This powerpoint is based on Rubella- German Measles. The information provided is sufficient for a MBBS student for PSM/Community medicine as a subject.

1. RUBELLA

2. TIMELINE
Mid 18th century
First reporting of Rubella
1941
Norman Gregg (Ophthalmologist)
reported associations of
Congenital cataracts with other
Congenital defects in children born
to mothers who had rubella during
their pregnancy.
1962
Virus was isolated
1967
Attenuated vaccine was developed.

3. INTRODUCTION = WHAT IS RUBELLA?
 Also known as German Measles
 Acute childhood infection. (3 days infection)
 Teratogenic disease. If mother during pregnancy, gets the disease, the foetus
will develop CRS(Congenital Rubella Syndrome).
 Epidemic form. Epidemic every 4-9 years.
 Worldwide 1,00,000 children are born with CRS.

4. WHAT IS THE EPIDEMIOLOGY OF RUBELLA?
 Agent: RNA virus of Togavirus family. Only 1 antigenic type is known.
 Source of infection: Cases (Clinical<Sub-clinical). Carriers are not sources of
infection.
 Transmission: droplets, droplet nuclei(aerosols), chain transmission.
 Age: children: 3-10 years. But in developed countries, >15 years accounts for
70% of the cases.
 Sex: M=F
 Immunity: Life-Long immunity.

5. WHEN DOES THIS DISEASE OCCUR?
 Seasonal pattern: Late Winter and Spring.
 Temperate areas.
 Incubation period: 2-3 weeks
 Period of communicability: 1 week before appearance of rash to 1 week after
disappearance of rash.

6. CLINICAL FEATURES OF RUBELLA
 Majority of cases are asymptomatic.
 4 stages: Prodromal stage, Stage of lymphadenopathy, Stage of rashes and Stage of
complications.
 STAGE I: PRODROMAL STAGE: Mild symptoms like coryza, sore throat, low grade
fever.
 STAGE II: STAGE OF LYMPHADENOPATHY: Enlargement of post auricular and
posterior cervical lymph nodes.
 STAGE III: STAGE OF RASHES: Rash first appears on the face usually within 24 hours
of stage I. Rashes are minute, discrete. pinkish, macular rash. Then they start
spreading to trunk and extremities, but by this time the rashes on face disappears.
 STAGE IV: STAGE OF COMPLICATIONS: Complications like arthralgia, encephalitis,
thrombocytopenic purpura may occur.

7. CONGENITAL RUBELLA SYNDROME (CRS)
 CRS is congenital infection of rubella present in
neonate since birth.
 Infection started during pregnancy. Mother is
firstly infected, then she passes the infection to
the foetus. Infection during 1st trimester of
pregnancy shall result in serious birth defects.
 Confirmation/ Diagnosis of CRS:
antibody titre is checked.
a. If IgM is present at birth  CRS is confirmed.
b. If IgG persists for >6 months post parturition  CRS
is confirmed.
 Triad of CRS:
SNHL
Congenita
l cataract
Heart
Anomalie
s
TRIAD
OF
CRS