Rubella is a disease caused by a virus (Rubivirus), which is easily transmitted through the respiratory tract via coughing, sneezing, and nasal secretions1. It is also quite common for an infected mother to pass the virus to the fetus, which can cause serious harm to the baby.

Symptoms

Symptoms may take a while to appear, but the virus can be spread up to 7 days before the person notices any reaction. There are even cases of people infected with rubella who do not show any symptoms, and it can go unnoticed. Even for those who do not show symptoms, the disease can be detected through blood tests by checking for immunoglobulins (IgM or IgG). These tests are requested by the obstetrician during prenatal care.

Consequences of Rubella During Pregnancy

Once a pregnant woman is infected with the rubella virus, there are no methods, at least for now, that can fully protect the baby, preventing its infection. The recommendation is to see your doctor immediately so that, through tests, they can identify if the baby was affected by the virus2. And of course, the most effective way is prevention! Rubella in adults is not considered a serious disease. However, for pregnant women it is quite aggressive, mainly because of the potential consequences for the fetus. The risk of miscarriage increases considerably in cases of infection, especially in the first trimester, and the most serious consequence is a series of developmental problems in the fetus, known as congenital rubella syndrome (CRS), causing complications. It usually causes some type of fetal malformation such as: deafness (which is usually only diagnosed when the baby is born and is the most common), eye problems (blindness, cataracts, glaucoma, microphthalmia, and retinopathy), heart defects, microcephaly, and liver problems like fibrosis.

When to Get the Rubella Vaccine

These fetal malformations can occur if the mother becomes infected with the virus or even if she receives the rubella vaccine while already pregnant, even without knowing. For these reasons, the vaccine is recommended when a woman is planning to become pregnant, at least one month before pregnancy begins. If this is your case, try not to worry too much. Although there is a possibility of the disease manifesting even after vaccination, there are no concrete reports of fetuses being infected this way3.

High-Risk Situation

Rubella can cause more serious consequences for the baby if the mother is infected during pregnancy, especially during the first 3 months, which is when the fetus is most likely to contract the disease. After this period, the risk is lower, and after the 4th month of pregnancy, severe complications are almost ruled out.

Rubella Test – IgG and IgM

In the first tests performed during prenatal care, the doctor usually orders a blood test for rubella serology. This test detects whether you have antibodies against the virus in your blood, allowing proper precautions to be taken based on the result. The test identifies whether IgG or IgM antibodies are present, which indicate the presence of the virus. If IgG antibodies are detected, it means that you are immune to the virus, but the infection occurred in the past; if IgM is present, it means you contracted the disease recently. When the virus first enters our body, it initially produces IgM antibodies, so their detection suggests a recent infection. If only IgG antibodies are detected, it means you were infected in the past and your immune system has already fought off the virus. The body “produces” memory antibodies known as IgG. These antibodies remain in the body for life, and even if the person comes into contact with the virus again, the immune system is already “armed” to fight it.

How the Test to Detect Rubella is Done

The test is performed through a blood sample taken from a vein, just like standard blood tests, and usually requires only eight hours of fasting. Rubella serology is used to diagnose whether the person has already had contact with the virus or has had the vaccine. It is a very effective diagnostic tool and is ordered during prenatal care or for women who are preparing to become pregnant. The results are fast and presented clearly and objectively.

Possible Results

Non-reactive IgM and IgG: means there has never been contact with the virus and there has also been no vaccination, or if there was, it was not effective. Therefore, extreme care is needed to avoid infection during pregnancy. Non-reactive IgM and reactive IgG: means you are immune to rubella, as the memory antibodies are present in your blood, indicating that you have either had contact with the virus or were effectively vaccinated. Therefore, you have a low risk of infection. Reactive IgM and non-reactive IgG: means you were recently infected with the virus (between 2 and 6 weeks ago). Attention, this is the scenario that requires the most alertness for pregnant women and special care for the baby.

Symptoms of Rubella

Rubella symptoms typically last up to five days. The most common are:

  • Cold-like symptoms (runny nose, sore throat, cough);
  • Fever (mild);
  • Eye irritation or even conjunctivitis;
  • Tiredness;
  • Swollen lymph nodes in the neck area;
  • Joint pain.

A common sign of rubella is reddish spots on the face, which can spread to other parts of the body and in most cases are very itchy. If you get rubella during pregnancy, there is not much that can be done to protect the baby. But do not hesitate to see your doctor to learn which tests to do to monitor your baby’s development and make sure everything is progressing well.

Treatment of Rubella

There is no effective treatment for rubella; only recommendations, especially for pregnant women, such as rest and drinking plenty of fluids. Some fever reducers and painkillers are usually prescribed. The best form of prevention is to get vaccinated and try to stay away from people who have rubella. The vaccine is part of the MMR (measles, mumps, and rubella) and MMRV (measles, mumps, rubella, and varicella) vaccines. See also: First Pregnancy – Initial Tests and Procedures Photos: 3907349, Content Provider(s): CDC