DOCTORS AT Vancouver's
Children’s Hospital are closely
Studying possible complications of
immunization against German
measles, or Rubella. .

Dr. Aubrey Tingle, a paediatric
immunologist, says the rubella
virus, both in its natural state and
in the form used for immuniza-
tion, can cause problems in the
joints similar to those'suffered by
arthritis patients. Dr. Tingle expe-
rienced this side-effect himself
when he had rubella as an intern.

Arthritis symptoms have long
been associated with the rubella
virus. (Rubella vaccine contains
rubelia viruses which have been
altered so as not to cause the
disease but to trigger immunity
against it.) The effects usually
wear off quickly, without causing
long-term problems.

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However, Dr. Tingle’s work has
shown that some patients develop
a more chronic arthritis, with ef-
fects lasting longer than 12 to 18
months, Isolation of virus particles
from fluid in the affected joints
shows the connection between the
two.

USUALLY HARMLESS

Rubella . vaccine is routinely
given to two groups of people:
children ‘over one year old and
previously non-immunized women
of childbearing age. For the most
part the disease is relatively
harmless; it results in a fever and a
rash which heals on its own.

‘But the virus can cause serious
birth defects in the babies of
women exposed to rubella,

‘ especially in early pregnancy when

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the woman may not even know she
is pregnant.

A small proportion of children
vaccinated against rubella develop
various types of juvenile
rheumatoid arthritis, characterized
by joint pain and destruction of
joint surfaces. However ‘‘acquir-
ing natural rubella is associated
with more severe problems. The
arthritis occurs more frequently,
and is generally longer lasting,”
says Dr. Tingle.

HIGHER RISK

“The basic premise, therefore, is
that the vaccine is safe in children;
its benefits far outweigh the possi-
bility of any joint complaints,’’ he
adds.

Young women who are vac-
cinated run a higher risk of

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2928

35 - Wednesday, May 28, 1986 - North Shore News

Rubella virus, arthritis linked

developing problems. Among
those who have not been previous-
ly exposed to the virus, either
through having the disease or
through vaccination, 10 to 15 per
cent develop acute arthritic symp-
toms two or three weeks after im-
munization.

One-third of these women
develop a more chronic form of
arthritis.

Dr. Tingle emphasized that, in
both children and adults, the ar-
thritic effects of natural rubella are
more severe than those from im-
munization. Thus, his findings
should not be used to discourage
immunization, he says.

CONTROLS OUTBREAKS

Besides, immunization is impor-
tant in controlling outbreaks of

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rubella, he says. Even with routine
vaccination programs, rubella
epidemics still occur; B.C. is just
recovering from an epidemic which
began in the Fall of 1984,

In addition, many mothers were
not immunized when children,
since the vaccine has been available
publicly only since 1969. Non-
immunized women in areas with
tubelia epidemics run a high risk
of bearing children with rubella-
related birth defects.

Finally, an important question
remains, Dr. Tingle says: how
many children with juvenile
rheumatoid arthritis got the disease
as a result of rubella virus, either
natural or from immunization?

Dr. Tingle’s research was funded
by the Medical Research Council
of Canada, the Arthritis Society of
Canada, and the Vancouver Fund.

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