August 6, 2012
Epidemiology of Rubella
Pregnant women are one vulnerable group susceptible to contracting a viral disease. One viral disease that pregnant women can contract is rubella. Rubella is often a mild disease that affects children, adolescents, young adults, and is susceptible to pregnant women. The disease can be devastating when transmitted to the fetus. This paper will discuss the definition and description of epidemiology as well as the steps and methods of epidemiology as it relates to rubella and congenital rubella, by using the epidemiology triangle. The different types of epidemiology and various levels of prevention for rubella and congenital rubella will be viewed. Epidemiology is a valuable tool concerning nursing and health care. Epidemiology is defined as “the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems” (Centers for Disease Control, 2006). Epidemiology is important concerning population health management because it examines how health related issues affect a community. This type of knowledge is used to determine how to lessen exposure to disease throughout the world. Epidemiology is considered the basic science of public health (Stanhope, Lancaster, 2012). Like public health nursing, epidemiology is a complex and continually evolving field with a common focus: the optimal health for all members of all communities, local and global (2012). The practice of epidemiology also can be viewed as a community health problem solving process (The United South and Easter Tribe, Inc., 2009). The epidemiological process parallels the steps in processes familiar to health professions, like the diagnostic process, the nursing process, the scientific process, and the quality improvement process, especially if one sees the target process outcome as improving the health of specified populations vs. an individual (2009). First, there is the problem solving process, and this is by identifying the problem, and the factors involved. With rubella, the cause is a virus and is spread through the air and through close contact. Congenital rubella occurs when a pregnant woman usually during the first trimester, passes the virus to her developing fetus. Then there is the diagnostic process, which is the symptoms and identifying a possible diagnosis. Postnatal rubella (German measles) is a generally mild, self-limited illness characterized by rash, lymphadenopathy, and low-grade fever (National Center for Biotechnology Information, 1996). However, congenital rubella may cause a number of anomalies, depending on the organ system involved and gestational age (1996). Using the epidemiological process identifies who is at risk and how to prevent the distribution of the disease. Rubella occurs worldwide with a seasonal distribution (NCBI, 1996). The peak incidence of infection is in late winter or early spring (1996). There have been no major epidemics in the United States since vaccine licensure in 1969, and the incidence has decreased by 99 percent (1996). Continued cases of congenital rubella are due to infection in unvaccinated, susceptible young women (1996). Rubella can be prevented by routine childhood immunization and by immunization of susceptible adolescents and adult populations with live attenuated rubella vaccine (1996). Immunoglobulin is not very effective in prophylaxis of rubella in pregnant women, and its routine use is not generally recommended (1996). It should be considered only if termination of pregnancy is not acceptable to the mother under any circumstances (1996). Considering that congenital rubella affects the unborn fetus epidemiologist are concerned about mortality rates. Although measures of mortality reflect serious health problems and changing patterns of disease, they are limited in their usefulness (Stanhope, Lancaster, 2012). Mortality...