Measles and Rubella: Facts, Similarities, and Differences
Measles and Rubella
Measles and rubella are two diseases that produce a red rash over the whole body. Both diseases are caused by a virus and both are more common in children than in adults. Measles is the more serious of the two diseases. While many people recover from measles with no problems, some develop complications. Rubella is a milder disease and generally cause no complications. One exception occurs when a pregnant woman develops rubella, however. The rubella virus can cross the placenta and enter the baby's bloodstream, causing a serious condition known as congenital rubella syndrome.
The alternate names of measles and rubella can be confusing. Measles is also known as rubeola, which some people confuse with the word rubella. In addition, rubella is sometimes called German measles or the three-day measles.
Viruses That Cause the Infections
Measles and rubella are caused by different viruses. Measles is produced by a paramyxovirus named Morbillivirus. Rubella is produced by a togavirus called Rubivirus. Although there are differences between these two viruses, there are also some similarities.
Viruses exist as individual particles called virions. The virions of the measles and rubella viruses are roughly spherical in shape. Each virion consists of genetic material surrounded by a coat of protein. The genetic material is RNA (ribonucleic acid) instead of the DNA (deoxyribonucleic acid) that is present in many other viruses and in our cells. The protein coat is surrounded by a protective envelope made of lipids.
The measles and rubella viruses are spread in liquid droplets released from the nose or mouth during sneezing, coughing, talking, and exhaling. They are inhaled by other people and infect their bodies, usually settling in the respiratory system. A virus can also be passed from one person to another when someone touches a surface contaminated by the virus. Researchers have found that unvaccinated people living in close proximity to a person with measles have a 90% probability of developing the disease.
What Is Measles?
Common Symptoms of Measles
When a person is infected by the measles virus, they don't become sick immediately. There is an incubation period of one or two weeks before the first symptoms appear. While the disease symptoms described below are common, the lists isn't exhaustive. In addition, not everyone has all of the symptoms in the list. Another point to note is that individual symptoms listed below may occur in other diseases besides measles.
- The first symptoms of measles generally resemble those of the flu. The infected person coughs, sneezes, and has a runny nose.
- The person's eyes become red and may be sensitive to light.
- The person usually develops a fever. They may also lose their appetite and feel very tired.
- Young children may experience diarrhea and vomiting.
- About two days after the first symptoms arise, patches called Koplik spots (or Koplik's spots) may appear on the inside of the cheeks. The red spots often have a blue-white center. They exist for only a short time and may be missed by an observer.
- Approximately two days after the koplik spots appear, a red rash develops on the skin. The rash usually starts on the forehead or beside the ears. It then spreads over the face, travels downwards over the trunk and arms, and finally spreads over the lower body.
- The rash may or may not be itchy.
- A measles rash lasts for about five or six days and then disappears.
Patients are infectious for about four days before the first appearance of the rash and for about four days after the rash appears.
Treatment of the Viral Infection
Since measles and rubella are caused by a virus instead of a bacterium, they can't be cured by antibiotics. The body is usually left to destroy the virus by itself, although supportive treatment is given to make the patient feel as well as possible. Any complications that develop are treated more aggressively.
A person with measles or rubella or with any unexplained or prolonged symptoms must be under a doctor's care. The doctor will provide a diagnosis and decide on the appropriate treatment for the person and their specific problems.
Measles in Children
Some Complications of the Disease
Many people recover from measles with no additional problems. Some people develop new health disorders as a result of the infection, however. One of the most common complications is pneumonia. Otitis media and croup are other complications. Otitis media is an infection and inflammation of the middle ear. A person with croup has a swollen throat and produces a barking cough.
A very serious complication of measles is encephalitis, which is an inflammation of the brain. Luckily, it's a rare effect of the infection. Even rarer is a condition that may develop years after the initial infection by the measles virus. It arises due to the persistence of the virus in the body. The condition is known as SSPE (subacute sclerosing panencephalitis). In this disorder, brain and nerve tissue degenerate. Antiviral drugs can slow the progression of the disease. Unfortunately, the condition is often deadly.
Common Symptoms of Rubella
Rubella is generally a milder disease than measles and usually produces no complications. It may even be a subclinical infection (one that doesn't produce any symptoms). Rubella during pregnancy may be serious, however.
In children, the disease usually begins with a mild fever and swollen, painful lymph nodes behind the ears or in the back of the neck. These symptoms last for one or two days. They're followed by a rash that lasts for two to three days. A rubella rash is usually not as red as a measles rash and often lacks the angry or fiery appearance. Like a measles rash, the redness begins on the face and spreads downwards. It generally starts to disappear on the face before it reaches the bottom of the body.
Rubella may cause other symptoms, which are most common in teenagers and adults. These symptoms include a runny or stuffy nose, red eyes, loss of appetite, and a headache. Lymph nodes may be swollen. Some people—especially women—may experience aching joints.
A person who has rubella is contagious for about ten days before the rash appears and for one to two weeks after the rash appears.
Disease Complications During Pregnancy
If a woman develops rubella while she's pregnant, the baby may be born with congenital rubella syndrome. The risk is greatest in the first trimester of pregnancy, but problems can also develop in the later stages of the pregnancy.
Congenital rubella syndrome can be very severe and may cause the baby to have multiple disabilities. There may be heart, liver, bone marrow, or spleen defects. The baby may suffer from vision or hearing problems and may experience growth problems. He or she may also be mentally challenged.
Congenital Rubella Syndrome
The MMR (Measles, Mumps, and Rubella) Vaccine
Measles and rubella can both be prevented by a vaccine. The two vaccines are often mixed with the vaccine for mumps, another disease that is common in childhood. The combined vaccine is called the MMR (Measles, Mumps, and Rubella) vaccine. It's highly effective and has greatly reduced the incidence of measles and rubella. In developed countries these diseases are uncommon, although there have been some worrying outbreaks of measles recently which suggest that the disease may be making a comeback. Measles and rubella are common in many developing countries.
The MMR Vaccine, Andrew Wakefield, and Autism
In 1998, a UK doctor named Andrew Wakefield published a report in which he linked the MMR vaccine with autism and bowel disease. This caused a dramatic drop in the number of parents getting their children vaccinated with the vaccine.
Investigators were unable to duplicate Wakefield's research results. His work was discredited and he was accused of dishonesty. He was also accused of treating some children involved in his research with callousness. The Lancet, the respected medical journal that had published Wakefield's report, retracted the article. Wakefield's name was struck off the medical register and he was barred from practicing medicine in the UK. Andrew Wakefield maintains that he is innocent of any wrongdoing, however.
Vaccine Safety and Concerns
The video above mentions a measles outbreak that occurred in California and other states from December 2014 to February 2015. The outbreak is believed to have been started by an unvaccinated person who visited a Californian amusement park. The disease likely spread from this person to other unvaccinated people.
A Measles Outbreak in the UK
The fear of the MMR vaccine persisted in the UK for a long time after Wakefield's work was publicized. As a result, until recently a large number of children and teenagers were unvaccinated against measles, mumps, and rubella.
Health experts say that in order to prevent a measles outbreak about 95% of the population needs to be vaccinated. This produces what is known as "herd immunity". If fewer people are vaccinated, more people are likely to get sick. In some parts of the UK the vaccination rate amongst older children and teenagers has been far below the required safety level until recently.
In 2012, a measles outbreak occurred amongst older children and teenagers in parts of the UK. It was blamed on the fact that children weren't vaccinated due to the Wakefield scare. In the past there were only a few dozen to a few hundred cases of measles each year in England. In 2012 there were 2,030 cases. Fortunately, a catch-up vaccination program was successful and the number of measles cases gradually dropped.
Since the California and UK measles outbreaks mentioned above, more have occurred in various parts of the world. They are still appearing and are a public health concern. Prevention of measles is important due to the disease itself and to the complications that may develop.
In an ideal world, nobody would suffer from measles or rubella. Unfortunately, the viruses for both diseases still exist. Vaccination is sometimes a controversial topic, but observations show that when the MMR vaccine is widely used in an area, the incidence of measles, mumps, and rubella decreases dramatically. Anyone who has questions about the MMR vaccine should visit a doctor to discuss the situation.
Protection from measles and rubella is important because of the potentially serious complications of the diseases. Even if a person doesn't experience a complication, they can pass the virus to an unvaccinated person. This person may experience not only the unpleasant effects of the disease itself but also experience an annoying or even dangerous complication.
Questions & Answers
© 2013 Linda Crampton