Why do I need to be screened for immunity to rubella?
In the United States, your chances of being exposed to rubella (also known as German measles) are extremely low. But you need to know whether you're immune. If you're not immune to rubella and you come down with this illness during early pregnancy, it could be devastating for your baby. You could have a miscarriage or your baby could end up with multiple birth defects and developmental problems. Congenital rubella syndrome, or CRS, is the name given to the pattern of problems caused when a baby is born with the virus. So if you weren't screened for rubella immunity before you got pregnant, you'll have this blood test at your first prenatal appointment.
Fortunately, experts estimate that about 90 percent of the U.S. population over 5 years old is immune to rubella, either because they've been immunized against it or because they had the illness as a child. (People born in countries without routine rubella vaccination programs are less likely to be immune.) By the way, German measles is not the same as regular measles (rubeola), and having immunity from one illness does not protect you from the other. How common is rubella?
Rubella has become quite rare in the United States, thanks to a very successful vaccination program. Before the rubella vaccine was developed in 1969, a rubella epidemic in 1964 and 1965 caused 12.5 million cases of the disease and 20,000 cases of CRS in the United States. In contrast, between 2001 and 2005, there were a total of 68 reported cases of rubella and five reported cases of CRS. And in 2006, there were just 11 reported cases of rubella and only one case of CRS. That said, rubella outbreaks have occurred sporadically in the United States over the years, so it's still crucial to have your children vaccinated and to get vaccinated yourself (when you're not pregnant) if you're not already immune. In addition, about a third of the world's countries still lack rubella vaccination programs, so the virus remains common in many developing nations. The World Health Organization estimates that there are 110,000 cases of CRS every year. I'm pretty sure that I got the rubella vaccine as a child, but the test says I'm not immune. Is that possible? Yes, though it doesn't happen often. A small number of people who are vaccinated don't get an antibody response that's large enough to be detected by the screening test. It's also possible for the effect of the vaccine to wane over time. What are the symptoms of rubella?
Rubella is an acute viral illness, but the symptoms can be pretty nonspecific, which makes it hard to distinguish from other illnesses. In up to half of the cases, the symptoms are either nonexistent or so mild that you might not know you were infected. If you do have the typical symptoms, they start to show up about 12 to 23 days after you're exposed to the illness. You may have a low-grade fever, malaise, headache, swollen lymph nodes, joint pain and swelling, reddened eyes, and a stuffy or runny nose for one to five days before a rash erupts. The rash lasts only a few days, usually appearing first on the face and later spreading to other parts of the body. The swollen glands and joint pain can last several weeks. You're contagious one week before the rash first appears and for another week or so after. The most contagious period is when the rash is erupting.
What should I do if I think I've been exposed to rubella during pregnancy? Contact your healthcare practitioner right away and let her know that you think you've been exposed. Don't show up unannounced at your practitioner's office and risk infecting other pregnant women. If you need to be seen, the doctor's staff will make special arrangements so that you aren't sitting in a crowded waiting room. If you weren't previously immune or haven't been tested yet, your caregiver will want to do a blood test immediately to check for rubella-specific antibodies. You'll have another blood...
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