Related concepts:

German measles, Congenital rubella syndrome, Third disease, French measles, False measles, Scarlatina morbillosa, Hybrid measles

Introduction to rubella:

How tragic when a mild illness, scarcely worse than a cold, can cause such devastating effects on babies. Young parents, beware!

What is rubella?

Rubella is one of the classic rash illnesses of childhood. In ancient times, it was lumped in with measles, scarlet fever, and smallpox. For a while, it was thought to be halfway between measles and scarlet fever. It became known as scarlatina morbillosa (which means measles-like scarlet fever), rubeola scarlatinosa (which means scarlet-fever like measles), or hybrid measles.

A little more than a hundred years ago, it became clear that while rubella was similar to both measles and to scarlet fever, it was different. It became the third of the non-pox childhood rash illness (third disease). German scientists did most of the work (German measles), although some French scientists made important contributions (French measles). For a while, it was also called roseola, though we now know that rubella and roseola are distinctly different infections.

The main value in identifying this illness was that parents could relax! Rubella was much less serious than either measles or scarlet fever. If your child had a rash and a fever, this was the diagnosis you wanted the doctor to make.

Then in the 1940s everything changed. An Australian ophthalmologist named Normann Gregg observed that large numbers of cataracts and other birth defects occurred right after rubella outbreaks. He suggested that if pregnant women caught rubella, the unborn baby might be damaged. And Dr. Gregg was ridiculed.

At the time, the idea that an infection could hurt a baby was considered preposterous! The placenta was considered an unbreachable barrier that protected the baby from all illnesses, chemicals, toxins, drugs, alcohol, tobacco--any insult from the outside world.

Dr. Gregg became a laughingstock. But within a few years, his observations proved true.

This opened a new era in children’s health.

Today rubella is known as one of the TORCH infections (toxoplasmosis, others, rubella, CMV, and herpes). These infections in the mother cause many miscarriages, and affect up to 5 percent of all babies who live to be born. They are among the leading causes of birth defects and newborn deaths. A baby born with birth defects resulting from its mother's rubella infection is said to have congenital rubella syndrome. Thankfully this is now exceedingly rare.

Who gets rubella?

Rubella tends to arrive in epidemics, with major epidemics every six to nine years. The virus that causes rubella was first discovered in 1962, which helped scientists to learn a great deal by studying the 1964 epidemic.

There were 1.8 million people known to be sick with rubella in that epidemic. There were 20,000 known fetal deaths and about 30,000 infants born with severe birth defects.