Notes 221024 184609

‫الحصبه االلمانيه‬
‫اشراف الدكتور ‪/‬طه المجيدي‬
‫عمل الطالب ‪ /‬عمار البراشي‬

German measles is an acute,
contagious, viral
infection. Although it is a mild
infection in general in children, its
consequences are severe when it
affects pregnant women because
it causes the fetus to die or cause
birth defects, and it is
known as congenital rubella
syndrome.
The rubella virus is transmitted by

airborne droplets when a person
sneezes or coughs, and is the only
known host of the disease.
Symptoms of
infection
Symptoms of a child being ill are
usually mild and include a rash, a
cold fever of less than 39°C (39°C),
nausea, and a mild sore
throat. The rash, which occurs in
between 50 and 80% of cases,
usually begins on the face and
neck of the patient before
spreading to the lower part of the
body and lasts for 1 to 3 days. One
of the most clinical symptoms of
this disease is swollen lymph
nodes located behind the ears
and in the neck. As for the
infection of the disease in adults,
which is more common among
women, it leads to arthritis and
excruciating pain in it that usually
lasts for 3 to 10 days.
Once an individual is infected, the

virus spreads throughout his
body in a period of approximately
5-7 days. Symptoms of infection
usually appear within 2 to 3
weeks after exposure to the
virus. The period during which
transmission is most intense
usually ranges from 1 to 5 days
after the onset of the rash.
When a pregnant woman is
infected with the rubella virus at
an early stage of pregnancy, the
chance of transmitting the
infection to her fetus is 90%,
which may cause a miscarriage of
the fetus, stillbirth, or congenital
anomalies
known as congenital rubella
syndrome. It may take a year or
more for an infant with this
syndrome to get rid of the virus.
congenital rubella
syndrome
A child with congenital
rubella syndrome can suffer from
hearing and vision impairments,
heart defects, and other lifelong
disabilities, including autism,
diabetes and thyroid disorders -
diseases many of which require
expensive treatment, surgeries,
etc. of expensive care.
The risk of congenital rubella
syndrome is highest in countries
where women of childbearing age
are not immune to the disease
(either through vaccination or
after they have been infected with
rubella). Before the introduction
of the
vaccine, the number of infants
infected with congenital rubella
syndrome at birth was about 4
out of every 1,000 live births.
Mass vaccination against rubella

during the past decade has
practically eliminated it and
congenital rubella
syndrome in many developed and
some developing countries. In
April 2015, the WHO Region of
the Americas became the first to
be declared free of an endemic
rubella outbreak.
The incidence of congenital

rubella
syndrome is highest in the WHO
African and Southeast Asian
regions, which have the lowest
vaccination coverage rates.
Vaccination
Rubella vaccine is a live
attenuated strain that
has been in use for more than 40
years, and a single dose of it gives
an individual a long-term
immunity greater than 95%
similar to that acquired from
infection naturally.
Rubella vaccines are available

either as a monovalent (one
pathogen-exclusive vaccine) or in
combinations and, most
commonly, combined with other
vaccines, such as measles, mumps
or measles, mumps and varicella
(MMV) vaccines.
Post-vaccination
adverse reactions are generally
mild in nature and may include
pain and redness at the injection
site, hypothermia, rash and
muscle pain. Mass immunization
campaigns in the Region of the
Americas, which covered more
than 250 million
adolescents and adults, did not
result in the diagnosis of any
serious adverse reactions to the
vaccine.
WHO response
WHO recommends that all
countries that have
not yet introduced the rubella
vaccine should consider
introducing it using existing, well-
established measles vaccination
programmes.
After Member States in the

Western Pacific Region set a goal
for measles elimination, 3
WHO regions have set similar
targets for eliminating this
preventable cause of birth
defects. The Organization and its
partners are committed to
assisting Member States in
achieving their goals.
In April 2012, the

Measles Eradication Initiative -
now known as the Measles and
Rubella Eradication Initiative -
launched a Global Strategic Plan
for the Eradication of the two
diseases for the period 2012-
2020, which includes new global
goals for 2015 and 2020.
By the end of 2015, do
the following:
•Reduce global measles deaths by
at least 95% compared to 2000
levels.
•Reach regional
measles and rubella/congenital
rubella syndrome eradication
targets.
B
end of 2020:
•Measles and rubella eradication
in at least
5 WHO regions.
The strategy focuses on

implementing the following 5 core
components:
•Achieving and maintaining high

rates of vaccination coverage with
two (2) doses of measles and
rubella virus-containing vaccines;
•Monitor disease using effective

surveillance and evaluate program
efforts to ensure progress and
positive results from
immunization activities;
•Develop and maintain
preparedness and rapid response
measures for disease outbreaks
and provide effective treatment
for disease cases;
•Communicating and engaging the

public
in order to build bridges of trust
with its members and promote
the demand for vaccination;
•Conduct the necessary research

and development in support of
cost-effective measures and the
improvement
of vaccination and diagnosis of
the disease.
Based on the 2016 mid-term

review of the Global Vaccine
Action Plan, it was found that
efforts to control rubella were
lagging due to the failure of 45
Member States to
introduce the vaccine and two
regions (African and Eastern
Mediterranean) not yet set
targets for rubella elimination or
control.
The WHO Strategic Advisory

Group of Experts on Immunization
recommends greater
focus on improving national
immunization systems in general,
to ensure additional gains in
rubella control.
One province (the Americas) has

eliminated the epidemiological
transmission of rubella, and the
end of
congenital rubella syndrome has
been verified in 2015.
WHO, as one of the founding

members of the Measles and
Rubella Eradication Initiative,
provides technical support to
governments and communities to
improve routine immunization
programs and conduct targeted
vaccination campaigns. In
addition, the WHO Global
Laboratory Network for Measles
and Rubella Eradication supports
activities to diagnose rubella and
congenital rubella syndrome and
track the prevalence of rubella
viruses.

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‫الحصبه االلمانيه‬

‫اشراف الدكتور ‪/‬طه المجيدي‬

‫عمل الطالب ‪ /‬عمار البراشي‬

The rubella virus is transmitted by

Once an individual is infected, the

Mass vaccination against rubella

The incidence of congenital

Rubella vaccines are available

After Member States in the

In April 2012, the

The strategy focuses on

•Achieving and maintaining high

•Monitor disease using effective

•Communicating and engaging the

•Conduct the necessary research

Based on the 2016 mid-term

The WHO Strategic Advisory

One province (the Americas) has

WHO, as one of the founding

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