Rubella Virus. Wikimedia Commons
Almost everyone is familiar with the measles and mumps, but the 'R' in the MMR vaccine might not ring a bell. Here's the lowdown.
Discovery and Symptoms
Rubella is a disease caused by a virus of the same name. It can be spread through the air or by close contact with a carrier and cause symptoms like fever, headache, runny nose, bruising, bloodshot eyes, muscle or joint pain and a fine, red rash, for which the disease is named.
Rubella was first described in the late 1700s by German physician Friedrich Hoffmann. Other Germans studied it and suggested that it was derivative of either measles or scarlet fever, and the disease was nicknamed "German measles," after the doctors who were most familiar with it. In 1814, another German doctor, George de Maton, was called to a school to investigate an outbreak of skin rashes. He recognized the symptoms of German measles and, while examining his patients, realized that the sickness was distinct enough from measles to be its own disease. In 1881, the German measles was recognized as an individual disease, and was named rubella (Latin for "reddish") by British Army surgeon Henry Veale in 1886.
Not So Harmless, After All
For a while, rubella didn't receive much attention. It was a relatively mild illness with symptoms that were uncomfortable but not life-threatening, and lasted only three days to a few weeks. Through the rest of the 19th century, it became a sort of rite of passage for kids not unlike, more recently, chicken pox. Almost every child got sick with it, and would just have to suffer the rash and aches for a few days. This changed in 1941 when ophthalmologist Norman Gregg noticed that a few years after a local rubella outbreak, he would always see a large number of children with cataracts, and often a few other congenital defects, too. Further research showed that, while rubella was not particularly hard on the children or adults who contracted it, the disease could be devastating to unborn babies if their pregnant mother came down with it. Babies with congenital rubella syndrome could be born blind, deaf, with heart defects or with developmental disabilities.
Rubella could not be ignored as harmless any longer, and doctors in the U.S. and Europe started looking for a preventative treatment. In 1964, the last major epidemic of rubella in the U.S. broke out. Some 20,000 infants were born with congenital defects after the disease struck them in utero, and another 11,000 died. In 1969, Stanley Plotkin and colleagues from the Wistar Institute in Philadelphia developed a preventative rubella vaccine, which was then combined with the measles and mumps vaccines in 1972. After the vaccine's development, the number of rubella cases in the U.S. fell sharply, and today there are fewer than 1,000 cases reportedly annually. But Europe and Canada have not fared as well. In 2004, there was a rubella outbreak among an orthodox Protestant group in the Netherlands who had religious objections to vaccination; 387 cases of rubella were reported, and the disease then spread to Canada, resulting in 309 more cases there. Between the two countries, there were two fetal deaths and 14 babies born with congenital rubella syndrome.