest antibody levels were seen in younger children with J.R.A. ......Specific staining for rubella virus antigen was observed in the synovial fluid of 33 percent of patients with J.R.A. No antigen was detected in the synovial fluid from other patients. These observations suggest a possible role of rubella-virus infection in J.R.A. PMID: 48775

Eye problems - It is known that whenever the immune system is compromised, many latent viruses are capable of attacking the eyes and causing cataracts, glaucoma and uveitus.  Uveitis is inflammation of the uvea, the pigmented layer that lies between the inner retina and the outer fibrous layer composed of the sclera and cornea.  The uvea consists of the middle layer of pigmented vascular structures of the eye and includes the iris, ciliary body, and choroid.

Viruses are a fundamental etiology of ocular inflammation, which may affect all structures of the organ. Advances in molecular diagnostics reveal an increasingly broader spectrum of virus-associated intraocular inflammation, including all members of the herpes family, rubella virus, and other more rare causes such as Epstein-Barr and chikungunya virus. In particular, viruses of the herpes family are important causes of anterior and posterior uveitis.  PMID: 26089633

 Hearing problems - although we could find no links between tinnitus and the rubella virus, it is clear that hearing problems can be caused by the virus and emerge at any stage of low immunity in the person

A number of viral infections can cause hearing loss. Hearing loss induced by these viruses can be congenital or acquired, unilateral or bilateral. Certain viral infections can directly damage inner ear structures, others can induce inflammatory responses which then cause this damage, and still others can increase susceptibility or bacterial or fungal infection, leading to hearing loss. Typically, virus-induced hearing loss is sensorineural, although conductive and mixed hearing losses can be seen following infection with certain viruses. …….. In this review, we outline many of the viruses that cause hearing loss, their epidemiology, course, prevention, and treatment.

KEYWORDS: HIV; West Nile virus; cytomegalovirus; hearing loss; herpes simplex type 1; herpes simplex type 2; lymphocytic choriomeningitis virus; measles; mumps; rubella; rubeola; sensorineural hearing loss; sudden sensorineural hearing loss; varicella zoster virus    PMID:  25080364

 Heart disease - the effect of the rubella virus on the fetus and the newborn is well known, with congenital heart disease being a frequent result of infection.  What appears to be not as well known is that the rubella virus can cause heart disease later in life too, either from re-emergence or from direct infection, here is an example:

Perimyocarditis represents an inflammation of both the myocardium and pericardium. ..... In a 29-year-old woman, left ventricular function transiently deteriorated accompanied by ongoing cardiac inflammation a few days after illness. The titer of rubella virus increased from seronegative to more than 32-fold during the admission, and a rise in specific antirubella virus antibody was present. The patient was suspected of having perimyocarditis associated with the rubella infection.PMID: 12463628

 

Encephalitis - is now a known complication of the rubella virus, again it can affect the child but it can also affect adults.  The following paper is especially interesting as the virus is a vaccine virus and the paper lists some other complications of the virus:

Involvement of the central nervous system is common in measles, but rare in rubella. However, rubella virus (RV) can cause a variety of central nervous system syndromes, including meningitis, encephalitis, Guillain-Barré syndrome and sub acute sclerosing panencephalitis. We report the occurrence of one fatal case of the encephalitis associated with measles-rubella (MR) vaccine during an immunization campaign in São Paulo, Brazil. A 31 year-old-man, previously in good health, was admitted at emergency room, with confusion, agitation, inability to stand and hold his head up. Ten days prior to admission, he was vaccinated with combined MR vaccine (Serum Institute of India) and three days later he developed 'flu-like' illness with fever, myalgia and headache. Results of clinical and laboratory exams were consistent with a pattern of viral encephalitis. During hospitalization, his condition deteriorated rapidly with tetraplegia and progression to coma. On the 3rd day of hospitalization he died. Histopathology confirmed encephalitis and immunohistochemistry was positive for RV on brain tissue. RV was also detected by qPCR and virus isolation in cerebrospinal fluid, brain and other clinical samples. The sequence obtained from the isolated virus was identical to that of the RA 27/3 vaccine strain.  PMID:  24216323

 Brain damage - although the links with vaccines and various forms of brain damage like autism remain contentious, a considerable number of cases are now being reported from countries without the restrictions that seem to be being imposed in certain countries where neutrality is suspect.  Here is an example

The cases of 2 infants who developed acute encephalitis in close temporal proximity to receiving measles-mumps-rubella vaccination are described. One developed modified hypsarrhythmia and recovered ...... while the other remains severely neurologically handicapped. The timing between vaccination and symptom onset raises suspicion of the vaccine as the possible cause. PMID: 20840001

Dementia and Alzheimer's disease - whereas the rubella virus may cause encephalitis in the young, there appear to be links with both dementia and Alzheimers in old age.  Again because the rubella virus is a latent virus, it can re-emerge years after the original infection or vaccination.

Slow virus diseases are characterized by a long asymptomatic period, often months or years in duration, between the introduction of the infectious agent and the appearance of clinical illness. Two distinct groups cause serious degenerative diseases of the brain and spinal cord. The first to be identified are those caused by "unconventional agents," kuru and Creutzfeldt-Jakob disease. The second category, "conventional virus diseases," include SSPE (subacute sclerosing panencephalitis), PML (progressive multifocal leukoencephalopathy), progressive rubella encephalitis, and HIV encephalopathy.  PMID: 2727376

 Pancreatitis - There are other papers on Pubmed wich make clearer links than the one below, but this paper is interesting from a number of perspectives, not least of which is the link with the vaccines

We report a case of pancreatitis and parotitis in an adult male following immunisation with a trivalent mumps-measles-rubella vaccine. Presentation was 21 days after vaccination ..  A literature review revealed only five other such cases, with the Urabe strain of attenuated mumps virus appearing to be disproportionately represented. The Urabe vaccine strain has been withdrawn in some countries as it has been implicated disproportionately in the genesis of post-vaccination aseptic meningitis. Temporal separation of pancreatitis onset from vaccination raises the possibility that pancreatitis as a complication of mumps vaccination is under reported. PMID: 17291914

The conclusion here is that it was the mumps virus, because they found papers on this link, but from what can be ascertained, it could equally well have been the rubella virus.

A 12-year-old girl got abdominal pain three weeks after having received the second vaccination against MMR. MRCP showed dilatation of ductus choledochus and edema of caput pancreaticus. No stone was to be seen and the P-calcium level was normal. Hepatitis A virus, Ebstein-Barr virus, cytomegalovirus, enterovirus, serum col hemaggutinins, Yersinia and cystic fibrosis were all negative. Pancreatitis is seen with endemic parotitis and we suggest that MMR vaccination may have a causal connection with the above case. PMID: 12830760

 Encephalomyelitis - Encephalomyelitis is a general term for inflammation of the brain and spinal cord, and includes multiple sclerosis

Acute disseminated encephalomyelitis (ADEM) …… may follow vaccination in children or infection. Viral infection like measles, rubella, influenza, Epstein bar, HIV, herpes, cytomegalusvirus (CMV) and West Nile virus have been implicated in the causation. Among bacteria, group A hemolytic streptococcus, mycoplasma pneumonia, Chlamydia, Rickettesia and leptospira have been shown to cause ADEM. We describe acute disseminated encephalomyelitis due to tuberculosis in a 35 year old female who initially started with neuropsychiatric manifestations and later developed florid neurological deficit and classical magnetic resonance imaging (MRI) lesions suggestive of the disease. PMID:  21139988

 Pneumonia - and other lung diseases. 

A total of 110 consecutive patients with community-acquired pneumonia (CAP) admitted to 5 district general hospitals in Beijing during a 1-year period were assessed using the new assay. Among the children (under age 5) and adult patients (above age 18), respiratory syncytial virus (RSV) and rhinovirus (RV) were the most common etiological agents …. Atypical pathogens [included] rubella virus, measles virus, influenza type C virus, [and] human herpesvirus (HHV) PMID:  24086618

 Thyroid diseases - which are also caused by other viruses, but rubella is one of them

Viral infections are frequently cited as a major environmental factor involved in subacute thyroiditis and thyroid diseases.   This review examines the data related to the role of viruses in the development of thyroiditis. .....direct evidence of the presence of viruses or their components in the organ are available for retroviruses (HFV) and mumps in subacute thyroiditis, for retroviruses (HTLV-1, HFV, HIV and SV40) in Graves's disease and for HTLV-1, enterovirus, rubella, mumps virus, HSV, EBV and parvovirus in Hashimoto's thyroiditis.  PMID: 19138419

Others - Other organs are also affected by the virus, but as this page is long already and the message is clear, anyone with a specific interest is best to look on PubMed, where there are hundreds of papers on the subject. 

Where the virus goes in the body, once the immune system has been compromised, appears to depend to a certain extent on the psychological reasons why the immune system was compromised in the first place.  A table with a working hypothesis on the link between types of psychological problems and the organ affected is on this site - follow this LINK.

 Cause

 

The disease is caused by Rubella virus, a togavirus that is enveloped and has a single-stranded RNA genome. 

The Togaviridae include some very very unpleasant viruses many of which cause encephalitis, for example Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, Ross River virus, O'nyong'nyong virus, Chikungunya, and the Semliki Forest virus.

Increased susceptibility to infection might be inherited as there is some indication that "HLA-A1 or factors surrounding A1 on extended haplotypes are involved in virus infection or non-resolution of the disease".

Treatment and prevention

Prevention

Rubella infections are best prevented by active immunisation programs using vaccines containing:

  • disabled dead viruses - producing a so called 'inactivated vaccine'
  • an adjuvant that contains no heavy metals like Thiomersal or aluminium
  • and which are held in a body neutral excipient. 

As the adjuvant boost the immune system to build up immunity to both the excipient and virus, the contents of the excipient are of extreme importance.  Excipients containing peanut oil, fructose and milk and egg proteins have led to numerous allergies and food intolerances.

This too is important for people with cancer undergoing chemotherapy:

Children and adolescents <21 years of age at diagnosis and treated between 2001 and 2010 for various malignancies in the Department of Pediatric Hematology and Oncology, University of Frankfurt, were included in the retrospective chart review. Antibody levels against measles, mumps, rubella and varicella-zoster-virus (VZV) were routinely assessed at the time of diagnosis and within 12 months after completion of [chemo] therapy. Overall, 27%, 47%, 19%, and 17% of the patients lost their humoral immunity against measles, mumps, rubella, and VZV, respectively. The risk of losing protective antibody titers depended on age with a higher risk in younger children. PMID:  24793952

Treatment

Rest, sleeping, warmth [to help the immune system] and all forms of eating for health.  The observations provide specific examples of foodstuffs that have shown efficacy.

How it works

Very few hallucinations or similar experiences have been recorded for rubella, where they have they have mostly been caused by the complications of the fever.

The observations provide the mechanisms by which any healing has occurred.

References and further reading

  • J Clin Virol. 2013 Dec;58(4):737-40. doi: 10.1016/j.jcv.2013.10.016. Epub 2013 Oct 24.  Fulminant encephalitis associated with a vaccine strain of rubella virus.  Gualberto FA1, de Oliveira MI, Alves VA, Kanamura CT, Rosemberg S, Sato HK, Arantes BA, Curti SP, Figueiredo CA.  PMID:  24216323
  • Ophthalmology. 2011 Oct;118(10):1905-10. doi: 10.1016/j.ophtha.2011.03.033. Epub 2011 Jul 20. Comparison of rubella virus- and herpes virus-associated anterior uveitis: clinical manifestations and visual prognosis.  Wensing B1, Relvas LM, Caspers LE, Valentincic NV, Stunf S, de Groot-Mijnes JD, Rothova A.  PMID:  21764137
  • Vaccine. 2008 Feb 26;26(9):1166-72. doi: 10.1016/j.vaccine.2007.12.049. Epub 2008 Jan 22. Live attenuated measles and mumps viral strain-containing vaccines and hearing loss: Vaccine Adverse Event Reporting System (VAERS), United States, 1990--2003.   Asatryan A1, Pool V, Chen RT, Kohl KS, Davis RL, Iskander JK; VAERS team.
  • Adv Intern Med. 1978;23:353-83. Slow infections of the nervous system.  Johnson RT, ter Meulen V.   PMID: 415527
  • PLoS One. 2013 Sep 27;8(9):e75704. doi: 10.1371/journal.pone.0075704. eCollection 2013.  Development of a new resequencing pathogen microarray based assay for detection of broad-spectrum respiratory tract viruses in patients with community-acquired pneumonia.  Shen H1, Shi W, Wang J, Wang M, Li J, Zhang C, Nie K, Yang M, Zhang Y, Li A, Tan W, Ma X.  1Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China ; Futian District Center for Disease Control and Prevention, Shenzhen, Guangdong, China

 The eHealthme website also has a list, updated using US doctor supplied information, of conditions that appear to have been caused by rubella or the rubella virus.  Follow this LINK

Related observations