Rubella

=__**Disease/Drug of interest** : __=
 * Rubella/Meruvax II (part of the MMR vaccine) **

** Motivation and Background ** :
Although rubella transmission has been nearly eliminated in the United States, over 100,000 new cases arise in outside developing countries like Syria, Tajikistan, Macedonia, and Timor-Leste [1]. Over 60 percent of the case outbreaks are due to the inability of children being vaccinated because of the limited amount of vaccines [2]. The ability to successfully transport vaccines will enable the development of antibodies early, to enhance the defense system against this disease. Rubella is an acute, contagious infection that is caused by the Togavirus from the genus Rubivirus. Airborne respiratory droplets spread the virus to individuals who begin to display symptoms as early as 2-3 weeks. The virus multiplies in cells of the respiratory tract, and extends to local lymph nodes, and then undergoes spread to target organs such as the spleen [4] (gov website). Symptoms, although mild, include rash, fever, nausea, and mild conjunctivitis [1]. Women who contract the rubella infection during their first trimester of pregnancy have between a 50% and 90% chance of passing the infection to the developing fetus [3]. As a result the child may suffer from a range of birth defects such as, mild to extreme blindness, deafness, cardiac problems, mental retardation, and bone lesion [3]. Collectively these symptoms are known as Congenital Rubella Syndrome (CRS). Consequently children who are born with CRS may transmit the virus to others for more than a year after being born [1]. However, rubella is not normally a serious illness in children. Rather the primary danger of the disease is Congenital Rubella Syndrome [2].




 * References: **
 * 1) []
 * 2) http://www.ncbi.nlm.nih.gov/pubmed/26776468
 * 3) []
 * 4) Parkman PD. Togaviruses: Rubella Virus. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 55.
 * 5) Mangala Prasad, V.; Willows, S. D.; Fokine, A.; Battisti, A. J.; Sun, S.; Plevka, P.; Hobman, T. C.; Rossmann, M. G., Rubella virus capsid protein structure and its role in virus assembly and infection. //Proceedings of the National Academy of Sciences// **2013,** //110// (50), 20105-20110.
 * 6) []

**External links:**
http://www.cdc.gov/rubella/about/index.html

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=__**Target Information** : __=

[[image:r1.png width="273" height="206" caption="A"]][[image:vdsstream/r2.png width="343" caption="B"]][[image:r3.png width="261" caption="C"]]
Figure 2: A) Representation of the RV structure from []. B) Virtual representation of the RV capsid protein dimer [5]. C) Virtual representation of the RV capsid protein dimer in crystal form [5].

The rubella virus (RV) is a spherical 40- to 80-nm, positive-sense, single-stranded RNA virus consisting of an electron-dense 30- to 35-nm core surrounded by a lipoprotein envelope [4]. The RNA has a molecular weight of about 3 × 10-6. The rubella virus is often found in the cells of the lymph node or spleen. Once in the cell the RV nucleocapsid assemble on Golgi membranes and then budded into the organelle [5]. Common in most togaviruses, the structural proteins of RV are synthesized as a polyprotein precursor with the endoplasmic reticulum in the host cell [5].
 * Size ** **: molecular weight of the protein**
 * Location ** **:**
 * Function in a normal cell ** **:**

=__**Drug Information**** : **__=


 * Schematic figure of drug ** :

Since Meruvax II is a vaccine, it does not have aschematic figure, formula, molecular weight, or CAS number.
 * Formula ** :


 * Molecular weight ** : information not available
 * CAS Number ** : information not available

The vaccine is delivered through subcutaneous injection of a 0.5 mL dose, regardless of age Side effects of the Meruvax II include: difficulty in breathing or swallowing, hives itching (especially of feet), reddening of skin, swelling of eyes and inside nose, and unusual tiredness. Although not common, pain or tenderness of eyes, bruising or purple spots on skin, may be present. Meruvax II vaccine is commonly known as the MMR vaccine, which stands for measles, mumps, and rubella. The RA 27/3 strain of rubella virus was developed and successfully patented by the Wistar Institute Yes Thorough clinical trials of RV vaccines have been carried out in more than 28,000 human subjects (approximately 11,000 with MERUVAX II) in the United States and more than 20 additional countries [6]. A single injection of the vaccine has been shown to develop rubella hemagglutination-inhibition antibodies in 97% or more of susceptible individual however, about 1-5% of vaccinated individuals failed to produce antibodies after the primary dose [6]. The effectiveness of the rubella vaccine was reinforced in a series of double-blind controlled field trials that demonstrated a high degree of protective efficacy by protecting against the rubella disease [6].
 * Delivery method ** :
 * Side effects ** :
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 * Maker or company ** :
 * Is it patented ** ?
 * Clinical Trials Info ** :

__** Origin ** : __ A major rubella pandemic originated in Europe in the early 1960s and reached the USA in 1964. This caused an estimated 12.5 million cases of the disease. The result of this major outbreak was devastating, with 11,000 miscarriages, stillbirths and terminations, and the birth of 20,000 infants with congenital rubella syndrome (CRS) [3]. There are currently no present vaccines that treat rubella virus other than the meruvax II vaccine. Meruvax II is part of the MMR vaccine. Treatment like the MMR vaccine has also been successfully used in inducing antibodies against the measles, and mumps.
 * Alternatives to this drug ** :
 * Miscellaneous ** :
 * Other uses ** : can this drug be used to treat other diseases/conditions?