WHAT IS RUBIAS?Rubella is a viral infection that primarily affects children. The disease is now rare in the Netherlands because the rubella vaccine has been available since 1974. Occasionally, an epidemic occurs in the Netherlands among people who refuse to be vaccinated for reasons of principle or religion.
In children, the infection is usually mild, but in unborn children, the disease can lead to serious birth defects. Pregnancies can end in miscarriage or birth defects if an unvaccinated mother contracts rubella during pregnancy. The cause of rubella is the rubella virus , which only occurs in humans.HOW DOES THE INFECTION PROCESS?The rubella virus is highly contagious. A person can become infected through coughing or sneezing, but the virus can also spread over longer distances. A person carrying the virus infects an average of seven to eight other people. Moreover, the contagious period is quite long: from 10 days before the rash appears to about a week later. The first symptoms of infection are a rash and fever, which typically begin 14 to 16 days after infection.WHAT ARE THE SYMPTOMS OF RUBIAS?In half of those infected, no signs of infection are visible, while the other half usually develop a rash. This begins on the face and spreads rapidly, first to the upper body, and within a day or two, to the arms and legs. The pinkish-red rash initially consists of small spots. Later, these can merge, especially on the face. Older children and adults often experience listlessness, a fever, and swollen lymph nodes behind the ear and in the neck for a few days before the rash. Older girls and women may also experience joint pain.ComplicationsRubella almost never causes complications. In rare cases, a low platelet count (thrombocytopenia) or encephalitis develops. More common is joint pain or sometimes joint inflammation in the fingers, wrists, or knees. These symptoms usually disappear spontaneously within a month, but can sometimes last longer. Mortality is rare.
Rubella is particularly feared because it is so dangerous to unborn children. If a woman becomes infected with the rubella virus during the first three months of pregnancy, there is a high risk of a congenital condition in the baby. These can include heart and eye defects, hearing loss and deafness, retarded growth, a low platelet count, enlarged liver or spleen, central nervous system disorders, bone abnormalities, or urinary tract abnormalities. These conditions are known as congenital rubella syndrome (CRS). The earlier in the pregnancy the expectant mother becomes infected, the more severe the organ damage usually is. The infection can also lead to a miscarriage. Infection later in pregnancy can also cause abnormalities in the unborn child. These usually involve developmental delays and abnormalities in the immune system.CAN I GET RUBIAS AGAIN IF I HAVE HAD IT?Anyone who has had rubella is protected against the disease for life. Sometimes, someone can become infected again, but no symptoms develop. The two vaccinations in the National Immunization Program are also expected to provide lifelong protection.HOW IS RUBIAS TREATED?There is no treatment for rubella. It goes away on its own.VACCINATION AGAINST RUMBLAEveryone in the Netherlands who participates in the National Vaccination Program is vaccinated against rubella. The vaccine is part of the MMR vaccination (measles, mumps, and rubella). Children receive this shot, along with the meningococcal C vaccination, when they are 14 months old. In the year they turn 9, they receive the second MMR vaccination. They receive this at the same time as the DTP vaccination (against diphtheria, tetanus, and polio). The second MMR vaccination at age 9 is necessary because the first one is ineffective in approximately 5% of children. Children vaccinated against rubella cannot infect others. The rubella vaccine in the National Vaccination Program is a live vaccine. It uses a highly attenuated rubella virus, which does not make you sick but does provide immunity against rubella.Side effects of rubella vaccinationThe MMR vaccine usually causes few side effects. If they do occur, they are usually mild and short-lived. Because the MMR vaccine contains weakened, live viruses that need time to multiply, any side effects only occur 5 to 12 days after vaccination. The first MMR vaccination causes a side effect in 5 to 10% of children. They usually become listless, develop a fever, and/or a rash. This usually subsides after 1 to 2 days. Some children develop a high fever and a severe rash. Children who are susceptible to this sometimes experience a febrile seizure due to the fever from the MMR shot. However, this is rare and occurs in 1 in 5,000 to 10,000 children. Symptoms almost never occur after the second MMR shot. Older children may faint, as with any injection.
The advantage of combining three vaccines is that one shot protects against three diseases simultaneously. This is not a problem for the body's immune system. The combination of vaccines also doesn't cause additional or more severe side effects than individual vaccines. Because each shot carries a risk of side effects, it's actually better to combine multiple shots. Simultaneously administering the meningococcal vaccine and the MMR vaccine also doesn't cause additional or worse side effects than when administered separately. Children receive the MMR vaccine at an age when several illnesses can occur. This can happen by chance right after the vaccination. The vaccine is then quickly assumed to be the cause. This is understandable, but almost never justified. There are rare diseases for which it can't always be ruled out that they were caused by the vaccine. For example, 1 in 25,000 children experiences a temporary platelet deficiency. An even smaller percentage experiences temporary joint pain. But no side effect has been proven to cause permanent damage, no matter how threatening it may seem. For example, the vaccines do not cause autism, brain damage, developmental delays, epilepsy, or death (such as sudden infant death syndrome).What to do in case of side effects?Paracetamol can help with mild side effects, but this is usually not necessary. For fever, it is usually sufficient to dress the child coolly and perhaps sponge them down or bathe them. If the child develops very severe or unexpected symptoms, it is important to contact the GP. This could indicate something other than a side effect, such as a serious infectious disease. It is also important to report severe or unexpected symptoms to the child health clinic or the Municipal Health Service (GGD). They can then report the possible side effect to the National Institute for Public Health and the Environment (RIVM). The RIVM will record the possible side effect and ensure it is investigated further.When is vaccination unwise?Medical reasons for postponing the MMR vaccination include pregnancy, severe immune system disorders (both congenital and acquired due to treatment with anticancer drugs (cytostatics) or high-dose corticosteroids or other immunosuppressive drugs), blood transfusions, or administration of gamma globulin. Children with allergies (such as hypersensitivity to chicken egg protein) can be vaccinated as usual. |
