What is rubella?
Rubella is a usually innocuous viral childhood disease which is caused by the rubella virus. She distinguishes itself after an incubation period of 14 to 21 days by stuffed lymph nodes behind the ears, followed by a rash with red spots. The rash begins on the face and neck, after which he spreads to the trunk and extremities. Also occur fever, conjunctivitis and joint for. In general, the infected people are hardly ill and is rapidly about the disease.
The risk of complications or severe course is very small. Nevertheless, in the Netherlands by the state everyone vaccinated against rubella because by making the disease in early pregnancy, severe birth defects of the fruit can cause:
- eye diseases such as cataracts and glaucoma, resulting in impaired vision or blindness
- loss of hearing (deafness) as a result of damage to the auditory nerve (nerve that the information of the ear is transferred to the brains)
- heart defects (patent ductus arteriosus and narrowing of the pulmonary artery).
The best known example of such complications concerning Princess Christina, who suffered eye problems since her mother, Queen Juliana, during pregnancy with the virus became infected.
To prevent birth defects were vaccinated in the Netherlands since 1974, girls in their eleventh year of life against rubella. Women who had a child and had not been vaccinated were given the opportunity to be vaccinated.
With these measures was, however, not entirely eradicated in Netherlands rubella. This is because there are people who make less than antibodies after vaccination and so are not protected (non-responders). Furthermore, Miss some girls the vaccination and boys were not vaccinated.
This kept so many non-immune people in the population that the occurrence of rubella epidemic little remained possible. Therefore, since 1987 in the Netherlands, all children, boys and girls, though vaccinated as a baby. This is the percentage of non-susceptible individuals in the population has become so high that the virus can no longer maintain and even the few unprotected individuals so take advantage of the herd effect (herd immunity).
Around the turn of the year 2004-2005 also occurred in the Netherlands in the so-called Bible Belt, where relatively many people live who can not be immunized for religious motives, such epidemietje again with at least 128 serologically confirmed cases. More than 90% of them (118) for religious reasons was not vaccinated. None of the confirmed cases had been vaccinated. The actual number will have higher many times as there are often no serological examination and the disease often goes unnoticed. Afterward RIVM reported that until July 2005 29 confirmed cases had been reported in pregnant women with at least 1 case of congenital rubella syndrome as a result.
Treatment of patients whose mothers were infected during pregnancy
There are opportunities for young children:
- The congenital eye disorder can sometimes be corrected with cataract surgery.
- Congenital hearing loss can be treated with hearing aids. But congenital deafness can not be treated with a cochlear implant because the auditory nerve is not sufficiently developed.
- The congenital heart defect can sometimes be corrected with heart surgery