Rubella in babies and pregnant women by Hilary

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Rubella in babies and pregnant women

by

In 1973 at the age of 19, my then boss told me to go and have a rubella

vaccine, because my records showed I hadn’t, and rubella was going around.

He didn’t want me off work, since we dairy-herd testers worked 24 days on,

rest of the month off. Anyone who got sick was a pain in the neck.

Being a conforming dutiful employee, I trotted off, had the jab and carried

on working. Within three weeks I had carpal tunnel syndrome and very sore

joints which, I was told, was the price you pay for doing something as

stupid as full-on gymnastics in earlier years. The carpal tunnel was

operated on, and the joints settled down into a pattern of progressively

worsening and " learning to live with it " each winter and " freedom " in the

summer.

In August 1980, having got married, my then doctor (an American), on

hearing of the prospect of " pregnancy " , made me have a blood test. Happily,

he told us that since I had beautifully high levels of rubella antibodies,

I could go ahead and get pregnant, so I did.

At about 8 weeks pregnant I got as sick as a dog, and couldn’t figure it

out, so went to the doctor who took a blood test. I didn’t think of

rubella, because I had " immunity " , but did discuss " viral infections " with

a friend of mine who was a midwife. She explained several things, the most

important of which at that time was that ALL VIRUSES CAN CAUSE DEFECTS.

The medical people use an acronym called TORCH to define these defects.

This acronym stands for:

T = Toxoplasma gondii

O = Other viruses (HIV, herpes simplex, chicken pox, human parvovirus,

Treponema pallidum, measles, mumps…)

R = Rubella

C = Cytomegalovirus

H = Herpes simplex.

In order of severity of the first 5:

1 = HIV,

2 = Cytomegalovirus,

3 = Toxoplasma gondii,

4 = Rubella,

5 = Chickenpox, etc8.

My friend explained that the reason all these different ‘nasties’ could

cause almost identical defects was that viruses pull Vitamin A out of the

system. If you feed a pregnant dog a diet deficient in Vitamin A (but no

viruses) you will get TORCH defects in the puppies. If children in Africa

who are malnourished get measles, they can go blind (as can babies born

with congenital rubella effects, except in babies the blindness is

permanent.). But the blindness in malnourished children is reversible with

Vitamin A. The reason for these defects in babies is that in the first few

weeks that a baby is forming, cells divide very quickly. One of the

nutritional keys to proper cell division is vitamin A, and if a mother

contracts any virus, the body uses that Vitamin A to fight the infection…

but the baby keeps on forming – minus one essential building block.

The problem with this Vitamin A information is that the studies done on

animals are old, and have not been recently corroborated, nor have any

studies been done on pregnant women. I don’t suppose they thought it worthy

of study.

According to the medical literature, if a pregnant woman gets rubella in

the first 4 weeks of gestation, 30 – 50% of babies run the risk of

congenital malformations. Infection between the fifth and eighth week gives

a risk of 25%; and during the ninth to twelfth weeks it is 8%, giving an

overall risk in the first trimester of 20%1.

The logical thought, to me, is not, " That is high, have the jab " , but, " How

is it that 80% of babies come through rubella in utero, in the first

trimester, with no problems? What went wrong in the babies who had

deformities? " I believe that diet and Vitamin A in the mother is the answer.

But this line of thought was not " there " in my first pregnancy because I

had not even considered that the vaccine-produced antibodies might not

work. I was sick, and all I knew then was that if any virus could cause

defects, something had to be done. So, at 8 weeks, really sick, funny rash,

glands up on back of neck and behind ears, the shot-gun approach was

used…vitamin A, B, C, D, E, F, G, H,…the lot.

Another blood test was taken at the next antenatal visit, but I felt fine,

and nothing further was said during the pregnancy. Neither did we think to

ask.

I enjoyed the winter during that pregnancy. No joint-pain – what a way to

go. And Ian was born with no signs of any " TORCH " problems.

But what a rotten winter the following one was! However, by the next winter

No 2 was on the way. Another pain-free fantastic winter, bouncing around

like a spring donkey, which is pretty hard to do when you carry like an

elephant with twins!

The winter after ’s birth was so bad that a lot of time was spent in

tears (won’t use painkillers), and the two following it were not that much

better. In desperation, when was four, I went to my GP with a whole

load of questions like:

Why does this " arthritis " only come in the winter?

Why did it start after the rubella jab?

Why does it stop in the summer?

What is the solution?

His only reply was to question 4. " Get pregnant every year. "

I lost my rag and stormed out of his rooms taking my file. In the car, I

decided to have a read, and staring up at me were the blood tests done when

I was pregnant with Ian. I had had rubella. I went back in and asked the

doctor why he hadn’t told me. His response ensured I never went back. So I

found another more sympathetic (I thought) GP. (My second thought was to

query how was it that someone who, a few weeks before the pregnancy, could

have " immunity " then get rubella when pregnant?)

The new GP had no idea where to start with my " arthritis " , so ticked

everything in the immunology boxes on the basis that if something abnormal

came up , we’d look at that and figure from there. I went to the medical

library and ran a Med-line search on every relevant word for rubella, only

to find lots of cases of carpal tunnel syndrome and arthritis following the

use of the rubella vaccine. I also found documented cases of women with

laboratory proof of immunity who caught rubella while pregnant, and some of

their babies had congenital rubella.2,3,4,5,6,7

I knew that this was common with cytomegalovirus but not with rubella. My

GP’s response was that this was so rare (1 in a million!) that no one he

knew of had come across this. Later, when I went to teach gymnastics, and

the subject came up during one of the Health Department’s ‘scareness’

campaigns, I found that three of us within the gym club had had the same

experience. I hadn’t realised that 3 million women lived in lin District!

In the meantime the GP decided that the tests showed an " immunodeficiency "

so maybe the vaccine was not the culprit. (Usual tactic – blame the

patient). So my file and all my tests were sent to the rubella expert in

America. He sent a nice letter back saying that since I was in New Zealand,

and not the States and so couldn’t sue anyone, he could easily confirm that

my arthritis was actually rubella vaccine-induced, but I should take heart,

because had I got it " naturally " it would have been much worse. Do

something about it? No – just learn to live with it.

Ian and both got rubella in their second year – diagnosed not by the

doctor, who couldn’t tell, but by the Plunket nurse on the basis of low

fever, swollen glands behind the ears, and a rash that did not leave a

stain. The question of whether or not they could pass it on to other

pregnant women never came up, for several reasons. The first was that it

was my policy never to take my babies anywhere if they were lethargic, or

grizzly, or I knew they were sick. Secondly, in an area where most women

were tested, immune or vaccinated, why should the issue even arise? The

conventional wisdom is " immunity means you won’t get it " and at that time

it was never questioned.

During the last measles vaccination campaign I started to look for data of

how much rubella was around now, but could find very little information on

this. The " experts " aren’t studying it. After all, why should they with a

vaccine to stop it all? In the past, all they studied was the levels of

15-year-olds who had natural immunity. That has not been done now for

nearly 20 years. So, last year, this parent got caught out, to my

embarrassment. I really should have known better.

After all, I had just written an article on rubella!

Hmmm….

Ian got sick. Very strange, I thought. Definitely a virus, with him not

liking the light (in goes the Vitamin A and Vitamin C), bit of a mild

headache, didn’t want to eat, mild sore throat. Just a low temperature and

sleeping a lot. Sort of nothing much, but not right. Then he said, " What’s

this rash, Mum? " I took one look, and straight away felt around the neck

and behind the ears, and there were the telltale glands. And no, the rash

did not leave a stain.

Rubella. I had just written about it, and missed the obvious! Why? Because

it never occurred to me that the children would get it twice. And where did

he get it from? I never found out. Could have been anywhere, anyone – even

a casual contact with a recently vaccinated child in Woolworth’s.

I rang the doctor’s surgery, detailed the symptoms, progression etc, and

they agreed it was most likely rubella. I really wanted some blood tests

done this time, because I wanted proof, but was laughed off the phone.

Waste of resources, he’s not going to die, etc – same excuses as when

had measles the second time – so I haven’t the " proof " I’d really have liked.

So, in answer to the issues raised in the letter in Wavelets:

Every pregnant woman should make it her business to find out her immune

status for rubella, even if previously vaccinated. Even so, this does not

guarantee immunity.

Every pregnant woman should know that every virus could cause TORCH. It is

her responsibility to ensure that her diet is such that she can fight off

any virus without depleting nutrients needed to build a baby. Damage done

at this stage is irreversible.

No one knows how much rubella is around at any one time. You can’t tell

when a child might get something. Or, for that matter, an adult. My husband

taught in schools with " mumpy " children for years but didn’t catch mumps

until the age of 63.

Every parent who decides not to immunise their children should, out of

fairness to everyone else, keep a close watch on their child. If they are

not ‘all-go’ as normal, don’t take them out, or risk exposing visitors to

them.

When discussing risks, ask your parents how you fared with rubella as a

child. Amongst my children, and my friends, rubella has proven to be

nuisance value only. Subclinical infections with no symptoms, but which

give immunity are estimated at 25%1.

The risks to normal children from rubella are remote. Complications from

rubella are rare, with the following observed in large epidemics where

virus load is heavy:

Transient arthralgia/arthritis – Rates vary from epidemic to epidemic –

London, 1962; 33% in 40 female adults, 6% in 34 males; Bermuda, 1971; 24%

under 11 yrs, 52% in 11 yrs and over1.

Encephalitis – usually cited at 1 in 6,000 cases1.

Purpura (reduction in platelet count) complicates rubella in rare

instances. Most patients become symptom-free in 2 weeks and platelet count

returns to normal values. May last from weeks to months1.

Prognosis – " …the prognosis is almost uniformly excellent. Rubella is one

of the most benign of all infectious diseases in children. However, the

rare complications of encephalitis and thrombocytopenic purpura may alter

the prognosis. Many reported deaths attributed to rubella infection reflect

errors in diagnosis " .1

The likelihood of a baby becoming congenitally deformed is

mother-dependant, in that her diet (Vitamin A, folic acid) and how many

weeks pregnant she is are the important factors. After all, 80% of pregnant

women who catch rubella in the first trimester do not have babies with

congenital deformities.

This leads to another problem not mentioned in the letter. What happens if

a mother finds out at the beginning of her pregnancy that she is not

immune? This is becoming more common, as children who were vaccinated as

babies, and again when they were 11, often lose their immunity. The

standard line from the Health Department is that the two shots result in

immunity for life. This is not true. A problem also exists where some

doctors, if a young mother has a history of vaccination, do not test for

immunity. They should, regardless.

If you are told that despite being vaccinated, you are no longer immune,

you will be offered a vaccination immediately after your baby is born. In

my opinion there are some very good reasons why you should not do this.

In mothers vaccinated 2 – 4 days after birth, significant amounts of

infectious rubella virus is shed from nasopharyngeal secretions and in the

breastmilk for two to three weeks after vaccination, although a period of

34 days has been noted in the literature. Infectious virus was recovered

from 56% of babies, none of whom showed any clinical evidence of rubella.

25% developed transient antibodies to rubella virus which became

undetectable after 18 – 20 weeks9.

So breastfed babies can mount a response to virus from their mothers, but

the response is not sustained. Natural, long-term immunity is not acquired.

Possible reasons for babies not developing permanent immunity are that

babies are selectively competent to mount immune responses. That competence

is age dependent, with certain immune components only reaching adult levels

at about 8 yrs of age. Research using the measles virus shows very clearly

that babies’ immune systems are quite different to adults,10 and that there

are some viruses and bacteria which a baby might fend off, but will not

develop immunity to, in the early months.

If a mother vaccinated with the rubella vaccine can excrete significant

quantities of rubella virus, can vaccinated infants also excrete virus? I

think so. Usually parents with babies have pregnant friends, but never have

I heard anyone query whether their vaccinated 15-month-old could pass the

rubella virus on to a pregnant friend or her children. This possibility

also needs considering since, to be consistent, parents who vaccinate their

children should make sure they are quarantined from all pregnant women or

her children for at least 21 days. In reality, this is never going to

happen, because mothers who vaccinate assume their child is " clean " .

So where did Ian get rubella? Who knows – but Ian got sick just over three

weeks after the local area had had their Form 1 MMR shots. Co-incidental or

causal? With an excretion time of up to 3 weeks after vaccination, and an

incubation time of around 14 days, I’d say the timing was impeccable.

References:

Krugman’s " Infectious Diseases of Children " 1998, 10th Edition, pg. 403-413.

British Medical Journal, 16 May 1987, pg. 1277-78

Medical Journal of Australia June 12, 1982 pg. 514-515

New England Medical Journal, 1988:319, pg. 1415-1416

Communicable Diseases Report, 1991:1 (R5), pg. 7-9

Pediatric Infectious Diseases Journal, 1994:13, pg. 812-815

Pediatric Infectious Diseases Journal, 1997:16, pg. 249-251.

Medicine International, No 51, March 1988, pg. 2107-2110.

Journal of Infectious Disease 1982: 145:5, pg. 655-666.

Nature Medicine 1996: 2(11), pg 1250-1354.

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Sheri Nakken, R.N., MA, Classical Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

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