Rubella

**FOR QUICK REFRENCE EXPOSURE PROCESS PLEASE REFER TO ATTACHMENT C

Overview:

Rubella is a contagious disease caused by a virus. It is also called “German measles”, but it is caused by a different virus than measles. Rubella was eliminated from the United States in 2004. Rubella elimination is defined as the absence of continuous disease transmission for 12 months or more in a specific geographic area. Rubella is no longer endemic (constantly present) in the United States. However, rubella remains a problem in other parts of the world. It can still be brought into the U.S. by people who get infected in other countries.

Mode of Transmission:

Rubella is transmitted primarily through direct or droplet contact from nasopharyngeal secretions

Examples of Transmission:

Rubella spreads from person-to-person through respiratory droplets from coughs or sneezes. Patients with rubella are contagious for 7 days before and 7 days or longer after onset of rash. The incubation period averages 14 days and ranges from 12 to 23 days.

Prevention:

Rubella is prevented through vaccination. The vaccine (MMR) also prevents measles and mumps and is a routine childhood immunization. The MMR vaccine does not cause autism. Currently two doses are recommended in childhood.

Precautions:

DROPLET

Signs and Symptoms:

The symptoms of rubella begin about 5-7 days after exposure to the virus. Symptoms are often mild and as many as 50% of infections may not have symptoms. When present, symptoms may include:

Fever
Rash - starts on the face and progresses down the body to the feet and lasts about 3 days
Lymphadenopathy (enlarged lymph nodes) in the head and neck may last several weeks

In older children and adults, symptoms may include a 1- 5 day prodrome (days preceding the rash) with low-grade fever, malaise, lymphadenopathy, and upper respiratory symptoms. Muscle and joint pain is common in adults.

Complications:

If a pregnant woman is infected with rubella, birth defects, including deafness, cataracts, heart defects, microcephaly, and liver and spleen damage, may occur in the fetus. If the mother is infected in the first 3 months of pregnancy, the chance of a birth defect is at least 20% and the chance of some adverse effect on the offspring is as high as 85%. In contrast, risks are much lower if infection occurs in the last 3 months of the pregnancy. Infection during pregnancy may also result in fetal death or premature delivery. Arthritis, generally lasting less than a month, is common in adult women. Encephalitis occurs in 1 in 6000 cases and bleeding (hemorrhage) into the brain, kidneys or gastrointestinal tract occur in about 1 in 3000 cases.

General Post Exposure Treatment:

The MMR vaccine should be given within three days of exposure to non-immune, non-pregnant individuals. Exposed susceptible personnel should be excluded from duty from day 5 after the first exposure to day 21 after last exposure, regardless of post-exposure vaccine.

Paperwork Required

OC Public Health Communicable Disease Exposure Form (policy 330.96) with Fire incident number on top. Should be faxed while still in the hospital Fax: (714) 564-4050 per county policy must be received within 7 calendar days

OC Public Health Communicable Disease Exposure Form

The City “Report of Employee Injury” form
Medical Service Order- RM -67 (when medical care is required)
Sharps Injury Log

Post Exposure Follow-up:

There is no specific medicine to treat rubella or make the disease go away faster. In many cases, symptoms are mild. For others, mild symptoms can be managed with bed rest and medicines for fever, such as acetaminophen.