#Rubella #German measles Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.

1. Kuldeep Vyas M.Sc. N
Rubella
German measles
Kuldeep Vyas M.Sc. N CHN
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2. The Teratogenic property of
the infection was documented
by an Australian
ophthalmologist Norman
McAlister Gregg, in 1941
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3.  Rubella, commonly known as German
measles, is a disease caused by Rubella virus.
The name is derived from the Latin, meaning
little red.
 Rubella is also known as German measles
because the disease was first described by
German physicians, Friedrich Hoffmann, in the
mid-eighteenth century.
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4.  Rubella is a disease caused by the rubella virus.
 Also known as German Measles or 3 day
measles
 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.
 Because of routine vaccination against rubella
since 1970 , rubella is now rarely reported
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5.  Rubella virus is single
stranded RNA virus
 Enveloped Spherical
 Virus multiply in the
cytoplasm of infected cell
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6. Rubella Viruses
• Rubella virus is a spherical, 40- to 80-nm,
• positive-sense, single-stranded RNA virus with spike-like,
hemagglutinin-containing surface projections.
• An electron-dense 30 to 35 nm core is surrounded by a
lipoprotein envelope. 6Kuldeep Vyas M.Sc. N CHN

7. Rubella Viruses
Rubella virus is the sole member of the genus Rubivirus in the family Togaviridae.
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8. Rubella Virus - Multiplication
+ strand
parental RNA
Non structural
proteins like
RNA polymerase
- strand
parental RNA
+ strand
progeny RNA
+ mRNA
Structural
proteinslike
capsids
Ribosome
RNA pol Ribosome
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9. AGENT
ENVIRONMENTHOST
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10. • Caused by an RNA virus of the togavirus
family.
• It can be propagated in cell culture
Agent
• Large no of rubella infections are Sub- clinical.
Source of
Infection
• It is much less communicable than measles.
• It probably extends from a week before
symptoms to about a week after rash appears.
Period of
communicability
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11. AGE
•Disease of childhood (3-10 years)
IMMUNITY
•One attacks results in life long immunity;
second attacks are rare.
• 40 % of women of child bearing age are
susceptible to rubella in India,
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12.  Disease usually occurs in a seasonal
pattern i.e. in temperate zones during
the later winter and spring, with
epidemics of every 4-9 years
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13.  The virus is transmitted directly from person to
person by droplet nuclei from nose and throat.
 The portal of entry is via the respiratory route.
 The virus can cross the placenta and infect the
foetus in uterus, leading to congenital rubella
in new born
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14. 2-3 weeks Average 18
days
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15.  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.
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16. Rubella - Symptoms
Symptoms normally appear 14 to 21 days after infection.
The rash often starts on the face and moves to the trunk and limbs. After 3 to 5 days, it
fades and disappears. It can be itchy.
Other symptoms include:
• a stuffy or runny nose
• headache
• a mild fever
• red, inflamed eyes
• nerve inflammation
• enlarged and tender lymph nodes
• aching joints
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17. Rubella - Symptoms
Though infection can happen at any age,
Rubella rarely affects young infants or people
over 40 years. A person who is infected with
rubella at an older age will normally have more
severe symptoms.
Rubella is also called as third day measlesor
German measles
Skin rashes due to rubella infection 17Kuldeep Vyas M.Sc. N CHN

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19.  "Rubella infection in
pregnant women during
the first three months of
pregnancy may result in
the baby being born with
birth defects or
congenital rubella
syndrome.
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21. Occurs in Neonates and Childhood
 Lasts for 13 – 15 days
 Leads to development of antibodies
 The appearance of antibodies
coincides the appearance of
suggestive immulogic basis for the
rash
 In 20 – 50 % cases of primary
infections are subclinical
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22. Congenital rubella syndrome
Congenital rubella syndrome occurs when a pregnant woman contracts the rubella virus, and
it passes through the placenta to the unbornchild.
The rubella virus can pass through the placenta and move
through the fetal circulation. It can destroy cells or prevent
them from dividing. This causes congenital rubella
syndrome.
This can trigger a loss of pregnancy or stillbirth, or it can
cause severe damage to the developing fetus, especially eye
problems, hearing problems, and heart damage.
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23. Congenital rubella syndrome
These effects on the infant can include:
• Deafness
• hearing impairment
• cataracts
• congenital heart disease
• Conjunctivitis
• anemia
• hepatitis
• developmental delay
• damage to the retina, known as retinopathy
• an unusually small head, lower jaw, or eyes
• liver, spleen or bone marrow issues, which
sometimes disappear shortly after birth
• low birth weight
Other conditions may appear as the child
develops. These might include:
• Autism
• Schizophrenia
• learning difficulties
• type 1 diabetes
Classical
Triad of
Rubella
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24. Congenital rubella syndrome
Cataract in infant due to
congenital rubella syndrome
CRS and rubella infection is
almost always have a prevalent
conjunctivitis
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25.  Congenital rubella syndrome (CRS) refers to
infants born with defects secondary to
intrauterine infection.
 It occurs if the infant has IgM rubella
antibodies shortly after birth or IgG antibodies
persist for more than 6 months, by the time
maternally derived antibodies would have
disappeared.
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26.  the most common and major defects are
deafness, cardiac malformations and cataracts.
deafness cataracts PDA
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27.  Other defects includes
 Glaucoma
 Retinopathy
 Microcephalus
 Cerebral palsy
 Intrauterine growth retardation
 Hepato-splenomegaly
 Mental and motor retardation
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28.  Throat swab culture for virus isolation and
serology.
 Haemagglutination inhibition test (HAI)
 Others includes ELISA test and radio-immune
assay.
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29.  There is no specific treatment for Rubella;
management is a matter of responding to
symptoms to diminish discomfort.
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30.  Rubella vaccine is given to children at 15
months of age as a part of the MMR (measles-
mumps-rubella) immunization.
 Isolation of the patient.
 Strict avoidance of close contact with patient.
 Vaccination to girls(11-14 years), duration of
immunity pffered being 10 years.
 Other precautionary measures are needed as
applied to air borne infection.
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31.  The MMR vaccine is a mixture of three live
attenuated viruses, administered via injection
for immunization against measles, mumps
and rubella.
 It is generally administered to children around
the age of one year, with a second dose before
starting school (i.e. age 4/5).
 The second dose is not a booster; it is a dose to
produce immunity in the small number of
persons (2-5%) who fail to develop measles
immunity after the first dose.
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32. MMR Vaccination
The only way to prevent the contraction of
rubella is through vaccination.
Taken with the measles and mumps vaccination,
the rubella vaccine prevents transmission.
The vaccine comes in the form of a live attenuated,
or weakened, virus. It is delivered at 12 to 15
months of age with a second dose at 4 to 6 years.
Any adult who has not yet had the measle, mumps,
and rubella (MMR) vaccine should receive it.
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33. MMR Vaccination / Side effects
Side effects of the vaccine are minimal.
Around 15 percent of people will have a mild fever
around 7 to 12 days after the injection, and 5
percent will develop a minor rash.
Teenage or adult women may experience joint
aches. Fewer than 1 in 1,000,000 have a severe
reaction.
There is no link between the MMR vaccinationand
autism. The dangers of not being vaccinated are
higher than the danger posed by any adverse
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