Rubella

1. RUBELLA

2. Rubella
Rubella (German measles) is a disease
caused by the rubella virus (RNA virus)
Rubella is usually a mild illness. Most people
who have had rubella or the vaccine are
protected against the virus for the rest of their
lives.
Due to routine vaccination against rubella since
1970 , rubella is now rarely reported.

3. Rubella
( German Measles )
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Rubella is also called as 3 day Measles or
German Measles caused by rubella virus
Family – Togaviridae
Genus - Rubivirus

4. MainClinicalEvents
 The clinical events occurring in the
neonatal age is more important and
divided into two major groups
1 Post Natal Rubella
2 Congenital Rubella

5. PostnatalRubella

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Occurs in Neonates
and Childhood
Adult infection
occurs through
mucosa of the
upper respiratory
tract spread to
cervical lymph
nodes
Viremia devlops after
7 – 9 day
Lasts for 13 – 15 days
Leads to
development of
antibodies

6. How Adults acquire Infection
In 20 – 50 % cases of primary infections are Acquired,
(i.e. not congenital), rubella is transmitted via airborne
droplet emission from the upper respiratory tract of
active cases.
The virus may also be present in the urine, feces and
on the skin.
There is no carrier state: the reservoir exists entirely
in active human cases.
The disease has an incubation period of 2 to 3
weeks.

7. Clinical Features
 Incubation period 18 days (range 14-21 days)
 Prodrome of low grade fever (one-five days before
rash)
 Exanthem. As the prodromal symptoms diminish,
the rash appears.
 Recovery

8. Systemic events of Rubella
Infection

9. Clinicalmanifestations
Malaise
Low grade fever Morbilliform rash
Rash starts on Face Extremities
Rarely lasts more than 5 days
No features of the rash give clues to
definitive diagnosis of Rubella.
May produce transient Arthritis, in women in
particular.
Serious complications are
• Thrombocytopenia
• Purpura
• Encephalits

10. Immunity- Protects


One attack of
Rubella infection,
protects for life
Immune mothers
transfer antibodies
to off springs who
are in turn are
protected for 4 – 6
months.

11. Epidemiology
 Occurs worldwide
 The virus tends to peak in countries with temperate
climates
 Common in children ages 5-10 years old
 Human are only known reservoir.
 Source of infection – Respiratory secretion
 Infants with CRS may shed virus for a year or more
 Immunity –life long
 Occurs round the year, peak in late winter and spring
season
 Transmission – droplet, vertical transmission
 I.P – 2-3 weeks average 18 days
 Rubella isworld wide in distribution
 Epidemics occur every 4-9 years.

12. Treatment and Prevention


Rubella is a mild self limited illness.
No specific treatment or Antiviral
treatment is indicated.
 However Laboratory proved and
clinically missed Rubella in the Ist 3-
4 months of pregnancy is associated
with fetal infections.

13. Congenital Rubella Syndrome
 Maternal viremia with Rubella infection
during pregnancy may result in infection
of placenta and fetus.


The growth rate of fetal cells are reduced.
Results in fewer number of cells after the
birth.
 Lead to deranged and hypo plastic organ
development.
 Results in structural damage and
abnormalities

14. Rubella infection – At various trimesters
 Ist trimester infections lead to abnormalities in 85

% of cases. and greater damage to organs
2nd trimester infections lead to defects in 16 %
 > 20 weeks of pregnancy fetal defects are
uncommon
 However Rubella infection can also lead to fetal
deaths, and spontaneous abortion.
 The intrauterine infections lead to viral excretion
in various secretion in newborn upto 12-18
months.

15. Clinical Findings
( Congenital Rubella Syndrome )
 Permanent manifestations may be
apparent at birth, become recognized
during the first year.
 Developmental abnormalities appear
during childhood and adolescents.

16. Treatment,Prevention, Control
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No specific treatment
is available
CRS canbe prevented by
effective immunizationof the
young childrenand teenage
girls, remainthe bestoptionto
preventCongenitalRubella
Syndrome.
The componentof Rubella in
MMRvaccineprotectsthe
vaccinated

17. MMR Vaccine
The MMR vaccine is a mixture of three
live attenuated viruses, administered via
injection for immunization against
measles, mumps and rubella