By Tayo Fasuan
A pregnant woman is able to provide all basic things needed for her unborn baby to survive: food, warmth, protection and even space for kicking around. In fact, a foetus lives large and feeds fat at the expense of its ‘carrier’ mother, who amazingly doesn’t mind because of the joy and satisfaction derived from carrying her baby. God bless all mothers indeed!
However, just as an expectant mother can protect and provide for her unborn child, she can also be a source of death and diseases to the baby too. Apart from the danger inherent in engaging in undesirable but avoidable activities like smoking, drinking, doing drugs and even eating prohibited foods during pregnancy, a pregnant woman can be unknowingly transmitting deadly pathogens and other biological substances to her child in the womb. Among those pathogens that can be transmitted are viruses.
Perhaps, a well-known example is the human immunodeficiency virus (HIV), the virus responsible for AIDS. While an infected mother might not be able to pass the virus to her unborn child during pregnancy, contact with her blood during labour and childbirth can lead to the baby contracting the virus. What’s more? The baby can further get the virus, even if he or she ‘escapes’ during childbirth, during breastfeeding, a process not only heightened by the potential presence of the virus in the breast milk, but by most babies’ mischievous attitude of testing their growing teeth on the nipples of their mothers, and sometimes drawing potentially infected blood in the process.
While most people are however extremely knowledgeable about HIV due to the whirlwind of information and orientation about the virus and its associating syndrome, a lesser, or perhaps, a carefree approach is being taken to a somewhat more damaging syndrome, whose virus is starting to pick pace in the contest for unborn child illnesses, deformities and death. The virus is called rubella virus and it causes congenital rubella syndrome in pregnant women and their foetuses.
Rubella virus belongs to a large virus family whose members are notorious for causing serious human diseases like encephalitis around the world. The virus usually causes a measles-like disease in children and adult also called rubella, with the associated characteristic red rashes also like measles, but with distinguishing criteria and co-symptoms. The rashes of rubella usually start and concentrate on the face, and may spread predominantly downward or not. Other differentiating symptoms include arthralgia (joint pain), lymphadenopathy (swollen of the lymph nodes like the joints of the thighs close to the pubic section and throat) and of course, fever. The symptoms may exist singly or in combination.
The disease is usually self-limiting and resolves with little or no treatment in affected children or adult within 3 to 4 days (except in rare, chronic cases). However, the effect on women who get infected in the first trimester of pregnancy (first three months) can be devastation, not really on them, but on the foetuses they carry in their womb. This is called congenital rubella syndrome. Studies have shown that most pregnant women whose babies are diagnosed with this syndrome, usually didn’t think much of the disease due to its short, acute and self-limiting nature.
Unlike most viruses and other pathogenic microorganisms, the rubella virus can cross placenta and infect the foetus, causing serious incurable illnesses and permanent deformities like blindness, deafness and mental retardation. Spontaneous and unexpected abortion/miscarriage can also result from the infection.
Rubella is transmitted by airborne respiratory droplets from infected people who are sick with the disease, through sneezing, coughing or even talking. The virus can also be present in urine, faeces, saliva and on the skin of infected individuals. Infected children are usually the major sources of infection, especially those with persistent infection, and they can easily transmit the virus to other children and more importantly, pregnant women.
Recently at an antenatal care session in Adeoyo General Hospital in Ibadan, Oyo State, Dr. Moses Adewumi, a virologist at the College of Medicine, University of Ibadan, carrying out researches on viral diseases resulting to child morbidity and mortality, highlighted the risks present for women who don’t get immunised or vaccinated against the virus before pregnancy. While he said that women in developed countries are mandated to be vaccinated before getting pregnant, he also emphasized the need for already pregnant women who are yet to be vaccinated to seek advice, get tested and treated if the associated symptoms are observed or noticed, either singly or in combination. Nevertheless, he advised already pregnant women not to go for vaccination since that would expose the baby to the virus.
Immunization against the virus is available in form of a vaccine combination called MMR vaccine (standing for Measles-Mumps-Rubella), and it is mandatory for everyone, especially children and women who intend to get pregnant at a later time in their lives. However, unlike the measles and mumps vaccines which are free, the rubella vaccine is not free and it is not subsidized by the government of Nigeria. Hence, it is usually paid for. Most mothers taking there children for MMR vaccination usually think they are being vaccinated free against the three viruses, but this is not usually so, except payment is made. Nevertheless, this should not be a limiting factor as the consequences of not taking it, for pregnant women, might be unpleasant and irrevocable.
For pregnant women who have noticed the symptoms of the disease stated above (red rash, joint pain, unusual fever and swollen lymph), free test is also been carried out by Dr. Adewumi at the Department of Virology, University College Hospital (UCH). Stay healthy.