Case 1.1 Diseases of the Skin and Eyes

You are out to coffee with your friend Diane, when she confides that she and her husband Ted are thinking of starting a family. She goes on to say that she has just come back from a checkup with her OB/GYN. “The doctor said I am healthy and everything,” she says, “but she wants to see my immunization records, to make sure I have been vaccinated for rubella before I get pregnant.” You nod. Diane wants to know why this vaccination would be important for her. 1. What is rubella?
Rubella (German measles) is an infection caused by the rubella virus. Although it most commonly occurs in young children, it can affect anyone. The illness is usually mild. However, rubella in a pregnant woman can cause serious damage to the unborn child. 2. Why would Diane’s doctor be concerned about Diane’s immunity to rubella?

If a pregnant women has rubella, the virus is likely to cause serious damage to the unborn child or cause a miscarriage. Rubella can lead to damage to the heart, brain, hearing and sight. The baby is likely to be born with a very serious condition called the congenital rubella syndrome.

Diane thanks you for your clear explanation. “I probably won’t be able to find my immunization records: you know I wasn’t raised in the U.S.” But Diane is not worried. “I think I had rubella as a child. I remember being very sick with a rash, high fever, and white spots in my throat. I even had to be in the hospital for a few weeks for pneumonia!” 3. If Diane has had rubella previously, should she have immunity?
If she had rubella or been vaccinated against it, then her immune system made antibodies to fight the viruses that cause them. But it might not have made enough antibodies to fight it, so she might have immunity and would still need to get vaccinated.

4. How could her doctor check her immune