Comparison of Rubella and Measles

Overview

• Rubella: Also known as German measles, caused by the rubella virus.
• Measles: Caused by a virus in the paramyxoviridae family, often referred to as "simple measles".

Disease Characteristics

• Rubella:
  • Considered milder, sometimes called "three-day measles".
  • Half of the infected might not realize they are infected.
  • Serious complications can occur.
• Measles:
  • Generally more severe with higher fever (can surpass 40°C).
  • Involves a 4-day fever and 3 Cs (Cough, Coryza, Conjunctivitis).
  • Koplik spots are a diagnostic feature.

Symptoms

• Common Symptoms:
  • Fever, rash, coryza (inflammation of nasal mucous membrane).
• Rubella-Specific Symptoms:
  • Fever usually below 38°C.
  • Cervical lymphadenopathy (enlarged lymph nodes), joint pain in adults, possible ear infection.
• Measles-Specific Symptoms:
  • Koplik spots inside the mouth (temporary).
  • Higher fever, classic symptoms worsen over 4 days.

Rash Characteristics

• Measles Rash:
  • Appears 2-4 days post initial symptoms, lasts up to 8 days.
  • Changes from red to dark brown.
  • Starts small and spreads to form a large rash.
• Rubella Rash:
  • Begins on face as pink bumps, can be itchy.
  • Fades to brown, skin may peel or flake.

Transmission

• Both Diseases:
  • Airborne, spread through coughs and sneezes.
  • Incubation period around 2 weeks.
  • Infectious period: Rubella (1 week before and after rash); Measles (4 days before and after rash).
  • High infectivity, especially measles (almost 100%).
• Not spread by insects.
• Recovery confers immunity.

Complications

• Rubella Complications:
  • Dangerous for pregnant women, high risk of miscarriage or stillbirth in first trimester.
  • Possible testicular swelling, encephalitis, nerve inflammation.
• Measles Complications:
  • Common complications: Diarrhea, pneumonia, acute brain inflammation.
  • Fatal cases often due to pneumonia.

Diagnosis

• Rubella:
  • Detection through rubella virus-specific IgM antibodies.
  • Caution needed as antibodies can persist over a year.
• Measles:
  • Typically based on symptoms.
  • Koplik spots can aid diagnosis.

Management

• Rubella:
  • No specific treatment; symptom management.
  • Usually mild and self-limiting.
• Measles:
  • No specific cure; oral rehydration, fever management, and antibiotics for secondary infections.
  • Vitamin A supplement beneficial for children.

Prevention

• Vaccination:
  • Primary preventive measure for both diseases.
  • MMR vaccine (measles, mumps, rubella) recommended for children at 12 months and second dose between ages 4-5.
  • Early vaccination not effective due to immature immune response.

Prognosis

• Both diseases are self-limiting with a generally good prognosis.
• Serious complications from measles can be fatal, while rubella poses significant risk to pregnancies.